Polio field census and vaccination of underserved populations--northern Nigeria, 2012-2013.

In 2012, the World Health Assembly declared completion of polio eradication a public health emergency. However, wild poliovirus (WPV) transmission remains endemic in three countries (Afghanistan, Nigeria, and Pakistan). In Nigeria, the National Stop Transmission of Polio (N-STOP) program, under the umbrella of the Nigerian Field Epidemiology and Laboratory Training Program (FELTP), has been developed to implement innovative strategies that address the remaining polio eradication challenges in Nigeria. One N-STOP initiative focuses on locating and vaccinating children aged<5 years in remote nomadic, scattered, and border populations in northern Nigeria, where low polio vaccination coverage likely contributes to ongoing WPV transmission. During August 2012-April 2013, N-STOP conducted field outreach activities that enumerated 40,212 remote settlements, including 4,613 (11.5%) settlements never visited by vaccination teams during previous polio supplemental immunization activities (SIAs). Enumeration resulted in documentation of 906,201 children aged<5 years residing in these settlements, including 53,738 (5.9%) who had never received polio vaccination, and in detection of 211 unreported cases of acute flaccid paralysis (AFP) with onset of illness in the 6 months before enumeration. Sustaining access to underserved populations in remote settlements in future SIAs will increase overall population immunity and should decrease WPV transmission. By providing a flexible and capable workforce consisting of Nigerian citizens, N-STOP is able to support evaluation and implementation of innovative polio eradication strategies in Nigeria while building local public health capacity with a potential to address other public health problems following the eradication of polio from Nigeria.