The challenge of poliomyelitis in tropical Africa.

Recent surveys of lameness attributable to poliomyelitis in several African countries have revealed rates of residual paralysis of two to 11 per 1,000 children, a prevalence implying annual incidence rates for poliomyelitis of 10-55 cases per 100,000 population. Factors responsible for this high incidence are the unsanitary conditions present in many African communities, especially rural and periurban areas. Whereas poliomyelitis is endemic in Africa and paralysis occurs early in childhood, the apprehension and alarm that is evident in the developed world is almost absent in Africa. Hence, the administrative and economic resources for massive programs of poliomyelitis vaccination are lacking. Lameness prevalence rates of 2.6 per 1,000 children in certain areas of Africa illustrate that the programs of immunization against poliomyelitis should be intensified.