What is the clinical evidence from this study?

Study design: Observational. Population: Poliomyelitis. Intervention: Oral poliovirus vaccine (OPV) campaigns. Primary outcome: Reported cases of wild poliovirus type 1 (WPV1).

September 21, 2023MMWR Morbidity and Mortality Weekly ReportOpen Access

Progress Toward Poliomyelitis Eradication — Afghanistan, January 2022–June 2023

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Key result

Afghanistan reported two wild poliovirus type 1 cases in 2022 and five in the first half of 2023, with all 2023 cases occurring in children who had reportedly received at least 16 oral vaccine doses.

Why the study?

Afghanistan and Pakistan remain the only countries with uninterrupted endemic wild poliovirus type 1 transmission since 2017, prompting an assessment of activities and progress toward polio eradication in Afghanistan.

Population

Poliomyelitis cases and surveillance activities in Afghanistan

Design

Surveillance report

Authors

ABAdam BjorkCenters for Disease Control and Prevention IAIrfan Elahi AkbarWorld Health Organization Regional Office for the Eastern Mediterranean SCSumangala ChaudhuryDepartment of Human Services

Discussion

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Implication

May signal incomplete protection despite repeated OPV doses; leaves open questions on vaccine effectiveness requiring further study.

Study Design

Type

Observational

Structured PICO

Population

National surveillance of children under 15 years in Afghanistan to monitor acute flaccid paralysis and wild poliovirus type 1 cases between January 2022 and June 2023.

Exposure

Polio eradication activities, including oral poliovirus vaccination campaigns and environmental surveillance.

Outcome

Reported cases of wild poliovirus type 1 (WPV1) and environmental detections in sewage samples.

Uninterrupted endemic WPV1 transmission continues in Afghanistan, highlighting the need to address vaccination coverage gaps and coordinate with Pakistan to achieve polio eradication.

Limitations

Outdated target population estimates might have limited the accuracy of reported supplementary immunization activity coverage.
The history of the reported number of OPV doses received by each patient as reported by the caregiver might be inaccurate depending on caregiver recall and the history-taking methods of the investigator.
Restrictions on house-to-house vaccination limit the effectiveness of vaccination campaigns in parts of the south and northeast regions.
Population movement between Afghanistan and Pakistan sustains transmission risk.

Cite This Study

Bjork et al. (2023) conducted an observational in Poliomyelitis. Oral poliovirus vaccine (OPV) campaigns was evaluated on Reported cases of wild poliovirus type 1 (WPV1). Afghanistan reported two wild poliovirus type 1 cases in 2022 and five in the first half of 2023, with all 2023 cases occurring in children who had reportedly received at least 16 oral vaccine doses.

synapsesocial.com/papers/6a9e7a34711dca9c88f58bbc https://doi.org/10.15585/mmwr.mm7238a1

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Progress Toward Poliomyelitis Eradication — Afghanistan, January 2022–June 2023

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

Progress Toward Poliomyelitis Eradication — Afghanistan, January 2022–June 2023

Discussion

Member takes

Implication

Study Design

Structured PICO

Limitations

Cite This Study

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