Key result
Prospective poliovirus surveillance and immunization monitoring in Pakistan and Afghanistan requires tens of millions annually.
Why the study?
The GPEI Strategic Plan for 2019-2023 commits to monitoring immunization campaign quality using LQAS and supporting poliovirus surveillance in Pakistan and Afghanistan, prompting an exploration of the costs of future options.
Observational
Yes
Poliovirus surveillance and campaign monitoring in Pakistan and Afghanistan will continue to require tens of millions of dollars annually, though current LQAS implementation provides limited information.
Answers are grounded in this paper and cite their sources.
Sustained tens-of-millions annual funding needed for polio surveillance in endemic regions; leaves open whether LQAS can be optimized for greater yield.
BACKGROUND: The Global Polio Eradication Initiative (GPEI) Strategic Plan for 2019-2023 includes commitments to monitor the quality of immunization campaigns using lot quality assurance sampling surveys (LQAS) and to support poliovirus surveillance in Pakistan and Afghanistan. METHODS: We analyzed LQAS and poliovirus surveillance data between 2016 and 2020, which included both acute flaccid paralysis (AFP) case-based detection and the continued expansion of environmental surveillance (ES). Using updated estimates for unit costs, we explore the costs of different options for future poliovirus monitoring and surveillance for Pakistan and Afghanistan. RESULTS: The relative value of the information provided by campaign quality monitoring and surveillance remains uncertain and depends on the design, implementation, and performance of the systems. Prospective immunization campaign quality monitoring (through LQAS) and poliovirus surveillance will require tens of millions of dollars each year for the foreseeable future for Pakistan and Afghanistan. CONCLUSIONS: LQAS campaign monitoring as currently implemented in Pakistan and Afghanistan provides limited and potentially misleading information about immunization quality. AFP surveillance in Pakistan and Afghanistan provides the most reliable evidence of transmission, whereas ES provides valuable supplementary information about the extent of transmission in the catchment areas represented at the time of sample collection.
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Kalkowska et al. (2021) conducted an observational in Poliovirus. Poliovirus surveillance and immunization campaign quality monitoring was evaluated on Costs of different options for future poliovirus monitoring and surveillance. Prospective immunization campaign quality monitoring and poliovirus surveillance in Pakistan and Afghanistan will require tens of millions of dollars annually.
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