Polio Legacy in Action: Using the Polio Eradication Infrastructure for Measles Elimination in Nigeria-The National Stop Transmission of Polio Program

Abstract

From 2012 to date, Nigeria has been the focus of intensified polio eradication efforts. Large investments made by multiple partner organizations and the federal Ministry of Health to support strategies and resources, including personnel, for increasing vaccination coverage and improved performance monitoring paid off, as the number of wild poliovirus (WPV) cases detected in Nigeria were reduced significantly, from 122 in 2012 to 6 in 2014. No WPV cases were detected in Nigeria in 2015 and as at March 2017, only 4 WPV cases had been detected. Given the momentum gained toward polio eradication, these resources seem well positioned to help advance other priority health agendas in Nigeria, particularly the control of vaccine-preventable diseases, such as measles. Despite implementation of mass measles vaccination campaigns, measles outbreaks continue to occur regularly in Nigeria, leading to high morbidity and mortality rates for children <5 years of age. The National Stop Transmission of Polio (NSTOP) program was collaboratively established in 2012 to create a network of staff working at national, state, and district levels in areas deemed high risk for vaccine-preventable disease outbreaks. As an example of how the polio legacy can create long-lasting improvements to public health beyond polio, the Centers for Disease Control and Prevention will transition >180 NSTOP officers to provide technical experience to improve measles surveillance, routine vaccination coverage, and outbreak investigation and response in high-risk areas.

Keywords: Nigeria; legacy; measles; polio.

Figure 1.

Map of Nigeria showing distribution of Nigeria National Stop Transmission of Polio (NSTOP)–supported local government areas (LGAs), including LGAs supported in security-compromised Borno state, 2013–2016. Abbreviations: FCT, Federal Capital Territory; IDP, internally displaced person; NSLOs, NSTOP LGA officers.

Figure 2.

Measles coverage by states in the 2015–2016 supplementary immunization activity in Nigeria (n = 16650). Source: 2016 measures Hanovia Medical Limited measles vaccination coverage survey report. Abbreviation: FCT, Federal Capital Territory.

Figure 3.

Reported number of measles cases and estimated coverage with the first dose of measles-containing vaccine (MCV1), Nigeria, 1980–2015 [16, 17]. Arrows indicate phased national measles vaccination campaigns, according to WHO data (http://ww.who.int/immunization/monitoring_surveillance/data/en).