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September 30, 2021MMWR Morbidity and Mortality Weekly ReportOpen Access

Progress Toward Poliomyelitis Eradication — Pakistan, January 2020–July 2021

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Key result

In Pakistan, wild poliovirus type 1 cases declined by 43% from 147 cases in 2019 to 84 cases in 2020, with only one case reported as of August 2021.

Why the study?

Wild poliovirus type 1 transmission persisted in only two countries as of August 2021, necessitating an update on progress toward polio eradication in Pakistan.

Population

Pakistan national surveillance and immunization data

Design

Public health surveillance report

Follow-up

January 2020-July 2021

Authors

CMChukwuma MbaeyiNational Center for Immunization and Respiratory DiseasesSBShahzad BaigAbdus Salam Centre for PhysicsZKZainul KhanWorld Health Organization - Pakistan

Discussion

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Implication

Progress toward WPV1 eradication in Pakistan is encouraging; leaves open whether cVDPV2 and COVID-19 disruptions will reverse gains.

Study Design

Type

Observational

Structured PICO

P
Population
Population-level surveillance of acute flaccid paralysis and environmental sewage sampling in Pakistan to monitor wild poliovirus type 1 and circulating vaccine-derived poliovirus type 2 during January 2020–July 2021.
I
Intervention
Supplementary immunization activities (SIAs) with oral poliovirus vaccine (OPV) and inactivated poliovirus vaccine (IPV).
O
Outcome
Incidence of wild poliovirus type 1 (WPV1) and circulating vaccine-derived poliovirus type 2 (cVDPV2) cases.

Main Result

Effect estimate: 43% reduction

Absolute Event Rate: 84% vs 147%

WPV1 cases in Pakistan declined significantly in 2020 and 2021, though cVDPV2 outbreaks and surveillance disruptions due to COVID-19 remain challenges to polio eradication.

Limitations

  • Disruption of active acute flaccid paralysis surveillance activities and field investigations due to the COVID-19 pandemic.
  • Recurrent challenges with vaccination campaign quality and repeatedly missed children in core reservoirs.
  • Increasing political instability in Afghanistan leading to migration of unvaccinated children into Pakistan.
  • Disruption of active AFP surveillance activities and field investigations due to the COVID-19 pandemic
  • Recurrent challenges with vaccination campaign quality
  • Increasing political instability in Afghanistan affecting migration

Cite This Study

Mbaeyi et al. (2021) conducted an observational in Poliomyelitis (WPV1 and cVDPV2). Supplementary immunization activities (SIAs) with oral poliovirus vaccine vs. 2019 baseline (historical control) was evaluated on Reported wild poliovirus type 1 (WPV1) cases (43% reduction). In Pakistan, wild poliovirus type 1 cases declined by 43% from 147 cases in 2019 to 84 cases in 2020, with only one case reported as of August 2021.

synapsesocial.com/papers/6a99b3713f5e7cfc13da6eedhttps://doi.org/10.15585/mmwr.mm7039a1
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Progress Toward Poliomyelitis Eradication — Pakistan, January 2018–September 20192019 · 26 citations
  2. 2Progress Toward Poliomyelitis Eradication — Pakistan, January 2017–September 20182018 · 16 citations
  3. 3Progress Toward Poliomyelitis Eradication — Afghanistan, January 2018–May 20192019 · 20 citations
  4. 4Implementation of coordinated global serotype 2 oral poliovirus vaccine cessation: risks of potential non-synchronous cessation2016 · 46 citations
  5. 5Progress Toward Poliomyelitis Eradication — Afghanistan, January 2019–July 20202020 · 33 citations