Mesfin G, Schluter W, Gebremariam A, Benti D, Bedada T, Beyene B, Yigzaw A, Taddess Z, Mbakuliyemo N, Babaniyi O
WHO Country Office, Addis Ababa, Ethiopia, P.O. Box 3069, UNECA Compound, Addis Ababa, Ethiopia.
East Afr Med J. 2008 May;85(5):222-31. doi: 10.4314/eamj.v85i5.9616.
Ethiopia had been polio-free for almost four years until December 2004. However, between December 2004 and February 2006, 24 children were paralysed as a result of infection with wild poliovirus imported from the neighbouring country of Sudan. In response, the country has attempted to document the impact of various response measures on the containment of wild poliovirus transmission.
This study aims at systematic and epidemiological assessment of the extent of the outbreak, its determinants, and the lessons learned as well as the implications for future control strategies to interrupt wild poliovirus transmission.
A cross-sectional study design with qualitative and quantitative data collection approaches was used to conduct the epidemiologic assessment.
All confirmed wild poliovirus cases, and reported acute flaccid paralysis cases in close proximity to the confirmed polio cases were the study subjects. Child caretakers and health service providers were interviewed as part of the investigation.
Between December 2004 and February 2006, eight children from Tigray Regional State, nine children from Amhara Regional State and seven children from Oromia Regional State were paralysed as a result of infection with wild poliovirus type 1. Genetic sequencing demonstrated two separate importations to Ethiopia. Risk factors that may have facilitated spread of the outbreak within the country included gaps in vaccination coverage and interruption of the cold chain system, gaps in acute flaccid paralysis surveillance performance, high population mobility, poor environmental sanitation, crowded living conditions and unsafe drinking water. In response to the outbreak, Ethiopia conducted detailed outbreak investigations within two days of confirmation of the index cases. Large-scale, house-to-house vaccination campaigns were also implemented. As a result, the three regions interrupted the wild poliovirus transmission within the regions within one year of confirmation of the index case.
Outbreak response activities were successful in interrupting the imported wild poliovirus transmission in Tigray, Amhara and Oromia Regional States of Ethiopia within a one-year period of time. In Ethiopia, programme strategies should be intensified to contain further spread and prevent future importation of wild poliovirus. Large-scale immunisation campaigns should reach every child, including those isolated by geography, poverty and security.
在2004年12月之前，埃塞俄比亚已近四年无脊髓灰质炎病例。然而，在2004年12月至2006年2月期间，有24名儿童因感染从邻国苏丹输入的野生脊髓灰质炎病毒而瘫痪。作为应对措施，该国试图记录各种应对措施对遏制野生脊髓灰质炎病毒传播的影响。
本研究旨在对疫情的范围、决定因素、经验教训以及对未来控制野生脊髓灰质炎病毒传播策略的影响进行系统的流行病学评估。
采用横断面研究设计，运用定性和定量数据收集方法进行流行病学评估。
所有确诊的野生脊髓灰质炎病毒病例，以及在确诊脊髓灰质炎病例附近报告的急性弛缓性麻痹病例均为研究对象。作为调查的一部分，对儿童看护人和卫生服务提供者进行了访谈。
在2004年12月至2006年2月期间，提格雷州的8名儿童、阿姆哈拉州的9名儿童和奥罗米亚州的7名儿童因感染1型野生脊髓灰质炎病毒而瘫痪。基因测序表明有两次独立的病毒输入埃塞俄比亚。可能促使疫情在该国传播的危险因素包括疫苗接种覆盖率存在差距、冷链系统中断、急性弛缓性麻痹监测工作存在差距、人口流动性高、环境卫生差、居住条件拥挤以及饮用水不安全。针对此次疫情，埃塞俄比亚在确诊首例病例后的两天内展开了详细的疫情调查。还开展了大规模的挨家挨户疫苗接种运动。结果，这三个地区在确诊首例病例后的一年内中断了本地区内的野生脊髓灰质炎病毒传播。
疫情应对活动成功地在一年内中断了埃塞俄比亚提格雷州、阿姆哈拉州和奥罗米亚州的野生脊髓灰质炎病毒输入传播。在埃塞俄比亚，应强化项目策略以遏制病毒的进一步传播并防止未来野生脊髓灰质炎病毒的输入。大规模免疫运动应覆盖每一名儿童，包括那些因地理位置、贫困和安全因素而被隔离的儿童。
