Rajput Laraib Shabbir, Noor Sana, Khan Muhammad Muneeb, Sajjad Mohammad, Farooq Sidra, Ullah Ayat
Department of Medicine, Dow University Hospital, Karachi, PAK.
Department of Community Medicine, Avicenna Medical and Dental College and Hospital, Lahore, PAK.
Cureus. 2024 Jul 25;16(7):e65356. doi: 10.7759/cureus.65356. eCollection 2024 Jul.
Background and objective Polio continues to be endemic in Pakistan despite substantial international efforts to combat it, which presents a serious public health concern. Strategies for eradicating polio depend on understanding the dynamics of pediatric polio transmission and the efficacy of surveillance. This research study aimed to critically evaluate the public health surveillance system for pediatric polio in Pakistan and propose recommendations for improvement. Methodology This study was conducted from June 2020 to July 2023 in three well-known hospitals in different areas of Pakistan and involved 26 patients. Reviews of medical records, interviews, and surveillance report analysis were all part of the data collection process. Descriptive statistics, chi-square tests, and logistic regression analysis were performed using SPSS Statistics version 27.0 (IBM Corp., Armonk, NY) with the statistical significance set at p<0.05. Results The highest incidence of polio was observed in children aged 13-24 months (nine patients, 34.62%), with males accounting for 14 cases (53.85%) and urban residents 16 cases (61.54%). Vaccination status significantly influences disease incidence (p<0.001), with two patients (7.69%) unvaccinated, 10 patients (38.46%) partially vaccinated, and 14 patients (53.85%) fully vaccinated. Paralysis was the predominant symptom in 16 patients (61.54%). Recovery outcomes varied, with eight patients (31%) fully recovering, 12 patients (46%) showing partial improvement, and six patients (23%) experiencing chronic motor impairments. Effective surveillance depends on timely reporting [odds ratio (OR): 2.15, p<0.001] and healthcare worker training (OR: 1.67, p<0.001), highlighting crucial aspects of polio management strategies. Conclusions Based on our findings, vaccination status significantly impacts polio occurrence, with a notable proportion found in partially vaccinated or unvaccinated children. Paralysis remains the primary symptom, with varied recovery outcomes, including chronic motor impairments in some cases. This study underscores Pakistan's ongoing challenges with pediatric polio, highlighting the crucial need for improved vaccination, surveillance, and rehabilitation efforts.
背景与目的 尽管国际社会为抗击脊髓灰质炎付出了巨大努力，但脊髓灰质炎在巴基斯坦仍然流行，这引起了严重的公共卫生问题。根除脊髓灰质炎的策略取决于对儿童脊髓灰质炎传播动态的理解以及监测的有效性。本研究旨在严格评估巴基斯坦儿童脊髓灰质炎公共卫生监测系统，并提出改进建议。方法 本研究于2020年6月至2023年7月在巴基斯坦不同地区的三家知名医院进行，并纳入了26名患者。病历审查、访谈和监测报告分析均为数据收集过程的一部分。使用SPSS Statistics 27.0版（IBM公司，纽约州阿蒙克）进行描述性统计、卡方检验和逻辑回归分析，设定统计学显著性为p<0.05。结果 脊髓灰质炎发病率最高的是13至24个月大的儿童（9例，34.62%），其中男性14例（53.85%），城市居民16例（61.54%）。疫苗接种状况对疾病发病率有显著影响（p<0.001），未接种疫苗的患者有2例（7.69%），部分接种疫苗的患者有10例（38.46%），完全接种疫苗的患者有14例（53.85%）。瘫痪是16例患者（61.54%）的主要症状。恢复结果各不相同，8例患者（31%）完全康复，12例患者（46%）有部分改善，6例患者（23%）有慢性运动障碍。有效的监测取决于及时报告[比值比（OR）：2.15，p<0.001]和医护人员培训（OR：1.67，p<0.001），这突出了脊髓灰质炎管理策略的关键方面。结论 根据我们的研究结果，疫苗接种状况对脊髓灰质炎的发生有显著影响，部分接种或未接种疫苗的儿童中发现了相当比例的病例。瘫痪仍然是主要症状，恢复结果各不相同，在某些情况下包括慢性运动障碍。本研究强调了巴基斯坦在儿童脊髓灰质炎方面持续面临的挑战，突出了加强疫苗接种、监测和康复工作的迫切需求。
