2013年1月至2014年9月尼日利亚在根除脊髓灰质炎方面取得的进展
Progress toward poliomyelitis eradication--Nigeria, January 2013-September 2014.
作者信息
Etsano Andrew, Gunnala Rajni, Shuaib Faisal, Damisa Eunice, Mkanda Pascal, Banda Richard, Korir Charles, Enemaku Ogu, Corkum Melissa, Usman Samuel, Davis Lora B, Nganda Gatei wa, Burns Cara C, Mahoney Frank, Vertefeuille John F
出版信息
MMWR Morb Mortal Wkly Rep. 2014 Nov 21;63(46):1059-63.
In 1988, the World Health Assembly resolved to interrupt wild poliovirus (WPV) transmission worldwide. By 2013, only three countries remained that had never interrupted WPV transmission: Afghanistan, Nigeria, and Pakistan. Since 2003, northern Nigeria has been a reservoir for WPV reintroduction into 26 previously polio-free countries. In May 2014, the World Health Organization declared the international spread of polio a Public Health Emergency of International Concern. Nigeria's main strategic goal is to interrupt WPV type 1 (WPV1) transmission by the end of 2014, which is also a main objective of the Global Polio Eradication Initiative's Polio Eradication and Endgame Strategic Plan for 2013-2018. This report updates previous reports (4-6) and describes polio eradication activities and progress in Nigeria during January 2013-September 30, 2014. Only six WPV cases had been reported in 2014 through September 30 compared with 49 reported cases during the same period in 2013. The quality of supplemental immunization activities (SIAs) improved during this period; the proportion of local government areas (LGAs) within 11 high-risk states with estimated oral poliovirus vaccine (OPV) campaign coverage at or above the 90% threshold increased from 36% to 67%. However, the number of reported circulating vaccine-derived poliovirus type 2 (cVDPV2) cases increased from four in 2013 to 21 to date in 2014, and surveillance gaps are suggested by genomic sequence analysis and continued detection of WPV1 by environmental surveillance. Interrupting all poliovirus circulation in Nigeria is achievable with continued attention to stopping cVDPV2 transmission, improving the quality of acute flaccid paralysis (AFP) surveillance, increasing vaccination coverage by strengthened routine immunization services, continuing support from all levels of government, and undertaking special initiatives to provide vaccination to children in conflict-affected areas in northeastern Nigeria.
1988年,世界卫生大会决定在全球范围内阻断野生脊髓灰质炎病毒(WPV)的传播。到2013年,仅有三个国家从未阻断过WPV传播:阿富汗、尼日利亚和巴基斯坦。自2003年以来,尼日利亚北部一直是WPV重新传入26个此前无脊髓灰质炎国家的疫源地。2014年5月,世界卫生组织宣布脊髓灰质炎的国际传播构成国际关注的突发公共卫生事件。尼日利亚的主要战略目标是在2014年底前阻断1型野生脊髓灰质炎病毒(WPV1)的传播,这也是全球根除脊髓灰质炎行动2013 - 2018年脊髓灰质炎根除及终局战略计划的主要目标。本报告更新了以往报告(4 - 6),并描述了2013年1月至2014年9月30日期间尼日利亚的脊髓灰质炎根除活动及进展。截至2014年9月30日,2014年仅报告了6例WPV病例,而2013年同期报告病例数为49例。在此期间,补充免疫活动(SIA)的质量有所提高;11个高危州内地方政府辖区(LGA)口服脊髓灰质炎疫苗(OPV)强化免疫活动覆盖率估计达到或超过90%阈值的比例从36%增至67%。然而,2型循环疫苗衍生脊髓灰质炎病毒(cVDPV2)报告病例数从2013年的4例增至2014年至今的21例,基因组序列分析及环境监测持续检测到WPV1提示存在监测漏洞。通过持续关注阻断cVDPV2传播、提高急性弛缓性麻痹(AFP)监测质量、通过强化常规免疫服务提高疫苗接种覆盖率、各级政府持续提供支持以及采取特别举措为尼日利亚东北部受冲突影响地区的儿童接种疫苗,在尼日利亚阻断所有脊髓灰质炎病毒传播是可以实现的。