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WEST AFRICA: Stopping the Polio Virus

Brahima Ouédraogo

OUAGADOUGOU, Mar 18 2010 (IPS) - The World Health Organisation (WHO) and its partners hope to eliminate the circulation of the polio virus in West Africa as soon as June by launching the first round of national synchronised immunisation days against the debilitating disease.

Nigeria would be the only country to curb the circulation of the polio-causing virus as late as 2011, according to the WHO.

“We want to curb the wild polio virus in the West African region by the end of June 2010,” says Dr Bokar Toure, coordinator of the inter-country team for WHO West Africa.

To ensure a better sweep of the operation that affects more than 85 million children under five in 19 countries in West and Central Africa, including Chad, Central African Republic and Cameroon, the WHO is mobilising more than 400,000 volunteer vaccinators. The WHO is working with the International Federation of Red Cross and Red Crescent Societies, the United Nations Children Fund and Rotary International.

“During this period, there will be many rounds of synchronised vaccinations to cover cross-border populations and movements,” Touré told IPS.

According to WHO inter-country team officials, polio eradication hopes are based on positive signs in Nigeria where there were improvements in the level of unvaccinated children who were covered by the programme, and the fact that socio-cultural resistance to vaccination is diminishing thanks to religious and community leaders.

Nigeria remains one of the most affected countries in the world and one of the foci of the epidemic with 388 cases representing 70 percent of polio cases in the sub region. For years, social and cultural constraints have prevented polio vaccination campaigns in the country.

The WHO hopes that rounds of synchronised immunisation will fill gaps left by routine immunisation sessions which many vaccination-aged people miss.

“It is the role of vaccinators, community health workers to organise the whole vaccination chain so that missed children can finally be vaccinated and we can find those parents who are reluctant (to vaccinate their children),” said Djamila Cabral, the WHO representative in Burkina Faso. She sadly notes a resurgence of polio since 2008 in countries of the sub region, including Burkina Faso.

In Burkina Faso, 15 cases were reported in 2009, the last case was in October 2009, despite six rounds of immunisation. According to the WHO, each reported case represents a contamination risk for 200 children.

“We are nearing our goal, but there are still children who don’t get vaccinated and we must find all these children and get them vaccinated,” Cabral told IPS.

Three million children are covered through vaccination this year in Burkina Faso.

“All three of my children have been vaccinated since the vaccination days began; in our neighbourhood we (a women’s group), go door to door to search for all children and help the health workers vaccinate,” said Pauline Zampaligré, who lives in Nagrin a neighbourhood on the outskirts of Ouagadougou.

“All children in the yard are vaccinated, as a matter of fact we get them vaccinated as soon as the radio and television messages announce the community health worker visits,” Aïssata Nonguierma, also from Nargrin, told IPS. She said the community’s enthusiastic response is due to the discovery a few years ago of a polio case in the area.

According to Dr. Kolonpiaré Apiako of the regional health commission for the south-west region of the country, more children were vaccinated this year than expected. “Of a goal set at 223,118 children expected (to be vaccinated) in the four health districts, we have vaccinated more than 225,000 children, in other words 101 percent,” he told IPS.

“We have all the means at our disposal to eradicate polio today. We have the funds, we have the materials, we have the human resources, we have committed political leaders and communities: everything is there for polio to be eradicated from our region,” said the Minister of Health of Burkina Faso, Seydou Bouda.

Polio mainly affects children under five. Initial symptoms are fever, fatigue, headache, vomiting, neck stiffness and pain in the limbs. In a few cases, polio causes paralysis, often permanent. Vaccination is the only means of prevention, according to the WHO.

One in 200 infections leads to irreversible paralysis, usually in the legs. Among the paralysed children, 5 to 10 percent die due to paralysis of respiratory muscles, according to the WHO.

Polio cases have nevertheless declined by over 99 percent between 1998 and 2006, from 350,000 to 1,997 reported cases. In 2008, there were only four countries where polio was still endemic (Afghanistan, India, Nigeria and Pakistan), down from more than 125 in 1988.

Launched in 1988, the Global Polio Eradication Initiative has helped immunise two billion children, reducing the incidence of polio by 99 percent. But the cessation of vaccinations in Nigeria in 2004 has contributed significantly to the resurgence of the disease. In 2009, 1,595 children in 24 countries have been paralysed after contracting polio.

The WHO is planning at least two synchronised polio immunisation days this year. The second round of the first day is planned for late April.

“There are many population movements, countries are very close, very open, so by putting people together (through synchronisation) we’re able to vaccinate a maximum of people, thereby maximising the efforts of donors and governments of affected countries,” Cabral told IPS.

To ensure the success of national immunisation days, the WHO announced training for field officers and expanded immunisation programme managers, and capacity building for logistics systems since vaccines require a cold chain.