Key result
The national immunization campaign significantly reduced the projected number of polio-infected individuals from around 8,000 to less than 20 within 30 days of multiple case introductions (p<0.001).
Why the study?
Does a national polio immunization campaign prevent poliovirus outbreaks in a simulated Lebanese population?
Does a national polio immunization campaign prevent poliovirus outbreaks in a simulated Lebanese population?
A computational simulation model demonstrated that the Lebanese National Polio Immunization Campaign significantly reduced the risk of a polio outbreak, highlighting that at least 90% coverage is required to prevent exponential transmission.
Supports polio outbreak modeling; leaves open real-world effectiveness without prospective validation.
BACKGROUND: After the re-introduction of poliovirus to Syria in 2013, Lebanon was considered at high transmission risk due to its proximity to Syria and the high number of Syrian refugees. However, after a large-scale national immunization initiative, Lebanon was able to prevent a potential outbreak of polio among nationals and refugees. In this work, we used a computational individual-simulation model to assess the risk of poliovirus threat to Lebanon prior and after the immunization campaign and to quantitatively assess the healthcare impact of the campaign and the required standards that need to be maintained nationally to prevent a future outbreak. METHODS: Acute poliomyelitis surveillance in Lebanon was along with the design and coverage rate of the recent national polio immunization campaign were reviewed from the records of the Lebanese Ministry of Public Health. Lebanese population demographics including Syrian and Palestinian refugees were reviewed to design individual-based models that predicts the consequences of polio spread to Lebanon and evaluate the outcome of immunization campaigns. The model takes into account geographic, demographic and health-related features. RESULTS: Our simulations confirmed the high risk of polio outbreaks in Lebanon within 10 days of case introduction prior to the immunization campaign, and showed that the current immunization campaign significantly reduced the speed of the infection in the event poliomyelitis cases enter the country. A minimum of 90% national immunization coverage was found to be required to prevent exponential propagation of potential transmission. CONCLUSIONS: Both surveillance and immunization efforts should be maintained at high standards in Lebanon and other countries in the area to detect and limit any potential outbreak. The use of computational population simulation models can provide a quantitative approach to assess the impact of immunization campaigns and the burden of infectious diseases even in the context of population migration.
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Alawieh et al. (2017) studied Poliomyelitis (n=7,773,402). National Polio Immunization Campaign vs. Prior to immunization campaign was evaluated on Cumulative number of infected individuals within 30 days of case introduction (p=<0.001). The national immunization campaign significantly reduced the projected number of polio-infected individuals from around 8,000 to less than 20 within 30 days of multiple case introductions (p<0.001).
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