Key result
Among 11 children with confirmed primary immunodeficiency disorders, 1 patient (9.1%) tested positive for poliovirus excretion 34 months after oral poliovirus vaccine ingestion.
Why the study?
What is the proportion of chronic poliovirus excretion among children with primary immunodeficiency disorders in Bangladesh?
Cross-Sectional (n=13)
Yes
What is the proportion of chronic poliovirus excretion among children with primary immunodeficiency disorders in Bangladesh?
The risk of chronic poliovirus excretion among children with primary immunodeficiency disorders in Bangladesh appears to be low.
Small PID cohort shows low chronic excretion; leaves open need for larger prospective surveillance before policy change.
BACKGROUND: Persons with primary immune deficiency disorders (PIDD) who receive oral poliovirus vaccine (OPV) may transmit immunodeficiency-associated vaccine-derived polioviruses (iVDPVs) and cause paralytic polio. The objective of this study was to identify children with PIDD in Bangladesh, and estimate the proportion with chronic poliovirus excretion. METHODS: Patients admitted at 5 teaching hospitals were screened for PIDD according to standardized clinical case definitions. PIDD was confirmed by age-specific quantitative immunoglobulin levels. Stool specimens were collected from patients with confirmed PIDD. RESULTS: From February 2011 through January 2013, approximately 96 000 children were screened, and 53 patients were identified who met the clinical case definition for PIDD. Thirteen patients (24%) had age-specific quantitative immunoglobulins results that confirmed PIDD. Of these, 9 (69%) received OPV 3-106 months before stool specimen collection. Among 11 patients, stool specimens from 1 patient tested positive for polioviruses 34 months after OPV ingestion. However, the poliovirus isolate was not available for genetic sequencing, and a subsequent stool specimen 45 days later was negative. CONCLUSIONS: The risk of chronic poliovirus excretion among children with PIDD in Bangladesh seems to be low. The national polio eradication program should incorporate strategies for screening for poliovirus excretion among patients with PIDD.
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Sazzad et al. (2014) conducted a cross-sectional in Primary immunodeficiency disorders (n=13). Oral poliovirus vaccine (OPV) was evaluated on chronic poliovirus excretion. Among 11 children with confirmed primary immunodeficiency disorders, 1 patient (9.1%) tested positive for poliovirus excretion 34 months after oral poliovirus vaccine ingestion.
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