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. 2019 Mar 14;37(12):1577-1583.
doi: 10.1016/j.vaccine.2019.02.008. Epub 2019 Feb 16.

Poliovirus immunity among children under five years-old in accessible areas of Afghanistan, 2013

Christopher H Hsu  1 , Kathleen A Wannemuehler  2 , Sajid Soofi  3 , Mohd Mashal  4 , Imtiaz Hussain  3 , Zulfiqar A Bhutta  3 , Larin McDuffie  5 , William Weldon  6 , Noha H Farag  7
Affiliations

Poliovirus immunity among children under five years-old in accessible areas of Afghanistan, 2013

Christopher H Hsu et al. Vaccine. .

Abstract

Background: Afghanistan remains among the three countries with endemic wild poliovirus transmission, and high population immunity levels are required to interrupt transmission and prevent outbreaks. Surveillance and vaccination of children in Afghanistan have been challenging due to security issues limiting accessibility in certain areas.

Methods: A serosurvey was conducted in 2013 within accessible enumeration areas (EAs) among children aged <5 years using samples collected for a national micronutrient assessment survey to assess poliovirus immunity in Afghanistan. Of 21194 total EAs in Afghanistan, 107 were inaccessible and therefore were excluded from the sampling frame.

Results: Population immunity was high overall but varied for the poliovirus serotypes, and was lowest for type 3 (95% [95% CI: 93%, 96%]) compared to type 1 (99% [95% CI:97%, 99%]) and type 2 (98% [95% CI:96%, 99%]). The proportion of the population immune to all three types was 93% (95% CI: 91%, 95%), and the proportion seronegative for all three types was 0.5% (95% CI: 0.2%, 1.7%).

Conclusion: Except for regional differences in immunity to type 3 virus, there were no other apparent differences in seroprevalence by region or by any of the demographic or nutritional characteristics assessed in this study. The study was not powered to provide provincial level seroprevalence estimates, but Paktika Province, in the South region, had the largest proportion of seronegative specimens for type 1 (4 seronegative of 17 serum specimens compared to 14 seronegative of 673 for the remainder of the areas). Among accessible children in Afghanistan, seroprevalence of antibodies to poliovirus was high, with most seroprevalence reported at 95% or greater. Despite high seroprevalence in areas assessed in this study, the continued detection of poliovirus cases in the South and East regions indicate that overall regional vaccination coverage and performance is not sufficient to stop polio transmission.

Keywords: Afghanistan; Eradication; Immunity; Poliovirus; Serosurvey.

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Conflict of interest statement

Conflicts of interest

All co-authors report no potential conflicts of interest.

Figures

Fig. 1.
Fig. 1.
Wild poliovirus type 1 (WPV1) cases and districts where national nutrition survey (NNS) and serology were collected - Afghanistan, 2013.
Fig. 2.
Fig. 2.
Regions and the respective provinces of Afghanistan.
See this image and copyright information in PMC

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References

    1. Duintjer Tebbens RJ, Pallansch MA, Cochi SL, et al. Modeling poliovirus transmission in pakistan and afghanistan to inform vaccination strategies in undervaccinated subpopulations. Risk Anal 2018;38(8):1701–17. - PMC - PubMed
    1. Elhamidi Y, Mahamud A, Safdar M, et al. Progress toward poliomyelitis eradication - Pakistan, January 2016-September 2017. MMWR Morb Mortal Wkly Rep 2017;66(46):1276–80. - PMC - PubMed
    1. Farag NH, Alexander J, Hadler S, et al. Progress toward poliomyelitis eradication-Afghanistan and Pakistan, January 2013-August 2014. MMWR Morb Mortal Wkly Rep 2014;63(43):973–7. - PMC - PubMed
    1. Farag NH, Wadood Mz, Safdar RM, et al. Progress toward poliomyelitis eradication-Pakistan, January 2014-September 2015. MMWR Morb Mortal Wkly Rep 2015;64(45):1271–5. - PubMed
    1. Hsu CH, Mahamud A, Safdar RM, et al. Progress toward poliomyelitis eradication - Pakistan, January 2015-September 2016. MMWR Morb Mortal Wkly Rep 2016;65(46):1295–9. - PubMed

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