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Sample records for achieving polio eradication

  1. Achieving polio eradication: a review of health communication evidence and lessons learned in India and Pakistan.

    Science.gov (United States)

    Obregón, Rafael; Chitnis, Ketan; Morry, Chris; Feek, Warren; Bates, Jeffrey; Galway, Michael; Ogden, Ellyn

    2009-08-01

    Since 1988, the world has come very close to eradicating polio through the Global Polio Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Polio Eradication Initiative communication strategies have become increasingly research-driven and innovative, particularly through the introduction of sustained interpersonal communication and social mobilization approaches to reach unreached populations. This review examines polio communication efforts in India and Pakistan between the years 2000 and 2007. It shows how epidemiological, social and behavioural data guide communication strategies that have contributed to increased levels of polio immunity, particularly among underserved and hard-to-reach populations. It illustrates how evidence-based and planned communication strategies - such as sustained media campaigns, intensive community and social mobilization, interpersonal communication and political and national advocacy combined - have contributed to reducing polio incidence in these countries. Findings show that communication strategies have contributed on several levels by: mobilizing social networks and leaders; creating political will; increasing knowledge; ensuring individual and community-level demand; overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and marginalized populations. The review concludes with observations about the added value of communication strategies in polio eradication efforts and implications for global and local public health communication interventions.

  2. Adapting Nepal's polio eradication programme.

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    Paudel, Krishna P; Hampton, Lee M; Gurung, Santosh; Bohara, Rajendra; Rai, Indra K; Anaokar, Sameer; Swift, Rachel D; Cochi, Stephen

    2017-03-01

    Many countries have weak disease surveillance and immunization systems. The elimination of polio creates an opportunity to use staff and assets from the polio eradication programme to control other vaccine-preventable diseases and improve disease surveillance and immunization systems. In 2003, the active surveillance system of Nepal's polio eradication programme began to report on measles and neonatal tetanus cases. Japanese encephalitis and rubella cases were added to the surveillance system in 2004. Staff from the programme aided the development and implementation of government immunization policies, helped launch vaccination campaigns, and trained government staff in reporting practices and vaccine management. Nepal eliminated indigenous polio in 2000, and controlled outbreaks caused by polio importations between 2005 and 2010. In 2014, the surveillance activities had expanded to 299 sites, with active surveillance for measles, rubella and neonatal tetanus, including weekly visits from 15 surveillance medical officers. Sentinel surveillance for Japanese encephalitis consisted of 132 sites. Since 2002, staff from the eradication programme have helped to introduce six new vaccines and helped to secure funding from Gavi, the Vaccine Alliance. Staff have also assisted in responding to other health events in the country. By expanding the activities of its polio eradication programme, Nepal has improved its surveillance and immunization systems and increased vaccination coverage of other vaccine-preventable diseases. Continued donor support, a close collaboration with the Expanded Programme on Immunization, and the retention of the polio eradication programme's skilled workforce were important for this expansion.

  3. WHO Polio Eradication Program: Problems and Solutions

    Directory of Open Access Journals (Sweden)

    S. M. Kharit

    2016-01-01

    Full Text Available In 2013 WHO re-evaluated its main goals of the polio eradication program. A modernization program was accepted with regard to the National vaccination calendars worldwide which includes a step-by-step refusal from the living polio vaccine (OPV and a total transition to the inactivated polio vaccine (IPV starting in 2019. Because of the total eradication of the polio type 2 virus, as an intermediate step the 3-valence OPV was substituted with the 2-valence OPV, which does not contain the type 2 polio virus, in April 2016. The aim of the article is to present the history of polio prevention and to state the reasons for the adoption of 3rd edition of the Global Polio Eradication Initiative. The new approaches were defined for eradication of wild polio virus type 1 and vaccine related strains. A new strategy for global switch to inactivated polio vaccine by 2019 was suggested.

  4. Polio Eradication Initiative (PEl) Emergency Plan: A Panacea for ...

    African Journals Online (AJOL)

    Background igeria has persistently fallen short of the goal to halt and eradicate the transmission of the poliomyelitis virus. The most recent failure of yet again another major polio eradication program under the Global Polio Emergency Initiative 2010-2012 calls for a review of the Nigerian Polio Eradication Initiative ...

  5. Polio eradication initiative in India: deconstructing the GPEI.

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    Sathyamala, C; Mittal, Onkar; Dasgupta, Rajib; Priya, Ritu

    2005-01-01

    The Global Polio Eradication Initiative (GPEI) promised eradication of polio by the year 2000 and certification of eradication by 2005. The first deadline is already a matter of history. With the reporting of polio cases in 2004, the new deadline for polio eradication by 2004 is postponed further. This article seeks to argue that the scientific and technical bodies spear-heading the GPEI, including the WHO, UNICEF, and the U.S. Centers for Disease Control, have formulated a conceptually flawed strategy and that it is not weak political will that is the central obstacle in this final push for global eradication. The validity of the claims of "near success" by the proponents of the GPEI is also examined in detail. By taking India as a case study, the authors examine the achievements of the GPEI in nine years of intense effort since 1995. They conclude that the GPEI is yet another exercise in mismanaging the health priorities and programs in developing countries in the era of globalization.

  6. Circulating Vaccine Derived Poliovirus and the polio eradication ...

    African Journals Online (AJOL)

    No Abstract. Key words: Polio, polio eradication, vaccine derived poliovirus, Oral polio vaccine, inactivated polio vaccine, surveillance. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading ... Metrics powered by PLOS ALM.

  7. Tracking progress toward global polio eradication, 2010-2011.

    Science.gov (United States)

    2012-04-20

    In January 2012, polio eradication was declared a "programmatic emergency for global public health" by the Executive Board of the World Health Organization (WHO). Since the Global Polio Eradication Initiative (GPEI) began in 1988, progress has been tracked by surveillance of acute flaccid paralysis (AFP) cases and testing of linked stool specimens for polioviruses (PVs) in WHO-accredited Global Polio Laboratory Network (GPLN) laboratories, complemented by sewage testing (environmental surveillance) in selected areas. Monitoring AFP surveillance quality at national and subnational administrative levels using standard performance indicators identifies potential gaps where PV circulation might go undetected; monitoring specimen transport and laboratory reporting timeliness identifies areas where reporting delays could lead to late response, permitting ongoing transmission. This report provides an assessment of 2010-2011 performance indicators for AFP surveillance at national and subnational levels in polio-affected countries and laboratory reporting at the regional level, updated from 2009-2010. Overall, 16 (62%) of 26 countries with circulating wild PV (WPV) met national AFP surveillance indicator targets during both 2010 and 2011. All three countries with reestablished WPV transmission and 16 of 19 countries with WPV outbreaks had substantial proportions (>20%) of their respective populations living in areas with underperforming surveillance during 2010 or 2011. Targets for timely reporting of PV isolation and type characterization results were met in three of six WHO regions in 2010 and five regions in 2011. To achieve polio eradication, efforts are needed to improve AFP surveillance and laboratory performance.

  8. Next Generation Inactivated Polio Vaccine Manufacturing to Support Post Polio-Eradication Biosafety Goals

    NARCIS (Netherlands)

    Thomassen, Y.E.; Oever, van 't A.G.; Oijen, van M.G.C.T.; Wijffels, R.H.; Pol, van der L.A.; Bakker, W.A.M.

    2013-01-01

    Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV) is scheduled. Moreover, a manufacturing process, using

  9. national immunisation days for polio eradication in uganda

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... NATIONAL IMMUNISATION DAYS FOR POLIO ERADICATION IN UGANDA: DID IMMUNISATION CARDS INCREASE COVERAGE? F. Nuwaha ... Methods: NIDs for polio eradication commenced in Uganda in 1996. Two rounds ... number of immunisation posts used were 13,000 of which about. 40% were ...

  10. Endgame for polio eradication? Options for overcoming social and political factors in the progress to eradicating polio.

    Science.gov (United States)

    Ganapathiraju, Pavan V; Morssink, Christiaan B; Plumb, James

    2015-01-01

    In 1988, the Global Polio Eradication Initiative (GPEI) was launched with the goal of eradicating polio by the year 2000. After 25 years, several dynamics still challenge this large public health campaign with new cases of polio being reported annually. We examine the roots of this initiative to eradicate polio, its scope, the successes and setbacks during the last 25 years and reflect on the current state of affairs. We examine the social and political factors that are barriers to polio eradication. Options are discussed for solving the current impasse of polio eradication: using force, respecting individual freedoms and gaining support from those vulnerable to fundamentalist 'propaganda'. The travails of the GPEI indicate the need for expanding the Convention on the Rights of the Child to address situations of war and civic strife. Such a cultural and structural reference will provide the basis for global stakeholders to engage belligerent local actors whose local political conflicts are barriers to the eradication of polio. Disregard for these actors will result in stagnation of polio eradication policy, delaying eradication beyond 2018.

  11. Next Generation Inactivated Polio Vaccine Manufacturing to Support Post Polio-Eradication Biosafety Goals

    OpenAIRE

    Yvonne E Thomassen; Aart G van 't Oever; van Oijen, Monique G. C. T.; Wijffels, René H.; van der Pol, Leo A.; Bakker, Wilfried A.M.

    2013-01-01

    Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV) is scheduled. Moreover, a manufacturing process, using attenuated virus strains instead of wild-type polioviruses, is demanded to enhance worldwide production of IPV, especially in low- and middle income countries. Therefore, development of an IPV from attenu...

  12. Poliovirus Studies during the Endgame of the Polio Eradication Program.

    Science.gov (United States)

    Arita, Minetaro

    2017-01-24

    Since the beginning of Global Polio Eradication Initiative in 1988, poliomyelitis cases caused by wild poliovirus (PV) have been drastically reduced, with only 74 cases reported in 2 endemic countries in 2015. The current limited PV transmission suggests that we are in the endgame of the polio eradication program. However, specific challenges have emerged in the endgame, including tight budget, switching of the vaccines, and changes in biorisk management of PV. To overcome these challenges, several PV studies have been implemented in the eradication program. Some of the responses to the emerging challenges in the polio endgame might be valuable in other infectious diseases eradication programs. Here, I will review challenges that confront the polio eradication program and current research to address these challenges.

  13. Models and analyses to understand threats to polio eradication.

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    Koopman, James S

    2017-12-22

    To achieve complete polio eradication, the live oral poliovirus vaccine (OPV) currently used must be phased out after the end of wild poliovirus transmission. However, poorly understood threats may arise when OPV use is stopped. To counter these threats, better models than those currently available are needed. Two articles recently published in BMC Medicine address these issues. Mercer et al. (BMC Med 15:180, 2017) developed a statistical model analysis of polio case data and characteristics of cases occurring in several districts in Pakistan to inform resource allocation decisions. Nevertheless, despite having the potential to accelerate the elimination of polio cases, their analyses are unlikely to advance our understanding OPV cessation threats. McCarthy et al. (BMC Med 15:175, 2017) explored one such threat, namely the emergence and transmission of serotype 2 circulating vaccine derived poliovirus (cVDPV2) after OPV2 cessation, and found that the risk of persistent spread of cVDPV2 to new areas increases rapidly 1-5 years after OPV2 cessation. Thus, recently developed models and analysis methods have the potential to guide the required steps to surpass these threats. 'Big data' scientists could help with this; however, datasets covering all eradication efforts should be made readily available.Please see related articles: https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0937-y and https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-017-0941-2 .

  14. Global polio eradication: Where are we in Europe and what next?

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    Celentano, Lucia Pastore; Carrillo-Santisteve, Paloma; O'Connor, Patrick; Danielsson, Niklas; Huseynov, Shahin; Derrough, Tarik; Adel Ali, Karam; Butler, Robb; Greco, Donato

    2017-05-03

    The world was never so close to reach the polio eradication: only 37 cases notified in 2016 in only three countries, but the game is not yet at the end. The risk of polio outbreaks in the EU is smaller than it has ever been in the past, but it is not so small that we can ignore it. The EU MS must remain alert and plan and prepare for managing polio events or outbreaks because of the possible dire consequences. The IPV only vaccination schedule universally applied in EU has achieved satisfactory coverage, but constantly leaving small accumulating pockets of susceptible individuals. Moreover the IPV only schedule is not an absolute barrier against poliovirus silent transmission as demonstrated in the recent Israel outbreak. The availability of annually revised S.O.P. from WHO GPEI on the identification and response of a polio event, without local poliovirus transmission or a polio outbreak with sustained transmission, helps and challenge EU countries to update their polio national preparedness plans. The EU/EEA area, in fact, is a peculiar area regarding the polio risk both for its vaccination policy, the large polio vaccines manufactures and the constant immigration from areas at polio high risk, but also EU include cultural and financial potentials crucial to sustain the polio end game strategy and reach the benefit of a world without polio risk. Poliovirus eradication will continue to be challenged as long as there is the worldwide presence of polioviruses in laboratories and vaccine production plants. Most of the world's OPV vaccines are produced in the EU and many laboratories and research centers store and handle polio viruses. EU Member States are engaged actively in implementing the poliovirus biocontainment plans that are part of the polio eradication strategy and to certify the destruction of poliovirus strains and potentially contaminated biological materials. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Polio Eradication and Endgame Plan - Victory within Grasp.

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    Patel, Manish; Menning, Lisa; Bhatnagar, Pankaj

    2016-08-07

    Since the launch of the Global Polio Eradication Initiative (GPEI) by the World Health Assembly (WHA) in 1988, the number of polio-endemic countries has decreased from 125 to 2 (Afghanistan and Pakistan). To secure the gains and to address the remaining challenges, the GPEI developed the Polio Eradication and Endgame Strategic Plan, 2013-2018 (the Plan), endorsed by all Member States at the WHA in May 2013. One of the major elements that distinguishes this Plan from previous GPEI strategies is the approach to ending all polioviruses, both wild and vaccine-derived. Overall, the Plan outlines four main objectives: (1) to stop all wild poliovirus (WPV) transmission; (2) to introduce inactivated polio vaccine (IPV), withdraw all oral polio vaccines (OPV), and strengthen immunization systems in countries with weak immunization systems and strong polio infrastructure; (3) to certify all regions as polio-free and safely contain all poliovirus stocks; (4) and to mainstream the investment in polio eradication to benefit other priority public health initiatives for years to come. Implementing the Plan and meeting the milestones in a timely manner will help to ensure that that the world remains permanently polio-free.

  16. Economic analysis of the global polio eradication initiative.

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    Duintjer Tebbens, Radboud J; Pallansch, Mark A; Cochi, Stephen L; Wassilak, Steven G F; Linkins, Jennifer; Sutter, Roland W; Aylward, R Bruce; Thompson, Kimberly M

    2010-12-16

    The global polio eradication initiative (GPEI), which started in 1988, represents the single largest, internationally coordinated public health project to date. Completion remains within reach, with type 2 wild polioviruses apparently eradicated since 1999 and fewer than 2000 annual paralytic poliomyelitis cases of wild types 1 and 3 reported since then. This economic analysis of the GPEI reflects the status of the program as of February 2010, including full consideration of post-eradication policies. For the GPEI intervention, we consider the actual pre-eradication experience to date followed by two distinct potential future post-eradication vaccination policies. We estimate GPEI costs based on actual and projected expenditures and poliomyelitis incidence using reported numbers corrected for underreporting and model projections. For the comparator, which assumes only routine vaccination for polio historically and into the future (i.e., no GPEI), we estimate poliomyelitis incidence using a dynamic infection transmission model and costs based on numbers of vaccinated children. Cost-effectiveness ratios for the GPEI vs. only routine vaccination qualify as highly cost-effective based on standard criteria. We estimate incremental net benefits of the GPEI between 1988 and 2035 of approximately 40-50 billion dollars (2008 US dollars; 1988 net present values). Despite the high costs of achieving eradication in low-income countries, low-income countries account for approximately 85% of the total net benefits generated by the GPEI in the base case analysis. The total economic costs saved per prevented paralytic poliomyelitis case drive the incremental net benefits, which become positive even if we estimate the loss in productivity as a result of disability as below the recommended value of one year in average per-capita gross national income per disability-adjusted life year saved. Sensitivity analysis suggests that the finding of positive net benefits of the GPEI remains

  17. Potential Use of Antiviral Agents in Polio Eradication

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    De Palma, Armando M.; Pürstinger, Gerhard; Wimmer, Eva; Patick, Amy K.; Andries, Koen; Rombaut, Bart; De Clercq, Erik

    2008-01-01

    In 1988, the World Health Assembly launched the Global Polio Eradication Initiative, which aimed to use large-scale vaccination with the oral vaccine to eradicate polio worldwide by the year 2000. Although important progress has been made, polio remains endemic in several countries. Also, the current control measures will likely be inadequate to deal with problems that may arise in the postpolio era. A panel convoked by the National Research Council concluded that the use of antiviral drugs may be essential in the polio eradication strategy. We here report on a comparative study of the antipoliovirus activity of a selection of molecules that have previously been reported to be inhibitors of picornavirus replication and discuss their potential use, alone or in combination, for the treatment or prophylaxis of poliovirus infection. PMID:18394270

  18. The Public Health Legacy of Polio Eradication in Africa.

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    Craig, Allen S; Haydarov, Rustam; O'Malley, Helena; Galway, Michael; Dao, Halima; Ngongo, Ngashi; Baranyikwa, Marie Therese; Naqvi, Savita; Abid, Nima S; Pandak, Carol; Edwards, Amy

    2017-07-01

    The legacy of polio in Africa goes far beyond the tragedies of millions of children with permanent paralysis. It has a positive side, which includes the many well-trained polio staff who have vaccinated children, conducted surveillance, tested stool specimens in the laboratories, engaged with communities, and taken care of polio patients. This legacy also includes support for routine immunization services and vaccine introductions and campaigns for other diseases. As polio funding declines, it is time to take stock of the resources made available with polio funding in Africa and begin to find ways to keep some of the talented staff, infrastructure, and systems in place to work on new public health challenges. The partnerships that helped support polio eradication will need to consider funding to maintain and to strengthen routine immunization services and other maternal, neonatal, and child health programs in Africa that have benefitted from the polio eradication infrastructure. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  19. Post-polio eradication: vaccination strategies and options for India

    Directory of Open Access Journals (Sweden)

    Jayakrishnan Thayyil

    2014-11-01

    Full Text Available In 1988, the World Health Organization (WHO resolved to eradicate poliomyelitis globally. Since then, the initiative has reported dramatic progress in decreasing the incidence of poliomyelitis and limiting the geographical extent of transmission. 2013 is recorded as the second consecutive year not reporting wild poliovirus (WPV from India. If the country can retain this position for one more year India will be declared as polio eradicated. What should be the future vaccination strategies? We searched and reviewed the full text of the available published literature on polio eradication via PubMed and examined Internet sources and websites of major international health agencies. The oral polio vaccine (OPV has been the main tool in the polio eradication program. Once WPV transmission is interrupted, the poliomyelitis will be caused only by OPV. India could expect 1 vaccine-associated paralytic polio per 4.2-4.6 million doses of OPV. Considering the threat of vaccine-derived viruses to polio eradication, WHO urged to develop a strategy to safely discontinue OPV after certification. The ultimate aim is to stop OPV safely and effectively, and eventually substitute with inactivated polio vaccine (IPV. The argument against the use of IPV is its cost. From India, field based data were available on the efficacy of IPV, which was better than OPV. IPV given intradermally resulted in seroconversion rates similar to full-dose intramuscular vaccine. The incremental cost of adopting IPV to replace OPV is relatively low, about US $1 per child per year, and most countries should be able to afford this additional cost.

  20. Impact of inactivated poliovirus vaccine on mucosal immunity: implications for the polio eradication endgame.

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    Parker, Edward Pk; Molodecky, Natalie A; Pons-Salort, Margarita; O'Reilly, Kathleen M; Grassly, Nicholas C

    2015-01-01

    The polio eradication endgame aims to bring transmission of all polioviruses to a halt. To achieve this aim, it is essential to block viral replication in individuals via induction of a robust mucosal immune response. Although it has long been recognized that inactivated poliovirus vaccine (IPV) is incapable of inducing a strong mucosal response on its own, it has recently become clear that IPV may boost immunity in the intestinal mucosa among individuals previously immunized with oral poliovirus vaccine. Indeed, mucosal protection appears to be stronger following a booster dose of IPV than oral poliovirus vaccine, especially in older children. Here, we review the available evidence regarding the impact of IPV on mucosal immunity, and consider the implications of this evidence for the polio eradication endgame. We conclude that the implementation of IPV in both routine and supplementary immunization activities has the potential to play a key role in halting poliovirus transmission, and thereby hasten the eradication of polio.

  1. Next generation inactivated polio vaccine manufacturing to support post polio-eradication biosafety goals.

    Science.gov (United States)

    Thomassen, Yvonne E; van 't Oever, Aart G; van Oijen, Monique G C T; Wijffels, René H; van der Pol, Leo A; Bakker, Wilfried A M

    2013-01-01

    Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV) is scheduled. Moreover, a manufacturing process, using attenuated virus strains instead of wild-type polioviruses, is demanded to enhance worldwide production of IPV, especially in low- and middle income countries. Therefore, development of an IPV from attenuated (Sabin) poliovirus strains (sIPV) was pursued. Starting from the current IPV production process based on wild type Salk strains, adaptations, such as lower virus cultivation temperature, were implemented. sIPV was produced at industrial scale followed by formulation of both plain and aluminium adjuvanted sIPV. The final products met the quality criteria, were immunogenic in rats, showed no toxicity in rabbits and could be released for testing in the clinic. Concluding, sIPV was developed to manufacturing scale. The technology can be transferred worldwide to support post polio-eradication biosafety goals.

  2. Next generation inactivated polio vaccine manufacturing to support post polio-eradication biosafety goals.

    Directory of Open Access Journals (Sweden)

    Yvonne E Thomassen

    Full Text Available Worldwide efforts to eradicate polio caused a tipping point in polio vaccination strategies. A switch from the oral polio vaccine, which can cause circulating and virulent vaccine derived polioviruses, to inactivated polio vaccines (IPV is scheduled. Moreover, a manufacturing process, using attenuated virus strains instead of wild-type polioviruses, is demanded to enhance worldwide production of IPV, especially in low- and middle income countries. Therefore, development of an IPV from attenuated (Sabin poliovirus strains (sIPV was pursued. Starting from the current IPV production process based on wild type Salk strains, adaptations, such as lower virus cultivation temperature, were implemented. sIPV was produced at industrial scale followed by formulation of both plain and aluminium adjuvanted sIPV. The final products met the quality criteria, were immunogenic in rats, showed no toxicity in rabbits and could be released for testing in the clinic. Concluding, sIPV was developed to manufacturing scale. The technology can be transferred worldwide to support post polio-eradication biosafety goals.

  3. Non-polio enteroviruses in acute flaccid paralysis children of India: vital assessment before polio eradication.

    Science.gov (United States)

    Dhole, Tapan N; Ayyagari, Archana; Chowdhary, Rashmi; Shakya, Akhalesh K; Shrivastav, Nikky; Datta, Tapas; Prakash, Vijay

    2009-01-01

    This study is an overview of non-polio enterovirus (NPEV) circulating in North India studied from the perspective of poliomyelitis eradication. Wild polio cases declined because of intensive oral polio vaccine immunization. As we approach global eradication of poliovirus (PV), NPEV causing acute flaccid paralysis (AFP) are equal cause of concern. A total of 46 653 AFP samples (World Health Organization) and apparently 1000 healthy contacts living in the same geographical area were studied (2004-2007). Serological identification of NPEV was done using RIVM-specific pools (The Netherlands). Untyped (UT)-NPEVs were sequenced directly from reverse transcription-polymerase chain reaction using pan-enterovirus (Pan-EV) primer (CDC, Atlanta, GA) targeting highly conserved 5'un-translated regions of the enterovirus. In this study, 12 513 NPEVs were isolated from the collected stool samples. Seroneutralization had identified 67% of NPEV isolates, whereas 32.6% remained as UT- NPEV. Of the typed NPEVs, Coxsackie-B accounted for 32.3%; followed by echoviruses-11, 12, 13, 7 between 8 and 28%. In sequencing few UT-NPEVs, some were identified also as echovirus-30, 11 and 18 which were probably present in mixtures as they remained UT-NPEV in ENT. Newly classified human enterovirus virus-86 (HEV) (EU079026), HEV-97(EU071767) and HEV-B isolate (EU071768) were isolated in AFP samples. This study provided definitive information about circulation, prevalence and new emerging NPEV in the polio-endemic region of India, hence they should be considered in AFP surveillance. This would help in adopting and planning new strategies in post-PV eradication era in the country. This is the right time to prepare for the future tasks while we head towards a polio-free region.

  4. "Why we could not eradicate polio from pakistan and how can we?"

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    Shah, Syed Zawar; Saad, Muhammad; Rahman Khattak, Mohammad Hasan; Rizwan, Muhammad; Haidari, Asma; Idrees, Fatima

    2016-01-01

    Polio is a major health problem and a deadly infectious disease in the developing countries. It is a viral illness caused by polio virus that can lead to paralysis, limb deformities, breathing problems or even death. Polio virus resides only in humans and passes on to the environment in the faeces of someone who is infected. Polio is still endemic in three countries, i.e., Pakistan, Nigeria and Afghanistan and is eradicated from the rest of the world. Pakistan is considered as the exporter of Wild Polio Virus (WPV) with highest number of polio outbreaks among endemic countries. With the start of World Polio Eradication Initiative in 1988, the number of polio cases has been reduced up to 99% worldwide until now. In 2015, Pakistan has shown a decrease of 70-75% in number of polio cases as compare to last year which is the result of good government's initiatives. Militant organizations such as Tehreek-e-Taliban Pakistan, Al-Qaeda and Boko haram movement of northern Nigeria are a major hurdle in the eradication of polio from these countries. The misconception of people about polio vaccine, insecurity within the country and poor health system are the reasons of failure of polio eradication campaigns in these regions. Awareness campaigns about polio for locals and development of proper health system will help in the eradication of polio. Once polio is eradicated, about 40-50 billion dollars can be saved globally. With the strong commitment, seriousness and good initiatives, polio will be eradicated from Pakistan within two years more likely.

  5. Surveillance systems to track progress toward global polio eradication - worldwide, 2012-2013.

    Science.gov (United States)

    Levitt, Alexandra; Diop, Ousmane M; Tangermann, Rudolf H; Paladin, Fem; Kamgang, Jean Baptiste; Burns, Cara C; Chenoweth, Paul J; Goel, Ajay; Wassilak, Steven G F

    2014-04-25

    In 2012, the World Health Assembly of the World Health Organization (WHO) declared completion of polio eradication a programmatic emergency. Polio cases are detected through surveillance of acute flaccid paralysis (AFP) cases and subsequent testing of stool specimens for polioviruses (PVs) at WHO-accredited laboratories within the Global Polio Laboratory Network (GPLN). AFP surveillance is supplemented by environmental surveillance, testing sewage samples from selected sites for PVs. Virologic surveillance, including genomic sequencing to identify isolates by genotype and measure divergence between isolates, guides Global Polio Eradication Initiative (GPEI) activities by confirming the presence of PV, tracking chains of PV transmission, and highlighting gaps in AFP surveillance quality. This report provides AFP surveillance quality indicators at national and subnational levels during 2012-2013 for countries that experienced PV cases during 2009-2013 in the WHO African Region (AFR) and Eastern Mediterranean Region (EMR), the remaining polio-endemic regions. It also summarizes the results of environmental surveillance and reviews indicators assessing the timeliness of reporting of PV isolation and of virus strain characterization globally. Regional-level performance indicators for timely reporting of PV isolation were met in five of six WHO regions in 2012 and 2013. Of 30 AFR and EMR countries that experienced cases of PV (wild poliovirus [WPV], circulating vaccine-derived poliovirus [cVDPV], or both) during 2009-2013, national performance indicator targets for AFP surveillance and collection of adequate specimens were met in 27 (90%) countries in 2012 and 22 (73%) in 2013. In 17 (57%) countries, ≥80% of the population lived in subnational areas meeting both AFP performance indicators in 2012, decreasing to 13 (43%) in 2013. To achieve polio eradication and certify interruption of PV transmission, intensive efforts to strengthen and maintain AFP surveillance are

  6. Resistance of polio to its eradication in Pakistan

    Directory of Open Access Journals (Sweden)

    Sher Zunaira

    2011-10-01

    Full Text Available Abstract Background This study is based on EPI (Expanded Program on Immunization immunization surveys and surveillance of polio, its challenges in immunization and the way forward to overcome these challenges. Methods Several Government documents, survey reports and unpublished program documents were studied and online search was made to find information on EPI Pakistan. SPSS 16 and Microsoft Excel 2007 were used for the statistical analysis. Results Immunization against polio is higher in urban areas as compared to rural areas. Marked variation in vaccination has been observed in different provinces of Pakistan in the last decade. Secondly 10-20% of the children who have received their first dose of trivalent polio vaccine were deprived of their 2nd and 3rd dose because of poor performance of EPI and Lack of information about immunization. Conclusion In spite of numerous successes, such as the addition of new vaccines and raising immunization to over 100% in some areas, EPI is still struggling to reach its polio eradication goals. Inadequate service delivery, lack of information about immunization and limited number of vaccinators were found to be the key reason for poor performance of immunization and for large number of cases reported each year due to the deficiency of second and third booster dose.

  7. Tracking progress toward global polio eradication--worldwide, 2009-2010.

    Science.gov (United States)

    2011-04-15

    Since the Global Polio Eradication Initiative (GPEI) began in 1988, progress has been tracked by 1) surveillance comprised of detection and investigation of cases of acute flaccid paralysis (AFP), coupled with environmental surveillance (sewage testing) in selected areas, and 2) timely testing of fecal specimens in accredited laboratories to identify polioviruses. The sensitivity of AFP case detection and the timeliness of AFP investigations are monitored with performance indicators. Polioviruses are isolated and characterized by the Global Polio Laboratory Network (GPLN). This report assesses the quality of polio surveillance and the timeliness of poliovirus isolation reporting and characterization worldwide during 2009--2010. During that period, 77% of countries affected by wild poliovirus (WPV) met national performance standards for AFP surveillance; underperforming subnational areas were identified in two of four countries with reestablished WPV transmission and in 13 of 22 countries with WPV outbreaks. Targets for timely GPLN reporting of poliovirus isolation results were met in five World Health Organization (WHO) regions in 2009 and in four of six regions in 2010; targets for timely poliovirus characterization were met in four WHO regions in 2009 and in five regions in 2010. Monitoring of surveillance performance indicators at subnational levels continues to be critical to identifying surveillance gaps that might allow WPV circulation to be missed in certain areas or subpopulations. To achieve polio eradication, efforts are needed to further strengthen AFP surveillance, implement targeted environmental surveillance, and ensure that GPLN quality is maintained.

  8. Understanding vaccine hesitancy in polio eradication in northern Nigeria.

    Science.gov (United States)

    Taylor, Sebastian; Khan, Mahmud; Muhammad, Ado; Akpala, Okey; van Strien, Marit; Morry, Chris; Feek, Warren; Ogden, Ellyn

    2017-11-07

    Vaccine hesitancy constitutes a major threat to the Global Polio Eradication Initiative (GPEI), and to further expansion of routine immunisation. Understanding hesitancy, leading in some cases to refusal, is vital to the success of GPEI. Re-emergence of circulating wild poliovirus in northern Nigeria in mid-2016, after 24months polio-free, gives urgency to this. But it is equally important to protect and sustain the global gains available through routine immunisation in a time of rising scepticism and potential rejection of specific vaccines or immunisation more generally. This study is based on a purposive sampling survey of 1653 households in high- and low-performing rural, semiurban and urban areas of three high-risk states of northern Nigeria in 2013-14 (Sokoto, Kano and Bauchi). The survey sought to understand factors at household and community level associated with propensity to refuse polio vaccine. Wealth, female education and knowledge of vaccines were associated with lower propensity to refuse oral polio vaccine (OPV) among rural households. But higher risk of refusal among wealthier, more literate urban household rendered these findings ambiguous. Ethnic and religious identity did not appear to be associated with risk of OPV refusal. Risk of vaccine refusal was highly clustered among households within a small sub-group of sampled settlements. Contrary to expectations, households in these settlements reported higher levels of expectation of government as service provider, but at the same time lesser confidence in the efficacy of their relations with government. Results suggest that strategies to address the micro-political dimension of vaccination - expanding community-level engagement, strengthening the role of local government in public health, and enhancing public participation of women - should be effective in reducing non-compliance, asan important set of strategies complementary to conventional didactic/educational approaches and working through

  9. Evaluating surveillance indicators supporting the Global Polio Eradication Initiative, 2011-2012.

    Science.gov (United States)

    2013-04-12

    The Global Polio Eradication Initiative (GPEI) was established in 1988 by the World Health Assembly to interrupt transmission of wild poliovirus (WPV); completion of this initiative was declared a programmatic emergency of public health in January 2012. Polio cases are detected through surveillance for acute flaccid paralysis (AFP) with linked stool specimens tested for polioviruses (PVs) at accredited laboratories within the Global Polio Laboratory Network (GPLN). AFP surveillance findings are supplemented by testing sewage samples (environmental surveillance) collected at selected sites. Virologic data guide where targeted immunization activities should be conducted or improved. Key performance indicators are used to 1) monitor AFP surveillance quality at national and subnational levels to identify gaps where PV transmission could occur undetected; 2) provide evidence of where PV circulation has been interrupted; and 3) allow timely detection of an outbreak. Standardized surveillance indicators allow progress to be monitored over time and compared among countries. This report presents AFP surveillance performance indicators at national and subnational levels for countries affected by polio during 2011-2012, and trends in environmental surveillance, updating previous reports. In the 19 countries with transmission of PV (WPV and/or circulating vaccine-derived poliovirus [cVDPV]) during 2011-2012, national performance indicator targets were met in 12 (63%) countries in 2011 and 13 (68%) countries in 2012. Seven countries (37%) in 2011 had ≥80% of the population living in areas meeting performance indicators, increasing to nine countries (47%) in 2012. Performance indicators for timely reporting of PV isolation and characterization were met in four of six World Health Organization (WHO) regions in 2011 and five regions in 2012. To achieve global polio eradication, efforts are needed to improve and maintain AFP surveillance and laboratory performance.

  10. Experiences and Lessons From Polio Eradication Applied to Immunization in 10 Focus Countries of the Polio Endgame Strategic Plan.

    Science.gov (United States)

    van den Ent, Maya M V X; Mallya, Apoorva; Sandhu, Hardeep; Anya, Blanche-Philomene; Yusuf, Nasir; Ntakibirora, Marcelline; Hasman, Andreas; Fahmy, Kamal; Agbor, John; Corkum, Melissa; Sumaili, Kyandindi; Siddique, Anisur Rahman; Bammeke, Jane; Braka, Fiona; Andriamihantanirina, Rija; Ziao, Antoine-Marie C; Djumo, Clement; Yapi, Moise Desire; Sosler, Stephen; Eggers, Rudolf

    2017-07-01

    Nine polio areas of expertise were applied to broader immunization and mother, newborn and child health goals in ten focus countries of the Polio Eradication Endgame Strategic Plan: policy & strategy development, planning, management and oversight (accountability framework), implementation & service delivery, monitoring, communications & community engagement, disease surveillance & data analysis, technical quality & capacity building, and partnerships. Although coverage improvements depend on multiple factors and increased coverage cannot be attributed to the use of polio assets alone, 6 out of the 10 focus countries improved coverage in three doses of diphtheria tetanus pertussis containing vaccine between 2013 and 2015. Government leadership, evidence-based programming, country-driven comprehensive operational annual plans, community partnership and strong accountability systems are critical for all programs and polio eradication has illustrated these can be leveraged to increase immunization coverage and equity and enhance global health security in the focus countries. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  11. Transitioning Lessons Learned and Assets of the Global Polio Eradication Initiative to Global and Regional Measles and Rubella Elimination.

    Science.gov (United States)

    Kretsinger, Katrina; Strebel, Peter; Kezaala, Robert; Goodson, James L

    2017-07-01

    The Global Polio Eradication Initiative has built an extensive infrastructure with capabilities and resources that should be transitioned to measles and rubella elimination efforts. Measles continues to be a major cause of child mortality globally, and rubella continues to be the leading infectious cause of birth defects. Measles and rubella eradication is feasible and cost saving. The obvious similarities in strategies between polio elimination and measles and rubella elimination include the use of an extensive surveillance and laboratory network, outbreak preparedness and response, extensive communications and social mobilization networks, and the need for periodic supplementary immunization activities. Polio staff and resources are already connected with those of measles and rubella, and transitioning existing capabilities to measles and rubella elimination efforts allows for optimized use of resources and the best opportunity to incorporate important lessons learned from polio eradication, and polio resources are concentrated in the countries with the highest burden of measles and rubella. Measles and rubella elimination strategies rely heavily on achieving and maintaining high vaccination coverage through the routine immunization activity infrastructure, thus creating synergies with immunization systems approaches, in what is termed a "diagonal approach." © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  12. The final push for polio eradication: addressing the challenge of violence in Afghanistan, Pakistan, and Nigeria.

    Directory of Open Access Journals (Sweden)

    Seye Abimbola

    2013-10-01

    Full Text Available Seye Abimbola and colleagues provide a view from Nigeria, Pakistan, and Afghanistan on global efforts to eradicate polio in those countries. Please see later in the article for the Editors' Summary.

  13. National, Regional and Global Certification Bodies for Polio Eradication: A Framework for Verifying Measles Elimination.

    Science.gov (United States)

    Deblina Datta, S; Tangermann, Rudolf H; Reef, Susan; William Schluter, W; Adams, Anthony

    2017-07-01

    The Global Certification Commission (GCC), Regional Certification Commissions (RCCs), and National Certification Committees (NCCs) provide a framework of independent bodies to assist the Global Polio Eradication Initiative (GPEI) in certifying and maintaining polio eradication in a standardized, ongoing, and credible manner. Their members meet regularly to comprehensively review population immunity, surveillance, laboratory, and other data to assess polio status in the country (NCC), World Health Organization (WHO) region (RCC), or globally (GCC). These highly visible bodies provide a framework to be replicated to independently verify measles and rubella elimination in the regions and globally. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  14. Polio eradication initiative in Afghanistan, 1997-2013.

    Science.gov (United States)

    Simpson, Diane M; Sadr-Azodi, Nahad; Mashal, Taufiq; Sabawoon, Wrishmeen; Pardis, Ajmal; Quddus, Arshad; Garrigos, Carmen; Guirguis, Sherine; Zahoor Zaidi, Syed Sohail; Shaukat, Shahzad; Sharif, Salmaan; Asghar, Humayan; Hadler, Stephen C

    2014-11-01

    This article reviews the epidemiology of polio, acute flaccid paralysis (AFP) surveillance, and the implementation of supplemental immunization activities (SIAs) in Afghanistan from 1997 thru 2013. Published reports and unpublished national data on polio cases, AFP surveillance, and SIAs were analyzed. Recommendations from independent advisory groups and Afghan government informed the conclusions. From 1997 thru 2013, the annual number of confirmed polio cases fluctuated from a low of 4 in 2004 to a high of 80 in 2011. Wild poliovirus types 2 and 3 were last reported in 1997 and 2010, respectively. Circulating vaccine-derived poliovirus type 2 emerged in 2009. AFP surveillance quality in children aged 8 per 100,000 population. Since 2001, at least 6 SIAs have been conducted annually. Afghanistan has made progress moving closer to eliminating polio. The program struggles to reach all children because of management and accountability problems in the field, inaccessible populations, and inadequate social mobilization. Consequently, too many children are missed during SIAs. Afghanistan adopted a national emergency action plan in 2012 to address these issues, but national elimination will require consistent and complete implementation of proven strategies. Published by Oxford University Press on behalf of the Infectious Diseases Society of America 2014. This work is written by (a) US Government employee(s) and is in the public domain in the US.

  15. national immunisation days for polio eradication in uganda

    African Journals Online (AJOL)

    hi-tech

    2000-02-02

    Feb 2, 2000 ... the Ministry of Health attributed this to hostile media, de- campaigning by some opposition groups and fearing that the polio vaccine was contaminated with the human immunodeficiency virus (HIV). Clearly therefore, there was need for remedial action. In a bid to increase NIDs coverage, NIDs cards were.

  16. The polio eradication effort has been a great success--let's finish it and replace it with something even better.

    NARCIS (Netherlands)

    Kimman, Tjeerd G; Boot, Hein J

    2006-01-01

    The polio eradication campaign has greatly reduced the effects of this disease, but many new challenges have emerged. These challenges include the occurrence of polio outbreaks caused by wild-type polioviruses or circulating vaccine-derived polioviruses (cVDPVs) in areas where vaccination coverage

  17. From intense rejection to advocacy: how Muslim clerics were engaged in a polio eradication initiative in Northern Nigeria.

    Directory of Open Access Journals (Sweden)

    Sani-Gwarzo Nasir

    2014-08-01

    Full Text Available Gambo Aliyu and colleagues describe an approach to eradicating polio in Northern Nigeria by engaging Muslim clerics in influencing community perceptions. Please see later in the article for the Editors' Summary.

  18. Polio Eradication Initiative (PEl) Emergency Plan: A Panacea for ...

    African Journals Online (AJOL)

    TNHJOURNALPH

    Department of Geography, University ofWashington, Seattle, Washington, USA. ABSTRACT. BACKGROUND. Nigeria has persistently fallen short of the goal to halt and eradicate the .... in Latin America in the 1980s, for example. Brazil also reveals intensified surveillance as an important element in starkly reducing the.

  19. Polio eradication efforts in regions of geopolitical strife: the Boko ...

    African Journals Online (AJOL)

    The World Health Organization aims to eradicate wild poliovirus worldwide by the end of 2018. Cameroon and Nigeria, neighboring countries, have been affected by the terrorist and militant activities of the Islamist sect Boko Haram. Impacted regions are mainly the far North of Cameroon and Northern Nigeria. Targets of ...

  20. World Health Organization Guidelines for Containment of Poliovirus Following Type-Specific Polio Eradication - Worldwide, 2015.

    Science.gov (United States)

    Previsani, Nicoletta; Tangermann, Rudolph H; Tallis, Graham; Jafari, Hamid S

    2015-08-28

    In 1988, the World Health Assembly of the World Health Organization (WHO) resolved to eradicate polio worldwide. Among the three wild poliovirus (WPV) types (type 1, type 2, and type 3), WPV type 2 (WPV2) has been eliminated in the wild since 1999, and WPV type 3 (WPV3) has not been reported since 2012. In 2015, only Afghanistan and Pakistan have reported WPV transmission. On May 25, 2015, all WHO Member States endorsed World Health Assembly resolution 68.3 on full implementation of the Polio Eradication and Endgame Strategic Plan 2013-2018 (the Endgame Plan), and with it, the third Global Action Plan to minimize poliovirus facility-associated risk (GAPIII). All WHO Member States have committed to implementing appropriate containment of WPV2 in essential laboratory and vaccine production facilities* by the end of 2015 and of type 2 oral poliovirus vaccine (OPV2) within 3 months of global withdrawal of OPV2, which is planned for April 2016. This report summarizes critical steps for essential laboratory and vaccine production facilities that intend to retain materials confirmed to contain or potentially containing type-specific WPV, vaccine-derived poliovirus (VDPV), or OPV/Sabin viruses, and steps for nonessential facilities† that process specimens that contain or might contain polioviruses. National authorities will need to certify that the essential facilities they host meet the containment requirements described in GAPIII. After certification of WPV eradication, the use of all OPV will cease; final containment of all polioviruses after polio eradication and OPV cessation will minimize the risk for reintroduction of poliovirus into a polio-free world.

  1. Polio eradication efforts in regions of geopolitical strife: the Boko Haram threat to efforts in sub-Saharan Africa.

    Science.gov (United States)

    Bigna, Jean Joel R

    2016-06-01

    The World Health Organization aims to eradicate wild poliovirus worldwide by the end of 2018. Cameroon and Nigeria, neighboring countries, have been affected by the terrorist and militant activities of the Islamist sect Boko Haram. Impacted regions are mainly the far North of Cameroon and Northern Nigeria. Targets of Boko Haram aggression in these zones include violence against polio workers, disruption of polio immunization campaigns, with consequent reduced access to health care and immunization. In addition to this significant problem, Northern Nigeria has historically seen rejection of polio virus vaccine initiatives. It remains to know how health systems can continue operations against polio in areas where Boko Haram operates. If appropriate measures are not urgently taken, it will be not possible to meet the 2018 goal of polio virus eradication. The response should include specialized immunization activities in conflict zones, will engagement of leaders. Countries should also explore immunization activities by soldiers and military personnel.

  2. Partition and Poliomyelitis: An Investigation of the Polio Disparity Affecting Muslims during India's Eradication Program

    Science.gov (United States)

    Hussain, Rashid S.; McGarvey, Stephen T.; Fruzzetti, Lina M.

    2015-01-01

    Background Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity. Methods and Findings A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI) stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977. Conclusions Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India. Limitations This study is

  3. Partition and poliomyelitis: an investigation of the polio disparity affecting Muslims during India's eradication program.

    Directory of Open Access Journals (Sweden)

    Rashid S Hussain

    Full Text Available Significant disparities in the incidence of polio existed during its eradication campaign in India. In 2006, Muslims, who comprise 16% of the population in affected states, comprised 70% of paralytic polio cases. This disparity was initially blamed on the Muslims and a rumor that the vaccination program was a plot to sterilize their children. Using the framework of structural violence, this paper describes how the socio-political and historical context of Muslim populations in India shaped the polio disparity.A qualitative study utilizing methods of rapid ethnography was conducted from May-August 2009 in Aligarh, Uttar Pradesh, India. Field methods included participant observation of vaccination teams, historical document research, and 107 interviews with both Global Polio Eradication Initiative (GPEI stakeholders and families with vaccine-eligible children. Almost all respondents agreed that Aligarh was a highly segregated city, mostly due to riots after Partition and during the 1990s. Since the formation of segregated neighborhoods, most respondents described that "Muslim areas" had been underdeveloped compared to "Hindu areas," facilitating the physical transmission of poliovirus. Distrust of the government and resistance to vaccination were linked to this disparate development and fears of sterilization influenced by the "Family Planning Program" from 1976-1977.Ethnic violence and social marginalization since the Partition and during the rise of Hindu nationalism led to distrust of the government, the formation of segregated slums, and has made Muslims victims of structural violence. This led to the creation of disease-spreading physical environments, lowered vaccine efficacy, and disproportionately higher levels of resistance to vaccination. The causes of the polio disparity found in this study elucidate the nature of possible other health disparities affecting minorities in India.This study is limited by the manual coding of the

  4. Polio eradication in India: progress, but environmental surveillance and vigilance still needed.

    Science.gov (United States)

    Chatterjee, Animesh; Vidyant, Sanjukta; Dhole, Tapan N

    2013-02-18

    Poliomyelitis has appeared in epidemic form, become endemic on a global scale, and has been reduced to near elimination, all within the span of documented medical history. Nevertheless, effective vaccinations, global surveillance network, development of accurate viral diagnosis prompted the historical challenge, global polio eradication initiative (GPEI). Environmental surveillance of poliovirus means monitoring of wild polio virus (WPV) and vaccine derived polio virus (cVDPV) circulation in human populations by examining environmental specimens supposedly contaminated by human feces. The rationale for surveillance is based on the fact that PV-infected individuals, whether presenting with disease symptoms or not, shed large amounts of PV in the feces for several weeks. As the morbidity: infection ratio of PV infection is very low, and therefore this fact contributes to the sensitivity of poliovirus surveillance, which under optimal conditions can be better than that of the standard acute flaccid paralysis (AFP) surveillance. The World Health Organization (WHO) has included environmental surveillance of poliovirus in the new Strategic Plan of the Global Polio Eradication Initiative for years 2010-2012 to be increasingly used in PV surveillance, supplementing AFP surveillance and the strategic advisory group of experts on immunization (SAGE) recommended a switch from tOPV-bOPV to remove the threat of cVDPV2 and to accelerate the elimination of WPV type 1 and 3 as bOPV is a more immunogenic vaccine and to introduce one dose of IPV in their vaccination schedule prior to OPV cessation. Copyright © 2012 Elsevier Ltd. All rights reserved.

  5. Optimal vaccine stockpile design for an eradicated disease: application to polio.

    Science.gov (United States)

    Tebbens, Radboud J Duintjer; Pallansch, Mark A; Alexander, James P; Thompson, Kimberly M

    2010-06-11

    Eradication of a disease promises significant health and financial benefits. Preserving those benefits, hopefully in perpetuity, requires preparing for the possibility that the causal agent could re-emerge (unintentionally or intentionally). In the case of a vaccine-preventable disease, creation and planning for the use of a vaccine stockpile becomes a primary concern. Doing so requires consideration of the dynamics at different levels, including the stockpile supply chain and transmission of the causal agent. This paper develops a mathematical framework for determining the optimal management of a vaccine stockpile over time. We apply the framework to the polio vaccine stockpile for the post-eradication era and present examples of solutions to one possible framing of the optimization problem. We use the framework to discuss issues relevant to the development and use of the polio vaccine stockpile, including capacity constraints, production and filling delays, risks associated with the stockpile, dynamics and uncertainty of vaccine needs, issues of funding, location, and serotype dependent behavior, and the implications of likely changes over time that might occur. This framework serves as a helpful context for discussions and analyses related to the process of designing and maintaining a stockpile for an eradicated disease. (c) 2010 Elsevier Ltd. All rights reserved.

  6. Polio Pictures

    Science.gov (United States)

    ... on CDC’s Eradication Efforts Polio Elimination in the United States Vaccination For Travelers Post-polio Syndrome For Healthcare Professionals Laboratory Testing Diagnostic Methods Specimens Poliovirus Containment ...

  7. How Drone Strikes and a Fake Vaccination Program Have Inhibited Polio Eradication in Pakistan: An Analysis of National Level Data.

    Science.gov (United States)

    Kennedy, Jonathan

    2017-10-01

    This article investigates whether the United States' counterinsurgency operations have inhibited polio eradication efforts in northwestern Pakistan, the world's last major reservoir of polio. Anecdotal evidence suggests that militants disrupt polio vaccination programs because of suspicions that campaigns are a cover for gathering intelligence on Central Intelligence Agency (CIA) drone targets. This paper analyzes national-level quantitative data to test this argument. Between 2004 and 2012, the number of polio cases in Pakistan closely mirrored the number of drone strikes. But from 2013 onward, polio cases increased while drone strikes fell. This can be explained by the CIA's use of a fake immunization campaign in a failed attempt to obtain the DNA of Osama bin Laden's relatives prior to his assassination in 2011. This seemingly vindicated militants' suspicions that vaccination programs were a cover for espionage. Militants consequently intensified their disruption of immunization campaigns, resulting in an increase in polio cases in Pakistan, as well as in Afghanistan, Syria, and Iraq. For politicians and military planners, drones are attractive because they are said to harm fewer civilians than conventional methods of warfare. However, this paper demonstrates that drone strikes had negative effects on the well-being of civilians in Pakistan and further afield because they undermined global efforts to eradicate polio.

  8. Monitoring Results in Routine Immunization: Development of Routine Immunization Dashboard in Selected African Countries in the Context of the Polio Eradication Endgame Strategic Plan.

    Science.gov (United States)

    Poy, Alain; van den Ent, Maya M V X; Sosler, Stephen; Hinman, Alan R; Brown, Sidney; Sodha, Samir; Ehlman, Daniel C; Wallace, Aaron S; Mihigo, Richard

    2017-07-01

    To monitor immunization-system strengthening in the Polio Eradication Endgame Strategic Plan 2013-2018 (PEESP), the Global Polio Eradication Initiative identified 1 indicator: 10% annual improvement in third dose of diphtheria- tetanus-pertussis-containing vaccine (DTP3) coverage in polio high-risk districts of 10 polio focus countries. A multiagency team, including staff from the African Region, developed a comprehensive list of outcome and process indicators measuring various aspects of the performance of an immunization system. The development and implementation of the dashboard to assess immunization system performance allowed national program managers to monitor the key immunization indicators and stratify by high-risk and non-high-risk districts. Although only a single outcome indicator goal (at least 10% annual increase in DTP3 coverage achieved in 80% of high-risk districts) initially existed in the endgame strategy, we successfully added additional outcome indicators (eg, decreasing the number of DTP3-unvaccinated children) as well as program process indicators focusing on cold chain, stock availability, and vaccination sessions to better describe progress on the pathway to raising immunization coverage. When measuring progress toward improving immunization systems, it is helpful to use a comprehensive approach that allows for measuring multiple dimensions of the system.

  9. Patients with Primary Immunodeficiencies Are a Reservoir of Poliovirus and a Risk to Polio Eradication

    Directory of Open Access Journals (Sweden)

    Asghar Aghamohammadi

    2017-06-01

    Full Text Available Immunodeficiency-associated vaccine-derived polioviruses (iVDPVs have been isolated from primary immunodeficiency (PID patients exposed to oral poliovirus vaccine (OPV. Patients may excrete poliovirus strains for months or years; the excreted viruses are frequently highly divergent from the parental OPV and have been shown to be as neurovirulent as wild virus. Thus, these patients represent a potential reservoir for transmission of neurovirulent polioviruses in the post-eradication era. In support of WHO recommendations to better estimate the prevalence of poliovirus excreters among PIDs and characterize genetic evolution of these strains, 635 patients including 570 with primary antibody deficiencies and 65 combined immunodeficiencies were studied from 13 OPV-using countries. Two stool samples were collected over 4 days, tested for enterovirus, and the poliovirus positive samples were sequenced. Thirteen patients (2% excreted polioviruses, most for less than 2 months following identification of infection. Five (0.8% were classified as iVDPVs (only in combined immunodeficiencies and mostly poliovirus serotype 2. Non-polio enteroviruses were detected in 30 patients (4.7%. Patients with combined immunodeficiencies had increased risk of delayed poliovirus clearance compared to primary antibody deficiencies. Usually, iVDPV was detected in subjects with combined immunodeficiencies in a short period of time after OPV exposure, most for less than 6 months. Surveillance for poliovirus excretion among PID patients should be reinforced until polio eradication is certified and the use of OPV is stopped. Survival rates among PID patients are improving in lower and middle income countries, and iVDPV excreters are identified more frequently. Antivirals or enhanced immunotherapies presently in development represent the only potential means to manage the treatment of prolonged excreters and the risk they present to the polio endgame.

  10. National choices related to inactivated poliovirus vaccine, innovation and the endgame of global polio eradication.

    Science.gov (United States)

    Thompson, Kimberly M; Duintjer Tebbens, Radboud J

    2014-02-01

    Achieving the goal of a world free of poliomyelitis still requires significant effort. Although polio immunization represents a mature area, the polio endgame will require new tools and strategies, particularly as national and global health leaders coordinate the cessation of all three serotypes of oral poliovirus vaccine and increasingly adopt inactivated poliovirus vaccine (IPV). Poliovirus epidemiology and the global options for managing polioviruses continue to evolve, along with our understanding and appreciation of the resources needed and the risks that require management. Based on insights from modeling, we offer some perspective on the current status of plans and opportunities to achieve and maintain a world free of wild polioviruses and to successfully implement oral poliovirus vaccine cessation. IPV costs and potential wastage will represent an important consideration for national policy makers. Innovations may reduce future IPV costs, but the world urgently needs lower-cost IPV options.

  11. Strategic Engagement of Technical Surge Capacity for Intensified Polio Eradication Initiative in Nigeria, 2012–2015

    Science.gov (United States)

    Yehualashet, Yared G.; Mkanda, Pascal; Gasasira, Alex; Erbeto, Tesfaye; Onimisi, Anthony; Horton, Janet; Banda, Richard; Tegegn, Sisay G.; Ahmed, Haruna; Afolabi, Oluwole; Wadda, Alieu; Vaz, Rui G.; Nsubuga, Peter

    2016-01-01

    Background. Following the 65th World Health Assembly (WHA) resolution on intensification of the Global Poliomyelitis Eradication Initiative (GPEI), the Nigerian government, with support from the World Health Organization (WHO) and other partners, implemented a number of innovative strategies to curb the transmission of wild poliovirus (WPV) in the country. One of the innovations successfully implemented since mid 2012 is the WHO's engagement of surge capacity personnel. Methods. The WHO reorganized its functional structure, adopted a transparent recruitment and deployment process, provided focused technical and management training, and applied systematic accountability framework to successfully manage the surge capacity project in close collaboration with the national counterparts and partners. The deployment of the surge capacity personnel was guided by operational and technical requirement analysis. Results. Over 2200 personnel were engaged, of whom 92% were strategically deployed in 11 states classified as high risk on the basis of epidemiological risk analysis and compromised security. These additional personnel were directly engaged in efforts aimed at improving the performance of polio surveillance, vaccination campaigns, increased routine immunization outreach sessions, and strengthening partnership with key stakeholders at the operational level, including community-based organizations. Discussion. Programmatic interventions were sustained in states in which security was compromised and the risk of polio was high, partly owing to the presence of the surge capacity personnel, who are engaged from the local community. Since mid-2012, significant programmatic progress was registered in the areas of polio supplementary immunization activities, acute flaccid paralysis surveillance, and routine immunization with the support of the surge capacity personnel. As of 19 June 2015, the last case of WPV was reported on 24 July 2014. The surge infrastructure has

  12. Contribution of Global Polio Eradication Initiative-Funded Personnel to the Strengthening of Routine Immunization Programs in the 10 Focus Countries of the Polio Eradication and Endgame Strategic Plan.

    Science.gov (United States)

    van den Ent, Maya M V X; Swift, Rachel D; Anaokar, Sameer; Hegg, Lea Anne; Eggers, Rudolf; Cochi, Stephen L

    2017-07-01

    The Polio Eradication and Endgame Strategic Plan (PEESP) established a target that at least 50% of the time of personnel receiving funding from the Global Polio Eradication Initiative (GPEI) for polio eradication activities (hereafter, "GPEI-funded personnel") should be dedicated to the strengthening of immunization systems. This article describes the self-reported profile of how GPEI-funded personnel allocate their time toward immunization goals and activities beyond those associated with polio, the training they have received to conduct tasks to strengthen routine immunization systems, and the type of tasks they have conducted. A survey of approximately 1000 field managers of frontline GPEI-funded personnel was conducted by Boston Consulting Group in the 10 focus countries of the PEESP during 2 phases, in 2013 and 2014, to determine time allocation among frontline staff. Country-specific reports on the training of GPEI-funded personnel were reviewed, and an analysis of the types of tasks that were reported was conducted. A total of 467 managers responded to the survey. Forty-seven percent of the time (range, 23%-61%) of GPEI-funded personnel was dedicated to tasks related to strengthening immunization programs, other than polio eradication. Less time was spent on polio-associated activities in countries that had already interrupted wild poliovirus (WPV) transmission, compared with findings for WPV-endemic countries. All countries conducted periodic trainings of the GPEI-funded personnel. The types of non-polio-related tasks performed by GPEI-funded personnel varied among countries and included surveillance, microplanning, newborn registration and defaulter tracing, monitoring of routine immunization activities, and support of district immunization task teams, as well as promotion of health behaviors, such as clean-water use and good hygiene and sanitation practices. In all countries, GPEI-funded personnel perform critical tasks in the strengthening of routine

  13. Polio Crisis in Costa Rica: Lessons Learned and Achievements

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    Gioconda Vargas-Morúa

    2015-05-01

    Full Text Available This presentation shows some of the consequences of the polio crisis in Costa Rica during the 1950’s, in order to preserve certain attitudes of Costa Ricans back then that are worth remembering: simplicity, solidarity and gratefulness. Hand in hand with highly service-oriented men and women, the country overcame the crisis and built one of the most iconic hospitals in Costa Rica: the National Children’s Hospital. It is worth rescuing the lessons learned and applying them to current times. This historical text was created based on the stories told by people who lived during the times of the crisis, on a 1956 notebook, on documents from the National Archive and the National Health and Social Security Library (BINASSS, for its name in Spanish, the Costa Rican Social Security System (CCSS, for its name in Spanish, Dr. Rodolfo Álvaro Murillo, and San Juan de Dios Hospital.  National and international newspapers were also reviewed. The consulted material confirms how the work of Costa Ricans, led by committed and service-oriented individuals, allowed for the construction of the National Children’s Hospital to take place -an institution that has served the Costa Rican people for fifty years. Costa Ricans also succeeded in eradicating polio long before several other countries around the world. The reactions of people in the 1950’s are lessons of solidarity and humanity that should not be forgotten; they should be remembered in order to value team work over individual work and make sure, no matter what our role in society is, to always stand by common well-being, as mid-century Costa Ricans did by overcoming their personal limitations and acting for the benefit of society.

  14. World witnesses a tumultuous year while India reports an eventful decade in the long story of polio eradication

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    Sanjay Chaturvedi

    2014-01-01

    Full Text Available With recent outbreaks in Syria and Horn of Africa, silent circulation of wild poliovirus type 1 (WPV1 in Israel, West Bank, and Gaza, and fresh spate of violence against vaccinators and their security personnel in Pakistan, the world is facing a turbulent final ascent to the summit of polio eradication. On the positive side, we may also be witnessing the end of wild poliovirus type 3 (WPV3 and defused programmatic crisis caused by funding gaps, while India registers third consecutive polio-free year. Having a cogent endgame plan 2013-2018, informed by some cardinal lessons learned from an eventful decade in India, is also a very significant development. Now, there is a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV. Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV to up-scaled routine immunization (RI, switch from trivalent oral polio vaccine (tOPV to bivalent oral polio vaccine (bOPV in 144 countries before 2018, stockpiling of mOPV, and simultaneous global cessation of bOPV before 2020. Role of antivirals in post-eradication era is still unclear. Some specific threats emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with weak RI and downscaled supplementary immunization activities (SIAs, tremendous pressure on peripheral health workers, and fatigued systems. Cultural resistance to transnational programs is taking a violent shape in some areas. Differential interpretations of ′right to say no′, on both sides of the divide, are damaging a global cause. Amidst all these concerns, let us not forget to underline the sacrifice made by frontline vaccinators working in some of the most challenging circumstances.

  15. World Witnesses a Tumultuous Year while India Reports an Eventful Decade in the Long Story of Polio Eradication.

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    Chaturvedi, Sanjay

    2014-04-01

    With recent outbreaks in Syria and Horn of Africa, silent circulation of wild poliovirus type 1 (WPV1) in Israel, West Bank, and Gaza, and fresh spate of violence against vaccinators and their security personnel in Pakistan, the world is facing a turbulent final ascent to the summit of polio eradication. On the positive side, we may also be witnessing the end of wild poliovirus type 3 (WPV3) and defused programmatic crisis caused by funding gaps, while India registers third consecutive polio-free year. Having a cogent endgame plan 2013-2018, informed by some cardinal lessons learned from an eventful decade in India, is also a very significant development. Now, there is a parallel pursuit against WPV and vaccine-derived poliovirus (VDPV). Endgame would also involve integration of at least one dose of affordable inactivated polio vaccine (IPV) to up-scaled routine immunization (RI), switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in 144 countries before 2018, stockpiling of mOPV, and simultaneous global cessation of bOPV before 2020. Role of antivirals in post-eradication era is still unclear. Some specific threats emerging at this stage are as follows: Global buildup of new birth cohorts in non-endemic countries with weak RI and downscaled supplementary immunization activities (SIAs), tremendous pressure on peripheral health workers, and fatigued systems. Cultural resistance to transnational programs is taking a violent shape in some areas. Differential interpretations of 'right to say no', on both sides of the divide, are damaging a global cause. Amidst all these concerns, let us not forget to underline the sacrifice made by frontline vaccinators working in some of the most challenging circumstances.

  16. ERADIKASI POLIO DAN IPV (INACTIVATED POLIO VACCINE

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    Gendrowahyuhono Gendrowahyuhono

    2012-09-01

    Full Text Available In the year 1988, World Health Organization (WHO claims that polio viruses should be eradicated after year 2000. However, until year 2010 the world have not been free from polio viruses circulation. So many effort had been achieved and it is estimated that the world will be free from polio virus after the year 2013. Control of poliomyelitis in Indonesia has been commenced since 1982 with routine immunization of polio program and the National Immunization Days (NID has been commenced since 1995,1996,2005 and 2006. When the world is free from polio virus, WHO suggests several alternative effort to maintain the world free from polio viruses : I stop the OPV (Oral Polio Vaccine and no polio immunization, 2 stop OPV and stock pile mOPV (monovalent OPV, 3 use OPV and IPV (Inactivated Polio Vaccine in a certain times, 4 use IPV only in a certain times. IPV has been used routinely in develop countries but has not been used in the developing countries. Several studies in development countries has been conducted, but had not been done in the developing countries. Indonesia collaboration with WHO has conducted the study of IPV in Yogyakarta Province since year 2002 until year 2010. The overall aim of the study is to compile the necessary data that will inform global and national decision-making regarding future polio immunization policies for the OPV cessation era. The data generated from the study will be particularly important to make decisions regarding optimal IPV use in developing tropical countries. It is unlikely that this data can be assembled through other means than through this study. The tentative result of the study shows that OPV immunization coverage in the year 2004 is 99% in four district and 93 % in the Yogyakarta city. Environment surveillance shows that there are 65.7% polio virus detected from 137 sewage samples pre IPV swich, and 4.8% polio virus detected from 83 sewage samples post IPV swich. Survey polio antibody serologis shows

  17. From their own perspective - constraints in the Polio Eradication Initiative: perceptions of health workers and managers in a district of Pakistan's Punjab province.

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    Mushtaq, Muhammad Umair; Shahid, Ubeera; Majrooh, Muhammad Ashraf; Shad, Mushtaq Ahmad; Siddiqui, Arif Mahmood; Akram, Javed

    2010-08-23

    The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. This paper describes the perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative (PEI) to ultimately provide evidence for designing future interventions. A qualitative cross-sectional study using focus group discussions and in-depth interviews was conducted in the Nankana Sahib District of Pakistan's Punjab province. Study subjects included staff at all levels in the PEI at district headquarters, in all 4 tehsils (sub-districts) and at 20 randomly selected primary health centers. In total, 4 FGD and 7 interview sessions were conducted and individual session summary notes were prepared and later synthesized, consolidated and subjected to conceptual analysis. The main constraints identified in the study were the poor condition of the cold chain in all aspects, poor skills and a lack of authority in resource allocation and human resource management, limited advocacy and communication resources, a lack of skills and training among staff at all levels in the PEI/EPI in almost all aspects of the program, a deficiency of public health professionals, poor health services structure, administrative issues (including ineffective means of performance evaluation, bureaucratic and political influences, problems in vaccination areas and field programs, no birth records at health facilities, and poor linkage between different preventive programs), unreliable reporting and poor monitoring and supervision systems, limited use of local data for interventions, and unclear roles and responsibilities after decentralization. The study highlights various shortcomings and bottlenecks in the PEI, and the barriers identified should be considered in prioritizing future strategies.

  18. From their own perspective - constraints in the Polio Eradication Initiative: perceptions of health workers and managers in a district of Pakistan's Punjab province

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    Mushtaq Muhammad Umair

    2010-08-01

    Full Text Available Abstract Background The success of the Global Polio Eradication Initiative was remarkable, but four countries - Afghanistan, Pakistan, India and Nigeria - never interrupted polio transmission. Pakistan reportedly achieved all milestones except interrupting virus transmission. This paper describes the perceptions of health workers and managers regarding constraints in the Polio Eradication Initiative (PEI to ultimately provide evidence for designing future interventions. Methods A qualitative cross-sectional study using focus group discussions and in-depth interviews was conducted in the Nankana Sahib District of Pakistan's Punjab province. Study subjects included staff at all levels in the PEI at district headquarters, in all 4 tehsils (sub-districts and at 20 randomly selected primary health centers. In total, 4 FGD and 7 interview sessions were conducted and individual session summary notes were prepared and later synthesized, consolidated and subjected to conceptual analysis. Results The main constraints identified in the study were the poor condition of the cold chain in all aspects, poor skills and a lack of authority in resource allocation and human resource management, limited advocacy and communication resources, a lack of skills and training among staff at all levels in the PEI/EPI in almost all aspects of the program, a deficiency of public health professionals, poor health services structure, administrative issues (including ineffective means of performance evaluation, bureaucratic and political influences, problems in vaccination areas and field programs, no birth records at health facilities, and poor linkage between different preventive programs, unreliable reporting and poor monitoring and supervision systems, limited use of local data for interventions, and unclear roles and responsibilities after decentralization. Conclusion The study highlights various shortcomings and bottlenecks in the PEI, and the barriers identified should

  19. Introducing an accountability framework for polio eradication in Ethiopia: results from the first year of implementation 2014-2015.

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    Kassahun, Aron; Braka, Fiona; Gallagher, Kathleen; Gebriel, Aregai Wolde; Nsubuga, Peter; M'pele-Kilebou, Pierre

    2017-01-01

    the World Health Organization (WHO), Ethiopia country office, introduced an accountability framework into its Polio Eradication Program in 2014 with the aim of improving the program's performance. Our study aims to evaluate staff performance and key program indicators following the introduction of the accountability framework. the impact of the WHO accountability framework was reviewed after its first year of implementation from June 2014 to June 2015. We analyzed selected program and staff performance indicators associated with acute flaccid paralysis (AFP) surveillance from a database available at WHO. Data on managerial actions taken were also reviewed. Performance of a total of 38 staff was evaluated during our review. our review of results for the first four quarters of implementation of the polio eradication accountability framework showed improvement both at the program and individual level when compared with the previous year. Managerial actions taken during the study period based on the results from the monitoring tool included eleven written acknowledgments, six discussions regarding performance improvement, six rotations of staff, four written first-warning letters and nine non-renewal of contracts. the introduction of the accountability framework resulted in improvement in staff performance and overall program indicators for AFP surveillance.

  20. Support for children identified with acute flaccid paralysis under the global polio eradication programme in Uttar Pradesh, India: a qualitative study

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    Yotsu Rie R

    2012-03-01

    Full Text Available Abstract Background Cases of polio in India declined after the implementation of the polio eradication programme especially in these recent years. The programme includes surveillance of acute flaccid paralysis (AFP to detect and diagnose cases of polio at early stage. Under this surveillance, over 40,000 cases of AFP are reported annually since 2007 regardless of the number of actual polio cases. Yet, not much is known about these children. We conducted a qualitative research to explore care and support for children with AFP after their diagnosis. Methods The research was conducted in a district of western Uttar Pradesh classified as high-risk area for polio. In-depth interviews with parents of children with polio (17, with non-polio AFP (9, healthcare providers (40, and key informants from community including international and government officers, religious leaders, community leaders, journalists, and academics (21 were performed. Results Minimal medicine and attention were provided at government hospitals. Therefore, most parents preferred private-practice doctors for their children with AFP. Many were visited at homes to have stool samples collected by authorities. Some were visited repetitively following the sample collection, but had difficulty in understanding the reasons for these visits that pertained no treatment. Financial burden was a common concern among all families. Many parents expressed resentment for their children's disease, notably have been affected despite receiving multiple doses of polio vaccine. Both parents and healthcare providers lacked information and knowledge, furthermore poverty minimised the access to available healthcare services. Medicines, education, and transportation means were identified as foremost needs for children with AFP and residual paralysis. Conclusions Despite the high number of children diagnosed with AFP as part of the global polio eradication programme, we found they were not provided with

  1. Outcomes of polio eradication activities in Uttar Pradesh, India: the Social Mobilization Network (SM Net and Core Group Polio Project (CGPP

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    Singh Vibha

    2011-05-01

    Full Text Available Abstract Background The primary strategy to interrupt transmission of wild poliovirus in India is to improve supplemental immunization activities and routine immunization coverage in priority districts with a focus on 107 high-risk blocks of western Uttar Pradesh and central Bihar. Villages or urban areas with a history of wild poliovirus transmission, or hard-to-reach or resistant populations are categorized as high-risk areas within blocks. The Social Mobilization Network (SM Net was formed in Uttar Pradesh in 2003 to support polio eradication efforts through improved planning, implementation and monitoring of social mobilization activities in those high-risk areas. In this paper, we examine the vaccination outcomes in districts of SM Net where the CORE Group works. Methods We carried out a secondary data analysis of routine monitoring information collected by the SM Net and the Government of India. These data include information about vaccination outcomes in SM Net areas and non-SM Net areas within the districts where the CORE Group operates. Statistical analysis was used to compare, between SM Net and non-SM Net areas, vaccination outcomes considered sensitive to social mobilization efforts of the SM Net. We employed Generalized Estimating Equations (GEE statistical method to account for Intra-cluster Correlation (ICC, and used 'Quasi-likelihood under the independence model criterion (QIC' as the model selection method. Results Vaccination outcomes in SM Net areas were as high as or higher than in non-SM Net areas. There was considerable variation in vaccination outcomes between districts. Conclusions While not conclusive, the results suggest that the social mobilization efforts of the SM Net and the CORE Group are helping to increase vaccination levels in high-risk areas of Uttar Pradesh. Vaccination outcomes in CORE Group areas were equal or higher than in non-CORE, non-SM Net areas. This occurred even though SM Net areas are those with

  2. The role of nurses and midwives in polio eradication and measles control activities: a survey in Sudan and Zambia

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    Haithami Salah

    2009-09-01

    Full Text Available Abstract Background Nurses and midwives are the key providers of nursing and midwifery services; in many countries, they form the major category of frontline workers who provide both preventive and curative services in the community. When the skills and experience of nursing and midwifery personnel are maximized, they can contribute significantly to positive health outcomes. We conducted a survey among nurses and midwives working at district level in Sudan and Zambia to determine their roles and functions in polio eradication and measles elimination programmes. Methods Nurses and midwives practising in four selected districts in Sudan and in Zambia completed a self-administered questionnaire on their roles and responsibilities, their routine activities and their functions during supplementary immunization campaigns for polio and measles. Results Nurses and midwives were found to play significant roles in implementing immunization programme activities. The level of responsibilities of nurses and midwives in their routine work related more to existing opportunities than to their job descriptions. In Zambia, where nurses reported constraints in performing their tasks, the reasons cited were an increase in the burden of disease and the shortage of health personnel. Factors identified as key to improving work performance included written job descriptions, opportunities for staff and career development and opportunities to earn extra income through activities associated with their jobs. Other non-monetary incentives mentioned included reliable transport, resources and logistics to support routine work in the district. However, in both countries, during supplementary immunization activities or mass campaigns for polio eradication and measles control, nurses and midwives took on more management responsibilities. Conclusion This study shows that nurses and midwives play an important role in implementing immunization activities at the district level and

  3. The role of nurses and midwives in polio eradication and measles control activities: a survey in Sudan and Zambia.

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    Nkowane, Annette Mwansa; Boualam, Liliane; Haithami, Salah; El Sayed, El Tayeb Ahmed; Mutambo, Helen

    2009-09-08

    Nurses and midwives are the key providers of nursing and midwifery services; in many countries, they form the major category of frontline workers who provide both preventive and curative services in the community. When the skills and experience of nursing and midwifery personnel are maximized, they can contribute significantly to positive health outcomes. We conducted a survey among nurses and midwives working at district level in Sudan and Zambia to determine their roles and functions in polio eradication and measles elimination programmes. Nurses and midwives practising in four selected districts in Sudan and in Zambia completed a self-administered questionnaire on their roles and responsibilities, their routine activities and their functions during supplementary immunization campaigns for polio and measles. Nurses and midwives were found to play significant roles in implementing immunization programme activities. The level of responsibilities of nurses and midwives in their routine work related more to existing opportunities than to their job descriptions. In Zambia, where nurses reported constraints in performing their tasks, the reasons cited were an increase in the burden of disease and the shortage of health personnel. Factors identified as key to improving work performance included written job descriptions, opportunities for staff and career development and opportunities to earn extra income through activities associated with their jobs. Other non-monetary incentives mentioned included reliable transport, resources and logistics to support routine work in the district. However, in both countries, during supplementary immunization activities or mass campaigns for polio eradication and measles control, nurses and midwives took on more management responsibilities. This study shows that nurses and midwives play an important role in implementing immunization activities at the district level and that their roles can be maximized by creating opportunities that

  4. Alternative administration routes and delivery technologies for polio vaccines.

    NARCIS (Netherlands)

    Kraan, H.; Stel, van der W.; Kersten, G.F.A.; Amorij, J.P.

    2016-01-01

    Global polio eradication is closer than ever. Replacement of the live attenuated oral poliovirus vaccine (OPV) by inactivated poliovirus vaccine (IPV) is recommended to achieve complete eradication. Limited global production capacity and relatively high IPV costs compared to OPV spur the need for

  5. Did the call for boycott by the Catholic bishops affect the polio ...

    African Journals Online (AJOL)

    However, all countries must remain focused to achieve eradication. In August 2015, the Catholic bishops in Kenya called for boycott of a polio vaccination campaign citing safety concerns with the polio vaccine. We conducted a survey to establish if the coverage was affected by the boycott. Methods: A cross sectional survey ...

  6. Coordination as a best practice from the polio eradication initiative: Experiences from five member states in the African region of the World Health Organization.

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    Okeibunor, Joseph; Nsubuga, Peter; Salla, Mbaye; Mihigo, Richard; Mkanda, Pascal

    2016-10-10

    As part of the efforts to eradicate polioviruses in the African Region, structures were put in place to ensure coordinated mobilization and deployment of resources within the framework of the global polio eradication initiative (PEI). The successes of these structures made them not only attractive to other public health interventions, but also caused them to be deployed to the response efforts of other diseases interventions, without any systematic documentation. This article documents the contributions of PEI coordination units to other public health interventions in the African Region of World Health Organization METHODS: We reviewed the contributions of PEI coordination units to other public health interventions in five countries in the African Region. The analysis identified significant involvement of PEI coordination structures in the implementation of routine immunization programs in all the countries analyzed. Similarly, maternal and child health programs were planned, implemented, monitored and evaluation the Inter-Agency Coordination Committees of the PEI programs in the different countries. The hubs system used in PEI in Chad facilitated the efficient coordination of resources for immunization and other public health interventions in Chad. Similarly, in the Democratic Republic of Congo PEI led coordination activities benefited other public health programs like disease control and the national nutrition program, the national malaria control program, and the tuberculosis control program. In Nigeria, the polio Expert Review Committee effectively deployed the Emergency Operation Center for the implementation of prioritized strategies and activities of the National Polio Eradication Emergency Plan, and it was utilized in the response to Ebola Virus Disease outbreak in the country. The PEI-led coordination systems are thus recognized as having made significant contribution to the coordination and delivery of other public health interventions in the African

  7. polio supplementary immunization campaign evaluation

    African Journals Online (AJOL)

    2013-08-20

    Aug 20, 2013 ... Introduction. Although there are no confirmed polio cases in South. Sudan since June 2009, vital indicators for polio eradication activities are not satisfactory [1.]. Hence, the recent huge polio outbreak in Somalia, Kenya and Ethiopia demanded a safety net SNIDs for four States, including Upper Nile.

  8. polio eradication in nigeria

    African Journals Online (AJOL)

    , vaccine safety, contamination, overdose as well as promotion of ... its paralytic effect is irreversible. Between 5~lO% of the cases of Poliomyelitis ..... misinformation and deliberate suppression of rights of “the underprivileged.(8). This situation ...

  9. The polio endgame.

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    Minor, Philip

    2014-01-01

    Paralytic poliomyelitis is a disease that became a public health issue at the beginning of the twentieth century and was more or less eliminated in developed countries by the early 1970s. The Global Polio Eradication Initiative of WHO has now eradicated endemic polio from all but three countries although re-introductions occur. The progress in polio eradication is striking and has accelerated over the last few years. It is likely that it will be finally eradicated from the world soon, the looming issue will then be how to stop vaccinating or modify immunization programs safely so that poliomyelitis does not re-emerge. This review article discusses the history and pathogenesis of poliomyelitis. The progress made, and challenges in sustaining the eradication of this debilitating infectious disease are considered.

  10. Coverage estimates and patterns of inactivated poliovirus vaccine (IPV) use prior to and during the polio eradication endgame, Jinan City, China, 2010–2015

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    Chang, Caiyun; Zhang, Ji; Zhou, Jingwen; Cao, Ruoming; Song, Kaijun; Liu, Chong; Zhang, Xianhui; Geng, Xingyi; Liu, Xiaoxue; Li, Chuanbin

    2016-01-01

    ABSTRACT Background: Use of inactivated poliovirus vaccine (IPV) in Jinan during the polio eradication endgame has not been previously documented. Two IPV-containing vaccines were made available as an option for Jinan parents in 2009. We describe coverage levels and patterns of use of IPV over time using data from the Jinan Childhood Immunization Information Management System (JNCIIMS). Methods: Children born between January 2010 and December 2014 who were registered in JNCIIMS were included in this study. Vaccination records were obtained from JNCIIMS on April 30, 2015. JNCIIMS distinguishes among available poliovirus vaccines; doses administered data were used to describe IPV usage over time. We identified the polio vaccination sequences used by children in the 2012 and 2013 birth cohorts. Coverage estimates were analyzed by birth cohort and migration status. We developed 3 categories for analysis: “resident child,” “migrant child” and “other child” according to migration status. Results: In total, 12,354 (11.7%) IPV, 5,893(5.6%) DTP-IPV-Hib vaccine and 87,054(82.7%) OPV doses were administered to children in the 2010 to 2014 birth cohorts. The proportion of children using an IPV-only schedule increased each year, consistent with the introduction of IPV that is called for by the Polio Eradication Endgame Strategic Plan 2013–2018. During this time, 4.7% children used a schedule containing both IPV and oral poliovirus vaccine (OPV). In the 2012 to 2013 birth cohorts, 14.4% children used an IPV-only schedule; 5.7% children used a sequential schedule, and 79.9% used OPV-only schedule. Use of IPV only schedules was higher among migrant children than among resident children. Among those sequential schedule using both IPV and OPV, 87.2% children used IPV for the first dose and 12.8% used OPV for the first dose. Conclusions: JNCIIMS provided a mechanism for tracking IPV and OPV vaccination patterns, and showed areas in need of improvement. Ensuring

  11. Coverage estimates and patterns of inactivated poliovirus vaccine (IPV) use prior to and during the polio eradication endgame, Jinan City, China, 2010-2015.

    Science.gov (United States)

    Chang, Caiyun; Zhang, Ji; Zhou, Jingwen; Cao, Ruoming; Song, Kaijun; Liu, Chong; Zhang, Xianhui; Geng, Xingyi; Liu, Xiaoxue; Li, Chuanbin

    2016-11-01

    Use of inactivated poliovirus vaccine (IPV) in Jinan during the polio eradication endgame has not been previously documented. Two IPV-containing vaccines were made available as an option for Jinan parents in 2009. We describe coverage levels and patterns of use of IPV over time using data from the Jinan Childhood Immunization Information Management System (JNCIIMS). Children born between January 2010 and December 2014 who were registered in JNCIIMS were included in this study. Vaccination records were obtained from JNCIIMS on April 30, 2015. JNCIIMS distinguishes among available poliovirus vaccines; doses administered data were used to describe IPV usage over time. We identified the polio vaccination sequences used by children in the 2012 and 2013 birth cohorts. Coverage estimates were analyzed by birth cohort and migration status. We developed 3 categories for analysis: "resident child," "migrant child" and "other child" according to migration status. In total, 12,354 (11.7%) IPV, 5,893(5.6%) DTP-IPV-Hib vaccine and 87,054(82.7%) OPV doses were administered to children in the 2010 to 2014 birth cohorts. The proportion of children using an IPV-only schedule increased each year, consistent with the introduction of IPV that is called for by the Polio Eradication Endgame Strategic Plan 2013-2018. During this time, 4.7% children used a schedule containing both IPV and oral poliovirus vaccine (OPV). In the 2012 to 2013 birth cohorts, 14.4% children used an IPV-only schedule; 5.7% children used a sequential schedule, and 79.9% used OPV-only schedule. Use of IPV only schedules was higher among migrant children than among resident children. Among those sequential schedule using both IPV and OPV, 87.2% children used IPV for the first dose and 12.8% used OPV for the first dose. JNCIIMS provided a mechanism for tracking IPV and OPV vaccination patterns, and showed areas in need of improvement. Ensuring appropriately sequenced IPV and OPV supports reduction of risk of vaccine

  12. Threats to polio eradication in high-conflict areas in Pakistan and Nigeria: a polling study of caregivers of children younger than 5 years.

    Science.gov (United States)

    SteelFisher, Gillian K; Blendon, Robert J; Guirguis, Sherine; Brulé, Amanda; Lasala-Blanco, Narayani; Coleman, Michael; Petit, Vincent; Ahmed, Mashrur; Mataruse, Noah; Corkum, Melissa; Nisar, Mazhar; Ben-Porath, Eran N; Gigli, Susan; Sahm, Christoph

    2015-10-01

    Elimination of poliovirus from endemic countries is a crucial step in eradication; however, vaccination programmes in these areas face challenges, especially in regions with conflict. We analysed interviews with caregivers of children living in two polio-endemic countries to assess whether these challenges are largely operational or also driven by resistance or misinformation in the community. We designed and analysed polls based on face-to-face interviews of a random sample of parents and other caregivers of children younger than 5 years in regions of Pakistan and Nigeria at high risk for polio transmission. In both countries, the sample was drawn via a stratified multistage cluster design with random route household selection. The questionnaire covered awareness, knowledge, and attitudes about polio and oral polio vaccine (OPV), trust in vaccination efforts, and caregiver priorities for government action. We assessed experiences of caregivers in accessible higher-conflict areas and compared their knowledge and attitudes with those in lower-conflict areas. Differences were tested with two-sample t tests. The poll consisted of 3396 caregivers from Pakistan and 2629 from Nigeria. About a third of caregivers who responded in higher-conflict areas of Pakistan (Federally Administered Tribal Areas [FATA], 30%) and Nigeria (Borno, 33%) were unable to confirm that their child was vaccinated in the previous campaign. In FATA, 12% of caregivers reported that they were unaware of polio, and in Borno 12% of caregivers reported that vaccinators visited but their child did not receive the vaccine or they did not know whether the child was vaccinated. Additionally, caregivers in higher-conflict areas are less likely to hold beliefs about OPV that could motivate acceptance and are more likely to hold concerns than are caregivers in lower-conflict areas. Beyond the difficulties in reaching homes with OPV, challenges for vaccination programmes in higher-conflict areas extend to

  13. Introduction of inactivated poliovirus vaccine leading into the polio eradication endgame strategic plan; Hangzhou, China, 2010-2014.

    Science.gov (United States)

    Liu, Yan; Wang, Jun; Liu, Shijun; Du, Jian; Wang, Liang; Gu, Wenwen; Xu, Yuyang; Zuo, Shuyan; Xu, Erping; An, Zhijie

    2017-03-01

    China's Expanded Program on Immunization (EPI) has provided 4 doses of oral poliovirus vaccine (OPV) since the 1970s. Inactivated poliovirus vaccine (IPV) became available in 2010 in Hangzhou as a private-sector, parent-chosen alternative to OPV. In 2015, WHO recommended that countries with all-OPV vaccination schedules introduce at least one dose of IPV, to mitigate risk associated with the withdrawal of type 2 OPV. We analyzed polio vaccine coverage and utilization in Hangzhou to determine patterns of IPV use and the occurrence of vaccine-associated paralytic polio (VAPP) in the various patterns identified. Children born between 2010 and 2014 and registered in Hangzhou's Immunization Information System (HZIIS) were included. VAPP cases were detected through the acute flaccid paralysis surveillance system. We used descriptive epidemiological methods to determine IPV and OPV usage patterns and VAPP occurrence. HZIIS data from 566,894 children were analyzed. Coverage levels of polio vaccine were greater than 92% for each birth cohort. Percentages of children using OPV-only, IPV-only, and IPV/OPV sequential schedules were 70.57%, 27.01% and 2.41%, respectively. IPV-only schedule utilization increased by birth cohort regardless of geographical area or whether the child was locally-born. The highest use of an all-IPV schedule (79.85%) was among urban, locally-born children in the 2014 birth cohort. Five VAPP cases were identified during the study years; all cases occurred following the first polio vaccine dose, which was always OPV for the cases. Type 2 vaccine virus was isolated from 2 VAPP cases, and type 2 and type 3 vaccine virus was isolated from one VAPP case. The incidence of VAPP in the 2010-2014 birth cohorts was 3.76 per 1million doses of OPV. Children in Hangzhou had high polio vaccination coverage. IPV-only schedule use increased by year, and was highest in urban areas among locally-born children. All cases of VAPP were associated with the first dose of OPV

  14. Risk Communication: The Over-Looked Factor in the Nigeria Polio ...

    African Journals Online (AJOL)

    The 2003 - 2004 polio vaccination boycotts in Nigeria threatened the global polio eradication initiative of having a polio-free world by 2005. Encouraged by the global eradication of smallpox from the world in 1980, World Health Organization (WHO) launched the Global Polio Eradication Initiative in 1988 seeking to ...

  15. Eradication of poliomyelitis in South Africa | Blecher | South African ...

    African Journals Online (AJOL)

    An international campaign under the leadership of the World Health Organisation is underway to eradicate polio from the world by the year 2000. South Africa may already be free of polio. However, to ensure eradication we need to move from a polio control programme to a polio eradication programme. This necessitates ...

  16. polio supplementary immunization campaign evaluation

    African Journals Online (AJOL)

    2013-08-20

    Aug 20, 2013 ... is the process of sharing information with the community about polio eradication activities, the polio immunization campaign and why it is important [5.]. In this evaluation, more than three-fourth of the families knew the campaign before the vaccination team visited their houses. Meaning that, majority of the ...

  17. Sailing in Uncharted Waters: Carefully Navigating the Polio Endgame.

    Science.gov (United States)

    Miller, Elizabeth; John, T Jacob

    2016-10-01

    In a Perspective linked to the research article by Isobel Blake and colleagues, Elizabeth Miller and T. Jacob John discuss the path towards global polio eradication and the challenges, strategies, and necessary precautions around oral polio vaccine cessation.

  18. Economic considerations for the eradication endgame.

    Science.gov (United States)

    Barrett, Scott

    2013-08-05

    An infectious disease will be eradicated only if it is eliminated everywhere, including in the hardest-to-reach, most vaccine-wary communities. If eradication is successful, it promises a dividend in the form of avoided infections and vaccinations. However, success is never certain unless and until eradication is achieved, and claiming the dividend means bearing the possibly great risk of re-emergence. Economic analysis of eradication evaluates these risks and rewards relative to the alternative of 'optimal control', and also exposes the incentives for achieving and capitalizing on eradication. Eradication is a 'game', because some countries may be willing to eliminate the disease within their borders only if assured that all others will eliminate the disease within their borders. International financing is also a game, because each country would rather free ride than contribute. Finally, for diseases such as polio, capitalizing on eradication is a game, for should any country continue to vaccinate in the post-eradication era using the live-attenuated polio vaccine, the countries that stop vaccinating will be exposed to the risk of vaccine-derived polioviruses. In the framework developed in this paper, eradication is a seductive goal, its attainment fraught with peril.

  19. A Brief History of Vaccines Against Polio.

    Science.gov (United States)

    Vashishtha, Vipin M; Kamath, Sachidanand

    2016-08-07

    Poliomyelitis, a dreaded disease of the last century that had already crippled millions of people across the globe, is now on the verge of eradication thanks mainly to two polio vaccines, inactivated polio vaccine (IPV) and oral polio vaccine (OPV). Ever since their development in late 1950s and early 1960s, the journey of their early development process, clinical trials, licensure and ultimately widespread clinical use in different countries provide a fascinating tale of events. Oral polio vaccine has been the mainstay of global polio eradication initiative (GPEI) in most of the countries. With the advent of 'polio endgame', the focus has now shifted back to IPV. However, there are certain issues associated with global cessation of OPV use and universal implementation of IPV in routine immunization schedules across the globe that need to be dealt with some urgency, before proclaiming the global victory over polio.

  20. Unraveling the Transmission Ecology of Polio.

    Directory of Open Access Journals (Sweden)

    Micaela Martinez-Bakker

    2015-06-01

    Full Text Available Sustained and coordinated vaccination efforts have brought polio eradication within reach. Anticipating the eradication of wild poliovirus (WPV and the subsequent challenges in preventing its re-emergence, we look to the past to identify why polio rose to epidemic levels in the mid-20th century, and how WPV persisted over large geographic scales. We analyzed an extensive epidemiological dataset, spanning the 1930s to the 1950s and spatially replicated across each state in the United States, to glean insight into the drivers of polio's historical expansion and the ecological mode of its persistence prior to vaccine introduction. We document a latitudinal gradient in polio's seasonality. Additionally, we fitted and validated mechanistic transmission models to data from each US state independently. The fitted models revealed that: (1 polio persistence was the product of a dynamic mosaic of source and sink populations; (2 geographic heterogeneity of seasonal transmission conditions account for the latitudinal structure of polio epidemics; (3 contrary to the prevailing "disease of development" hypothesis, our analyses demonstrate that polio's historical expansion was straightforwardly explained by demographic trends rather than improvements in sanitation and hygiene; and (4 the absence of clinical disease is not a reliable indicator of polio transmission, because widespread polio transmission was likely in the multiyear absence of clinical disease. As the world edges closer to global polio eradication and continues the strategic withdrawal of the Oral Polio Vaccine (OPV, the regular identification of, and rapid response to, these silent chains of transmission is of the utmost importance.

  1. Polio and Prevention

    Science.gov (United States)

    ... Photo Collections Videos Polio Today → Polio + Prevention Polio + Prevention Polio and prevention Polio is a crippling and ... a child for life. Learn more about polio + prevention The Virus The Vaccines The Communities Related resources ...

  2. Scale down of the inactivated polio vaccine production process

    NARCIS (Netherlands)

    Thomassen, Y.E.; Oever, van 't R.; Vinke, C.M.; Spiekstra, A.; Wijffels, R.H.; Pol, van der L.A.; Bakker, W.A.M.

    2013-01-01

    The anticipated increase in the demand for inactivated polio vaccines resulting from the success in the polio eradication program requires an increase in production capacity and cost price reduction of the current inactivated polio vaccine production processes. Improvement of existing production

  3. Reverse sequential therapy achieves a similar eradication rate as standard sequential therapy for Helicobacter pylori eradication: a randomized controlled trial.

    Science.gov (United States)

    Tsay, Feng-Woei; Wu, Deng-Chyang; Kao, Sung-Shuo; Tsai, Tzung-Jium; Lai, Kwok-Hung; Cheng, Jin-Shiung; Chan, Hoi-Hung; Wang, Huay-Min; Tsai, Wei-Lun; Tseng, Hui-Hwa; Peng, Nan-Jin; Hsu, Ping-I

    2015-02-01

    Sequential therapy is a two-step therapy achieving a promising eradication rate for Helicobacter pylori infection. The rationale of sequential method has been proposed that amoxicillin weakens bacterial cell walls in the initial phase of treatment, preventing the development of drug efflux channels for clarithromycin and metronidazole used in the second phase. The aim of this prospective, randomized, controlled study was to investigate whether the efficacy of reverse sequential therapy was noninferior to sequential therapy in the treatment of H. pylori infection. From January 2009 to December 2010, consecutive H. pylori-infected patients were randomly assigned to receive either sequential therapy (a 5-day dual therapy with pantoprazole plus amoxicillin, followed by a 5-day triple therapy with pantoprazole plus clarithromycin and metronidazole) or reverse sequential therapy (a 5-day triple therapy with pantoprazole plus clarithromycin and metronidazole, followed by a 5-day dual therapy with pantoprazole plus amoxicillin). H. pylori status was examined 6 weeks after the end of treatment by rapid urease and histology or urea breath test. One hundred and twenty-two H. pylori-infected participants were randomized to receive sequential (n = 60) or reverse sequential therapy (n = 62). The eradication rates, by intention-to-treat analysis, were similar: 91.9% (95% confidence interval (CI): 85.1-98.7%) for sequential therapy and 96.7% (95% CI: 92.2-101.2%) for reverse sequential therapy (p = .44). Per-protocol analysis also showed similar results: 91.8% (95% CI: 84.9-98.7%) for sequential group and 96.7% (95% CI: 92.2-101.2%) for reverse sequential therapy (p = .43). The two treatments exhibited comparable frequencies of adverse events (11.3% vs 6.7%, respectively) and drug compliance (98.4% vs 100%, respectively). The overall resistance rates of antibiotics were clarithromycin 10.5%, amoxicillin 0%, and metronidazole 44.2% of patients, respectively. The dual

  4. Polio endgame: the global introduction of inactivated polio vaccine.

    Science.gov (United States)

    Patel, Manish; Zipursky, Simona; Orenstein, Walt; Garon, Julie; Zaffran, Michel

    2015-05-01

    In 2013, the World Health Assembly endorsed a plan that calls for the ultimate withdrawal of oral polio vaccines (OPV) from all immunization programs globally. The withdrawal would begin in a phased manner with removal of the type 2 component of OPV in 2016 through a global switch from trivalent OPV to bivalent OPV (containing only types 1 and 3). To mitigate risks associated with immunity gaps after OPV type 2 withdrawal, the WHO Strategic Advisory Group of Experts has recommended that all 126 OPV-only using countries introduce at least one dose of inactivated polio vaccine into routine immunization programs by end-2015, before the trivalent OPV-bivalent OPV switch. The introduction of inactivated polio vaccine would reduce risks of reintroduction of type 2 poliovirus by providing some level of seroprotection, facilitating interruption of transmission if outbreaks occur, and accelerating eradication by boosting immunity to types 1 and 3 polioviruses.

  5. Polio communication.

    Science.gov (United States)

    Galaway, Michael

    2005-12-01

    Substantial investments are being made in the area of communication and social mobilisation to interrupt transmission of wild poliovirus. A number of organisations with active support from the Government of India and various state governments are implementing activities to raise awareness and encourage all families to immunise their children. A mass media campaign is the most recognised health promotion effort on media. Mass media efforts are being backed by intensive social mobilisation and interpersonal communication efforts in polio-endemic states. Advocacy and editorial media environment are key elements of the overall communication approach, creating a conducive environment for the polio programme.

  6. Achievements of an eradication program against caprine arthritis encephalitis virus in South Tyrol, Italy.

    Science.gov (United States)

    Tavella, Alexander; Bettini, Astrid; Ceol, Marco; Zambotto, Paolo; Stifter, Ernst; Kusstatscher, Natashia; Lombardi, Rosalba; Nardeli, Stefano; Beato, Maria Serena; Capello, Katia; Bertoni, Giuseppe

    2017-11-06

    Small ruminant lentivirus infections in goats affect both production and animal welfare. This represents a threat to the qualitative and quantitative growth of goat farming, recently observed in mountainous regions such as the Autonomous Province of Bolzano - South Tyrol (Italy). To monitor and eradicate the caprine arthritis encephalitis virus in this goat population, a compulsory eradication campaign was launched, based on a strict census of small ruminants and yearly serological testing of all animals, followed by the consequent culling of seropositive individuals. The campaign succeeded in completely eliminating cases of clinical disease in goats, while drastically reducing the seroprevalence at the herd as well as individual animal level. The serological outcome of the introduced control measures was determined using commercially available ELISA kits, demonstrating their suitability for use in this type of campaign, aimed at reducing seroprevalence as well as clinical manifestations of these infections. However, this clear success is diminished by the failure to achieve a complete eradication of these viruses. The reasons leading to the observed tailing phenomenon and the occurrence of new infections in already sanitised flocks are discussed and implementation of further measures are proposed. © British Veterinary Association (unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  7. Following in the footsteps of smallpox: can we achieve the global eradication of measles?

    Directory of Open Access Journals (Sweden)

    Morgan Oliver WC

    2004-03-01

    Full Text Available Abstract Background Although an effective measles vaccine has been available for almost 40 years, in 2000 there were about 30 million measles infections worldwide and 777,000 measles-related deaths. The history of smallpox suggests that achieving measles eradication depends on several factors; the biological characteristics of the organism; vaccine technology; surveillance and laboratory identification; effective delivery of vaccination programmes and international commitment to eradication. Discussion Like smallpox, measles virus has several biological characteristics that favour eradication. Humans are the only reservoir for the virus, which causes a visible illness and infection leading to life-long immunity. As the measles virus has only one genetic serotype which is relatively stable over time, the same basic vaccine can be used world-wide. Vaccination provides protection against measles infection for at least 15 years, although efficacy may be reduced due to host factors such as nutritional status. Measles vaccination may also confer other non-specific health benefits leading to reduced mortality. Accurate laboratory identification of measles cases enables enhanced surveillance to support elimination programmes. The "catch-up, keep-up, follow-up" vaccination programme implemented in the Americas has shown that measles elimination is possible using existing technologies. On 17th October 2003 the "Cape Town Measles Declaration" by the World Health Organisation and the United Nations Childrens Fund called on governments to intensify efforts to reduce measles mortality by supporting universal vaccination coverage and the development of more effective vaccination. Summary Although more difficult than for smallpox, recent experience in the Americas suggests that measles eradication is technically feasible. Growing international support to deliver these programmes means that measles, like smallpox, may very well become a curiosity of history.

  8. Polio Vaccine

    Science.gov (United States)

    ... doctorMost kids have no problems with the polio vaccine. However, call your doctor if your child has any reaction after getting the vaccine. Call ... Tell the doctor when (day and time) your child received the vaccine. You also should file a Vaccine Adverse Event ...

  9. Sailing in Uncharted Waters: Carefully Navigating the Polio Endgame.

    Directory of Open Access Journals (Sweden)

    Elizabeth Miller

    2016-10-01

    Full Text Available In a Perspective linked to the research article by Isobel Blake and colleagues, Elizabeth Miller and T. Jacob John discuss the path towards global polio eradication and the challenges, strategies, and necessary precautions around oral polio vaccine cessation.

  10. Epidemiology and Distribution of Polio Induced Deformities in ...

    African Journals Online (AJOL)

    Background: Poliomyelitis has remained endemic in Nigeria despite the efforts made by governments to eradicate the disease. The deformities arising from poliomyelitis (polio) make the establishment of rehabilitation centres a public health priority. Objective: To study the epidemiology, nature and distribution of polio ...

  11. Review of the Oral Polio Vaccineimmunization Coverage with ...

    African Journals Online (AJOL)

    routine and supplemental) in Zambia from 2000 to 2009, with the view of identifying opportunities for system strengthening, given that routine immunization is the “bed rock” for polio eradication. Design: A retrospective descriptive analysis design ...

  12. Another look at polio and postpolio syndrome.

    Science.gov (United States)

    Saxon, D F

    2001-01-01

    Polio survivors will likely be accessing the health care system because of acute and/or chronic conditions as they age. Therefore, they will again be interacting with health care professionals, especially orthopaedic and rehabilitation nurses. A comprehensive understanding of polio and postpolio syndrome will give orthopaedic and rehabilitation nurses the knowledge they will need to help polio survivors and their families achieve their highest potential and quality of life.

  13. Lessons From the Polio Endgame: Overcoming the Failure to Vaccinate and the Role of Subpopulations in Maintaining Transmission.

    Science.gov (United States)

    Thompson, Kimberly M; Duintjer Tebbens, Radboud J

    2017-07-01

    Recent detections of circulating serotype 2 vaccine-derived poliovirus in northern Nigeria (Borno and Sokoto states) and Pakistan (Balochistan Province) and serotype 1 wild poliovirus in Pakistan, Afghanistan, and Nigeria (Borno) represent public health emergencies that require aggressive response. We demonstrate the importance of undervaccinated subpopulations, using an existing dynamic poliovirus transmission and oral poliovirus vaccine evolution model. We review the lessons learned during the polio endgame about the role of subpopulations in sustaining transmission, and we explore the implications of subpopulations for other vaccine-preventable disease eradication efforts. Relatively isolated subpopulations benefit little from high surrounding population immunity to transmission and will sustain transmission as long as they do not attain high vaccination coverage. Failing to reach such subpopulations with high coverage represents the root cause of polio eradication delays. Achieving and maintaining eradication requires addressing the weakest links, which includes immunizing populations in insecure areas and/or with disrupted or poor-performing health systems and managing the risks of individuals with primary immunodeficiencies who can excrete vaccine-derived poliovirus long-term. Eradication efforts for vaccine-preventable diseases need to create performance expectations for countries to immunize all people living within their borders and maintain high coverage with appropriate interventions.Keywords. Polio; eradication; transmission; heterogeneity.

  14. Progress Toward Poliomyelitis Eradication - Afghanistan, January 2016-June 2017.

    Science.gov (United States)

    Martinez, Maureen; Shukla, Hemant; Nikulin, Joanna; Wadood, Mufti Zubair; Hadler, Stephen; Mbaeyi, Chukwuma; Tangermann, Rudolph; Jorba, Jaume; Ehrhardt, Derek

    2017-08-18

    Afghanistan, Pakistan, and Nigeria remain the only countries where the transmission of endemic wild poliovirus type 1 (WPV1) continues (1). This report describes polio eradication activities, progress, and challenges in Afghanistan during January 2016-June 2017 and updates previous reports (2,3). Thirteen WPV1 cases were confirmed in Afghanistan in 2016, a decrease of seven from the 20 cases reported in 2015. From January to June 2017, five WPV1 cases were reported, compared with six during the same period in 2016. The number of affected districts declined from 23 (including WPV1-positive acute flaccid paralysis [AFP] cases and positive environmental sewage samples) in 2015 to six in 2016. To achieve WPV1 eradication, it is important that Afghanistan's polio program continue to collaborate with that of neighboring Pakistan to track and vaccinate groups of high-risk mobile populations and strengthen efforts to reach children in security-compromised areas.

  15. Polio in Pakistan: Social constraints and travel implications.

    Science.gov (United States)

    Mushtaq, Asim; Mehmood, Sajid; Rehman, Muhammad Ateeq Ur; Younas, Asma; Rehman, Muhammad Saif Ur; Malik, Muhamamd Faheem; Hyder, Muhammad Zeeshan

    2015-01-01

    The Global Polio Eradication Initiative (GPEI) in Pakistan has faced failure despite being implemented successfully. Polio cases were successfully reduced by 99% until 2005. However, thereafter, new polio cases were registered, which continue to rise annually. This repeat polio outbreak has placed the country on watch by the World Health Organization (WHO) due to travelers, and Hajj and Umrah pilgrims. The present report reviews the published literature for determining the social constraints to the polio eradication initiative in Pakistan. Religion, politics, awareness, insecurity, inequity, governance, and social responsibility have been identified as key social factors in the failure of any vaccination campaign. Possible interventions have been proposed, which include effectively using modern mass media and educating vaccinators on the social and cultural background of the target community. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Experiences from polio supplementary immunization activities in ...

    African Journals Online (AJOL)

    2014-05-31

    May 31, 2014 ... immunization was low. Adopting proper planning and supervision, financial and political support, community involvement, improved vaccine logistics, and other measures utilized during the SIAs could help to improve routine immunization. Key words: Community involvement/participation, polio eradication, ...

  17. Drug combinations against Borrelia burgdorferi persisters in vitro: eradication achieved by using daptomycin, cefoperazone and doxycycline.

    Directory of Open Access Journals (Sweden)

    Jie Feng

    Full Text Available Although most Lyme disease patients can be cured with antibiotics doxycycline or amoxicillin using 2-4 week treatment durations, some patients suffer from persistent arthritis or post-treatment Lyme disease syndrome. Why these phenomena occur is unclear, but possibilities include host responses, antigenic debris, or B. burgdorferi organisms remaining despite antibiotic therapy. In vitro, B. burgdorferi developed increasing antibiotic tolerance as morphology changed from typical spirochetal form in log phase growth to variant round body and microcolony forms in stationary phase. B. burgdorferi appeared to have higher persister frequencies than E. coli as a control as measured by SYBR Green I/propidium iodide (PI viability stain and microscope counting. To more effectively eradicate the different persister forms tolerant to doxycycline or amoxicillin, drug combinations were studied using previously identified drugs from an FDA-approved drug library with high activity against such persisters. Using a SYBR Green/PI viability assay, daptomycin-containing drug combinations were the most effective. Of studied drugs, daptomycin was the common element in the most active regimens when combined with doxycycline plus either beta-lactams (cefoperazone or carbenicillin or an energy inhibitor (clofazimine. Daptomycin plus doxycycline and cefoperazone eradicated the most resistant microcolony form of B. burgdorferi persisters and did not yield viable spirochetes upon subculturing, suggesting durable killing that was not achieved by any other two or three drug combinations. These findings may have implications for improved treatment of Lyme disease, if persistent organisms or detritus are responsible for symptoms that do not resolve with conventional therapy. Further studies are needed to validate whether such combination antimicrobial approaches are useful in animal models and human infection.

  18. Drug combinations against Borrelia burgdorferi persisters in vitro: eradication achieved by using daptomycin, cefoperazone and doxycycline.

    Science.gov (United States)

    Feng, Jie; Auwaerter, Paul G; Zhang, Ying

    2015-01-01

    Although most Lyme disease patients can be cured with antibiotics doxycycline or amoxicillin using 2-4 week treatment durations, some patients suffer from persistent arthritis or post-treatment Lyme disease syndrome. Why these phenomena occur is unclear, but possibilities include host responses, antigenic debris, or B. burgdorferi organisms remaining despite antibiotic therapy. In vitro, B. burgdorferi developed increasing antibiotic tolerance as morphology changed from typical spirochetal form in log phase growth to variant round body and microcolony forms in stationary phase. B. burgdorferi appeared to have higher persister frequencies than E. coli as a control as measured by SYBR Green I/propidium iodide (PI) viability stain and microscope counting. To more effectively eradicate the different persister forms tolerant to doxycycline or amoxicillin, drug combinations were studied using previously identified drugs from an FDA-approved drug library with high activity against such persisters. Using a SYBR Green/PI viability assay, daptomycin-containing drug combinations were the most effective. Of studied drugs, daptomycin was the common element in the most active regimens when combined with doxycycline plus either beta-lactams (cefoperazone or carbenicillin) or an energy inhibitor (clofazimine). Daptomycin plus doxycycline and cefoperazone eradicated the most resistant microcolony form of B. burgdorferi persisters and did not yield viable spirochetes upon subculturing, suggesting durable killing that was not achieved by any other two or three drug combinations. These findings may have implications for improved treatment of Lyme disease, if persistent organisms or detritus are responsible for symptoms that do not resolve with conventional therapy. Further studies are needed to validate whether such combination antimicrobial approaches are useful in animal models and human infection.

  19. Lessons Learned From Managing the Planning and Implementation of Inactivated Polio Vaccine Introduction in Support of the Polio Endgame.

    Science.gov (United States)

    Zipursky, Simona; Patel, Manish; Farrell, Margaret; Gonzalez, Alejandro Ramirez; Kachra, Tasleem; Folly, Yann; Kurji, Feyrouz; Veira, Chantal Laroche; Wootton, Emily; Hampton, Lee M

    2017-07-01

    The Immunization Systems Management Group (IMG) was established as a time-limited entity, responsible for the management and coordination of Objective 2 of the Polio Eradication and Endgame Strategic Plan. This objective called for the introduction of at least 1 dose of inactivated polio vaccine (IPV) into the routine immunization programs of all countries using oral polio vaccine (OPV) only. Despite global vaccine shortages, which limited countries' abilities to access IPV in a timely manner, 105 of 126 countries using OPV only introduced IPV within a 2.5-year period, making it the fastest rollout of a new vaccine in history. This achievement can be attributed to several factors, including the coordination work of the IMG; high-level engagement and advocacy across partners; the strong foundations of the Expanded Programme on Immunization at all levels; Gavi, the Vaccine Alliance's vaccine introduction experiences and mechanisms; innovative approaches; and proactive communications. In many ways, the IMG's work on IPV introduction can serve as a model for other vaccine introductions, especially in an accelerated context. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  20. Polio Endgame, Information Gaps Related to Vaccines and Immunity.

    Science.gov (United States)

    Ahmad, Mohammad; Bahl, Sunil; Kunwar, Abhishek

    2016-08-07

    Evidence generated through research studies has guided programmatic actions and fine-tuned strategies for the Global Polio Eradication Initiative (GPEI). However, many gaps still persist in the understanding of a risk-free implementation of the polio endgame. Immediate concerns relate to the introduction of inactivated polio vaccine (IPV) and switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV) in routine immunization schedule. A comprehensive understanding of mucosal immunity in populations and best response options against circulating vaccine derived poliovirus (cVDPV) outbreaks in post tOPV-bOPV switch is essential to mitigate the risks of wild and vaccine-derived poliovirus importations and emergence of cVDPVs in polio-free countries. A clearer picture is also needed on few operational issues, interference between polio vaccines and other EPI vaccines and products related to polio endgame. It is also extremely important to develop mechanisms to identify and manage long-term poliovirus excretors who may pose a risk of reintroduction into the population after global eradication of poliovirus.

  1. The Journalists Initiatives on Immunisation Against Polio and Improved Acceptance of the Polio Vaccine in Northern Nigeria 2007-2015.

    Science.gov (United States)

    Warigon, Charity; Mkanda, Pascal; Banda, Richard; Zakari, Furera; Damisa, Eunice; Idowu, Audu; Bawa, Samuel; Gali, Emmanuel; Tegegne, Sisay G; Hammanyero, Kulchumi; Nsubuga, Peter; Korir, Charles; Vaz, Rui G

    2016-05-01

    The polio eradication initiative had major setbacks in 2003 and 2007 due to media campaigns in which renowned scholars and Islamic clerics criticized polio vaccines. The World Health Organization (WHO) partnered with journalists in 2007 to form the Journalists Initiatives on Immunisation Against Polio (JAP), to develop communication initiatives aimed at highlighting polio eradication activities and the importance of immunization in northern Nigeria. We evaluated the impact of JAP activities in Kaduna State by determining the total number of media materials produced and the number of newspaper clips and bulletins published in support of polio eradication. We also determined the number of households in noncompliant communities that became compliant with vaccination during 2015 supplementary immunization activities (SIAs) after JAP interventions and compared caregivers' sources of information about SIAs in 2007 before and after the JAP was formed. Since creation of the JAP, >500 reports have been published and aired, with most portraying polio vaccine positively. During June 2015 SIAs in high-risk wards of Kaduna STATE, JAP interventions resulted in vaccination of 5122 of 5991 children (85.5%) from noncompliant households. During early 2007, the number of caregivers who had heard about SIA rounds from the media increased from 26% in January, before the JAP was formed, to 33% in March, after the initiation of JAP activities. The formation of the JAP resulted in measurable improvement in the acceptance of polio vaccine in northern Nigeria. © 2016 World Health Organization; licensee Oxford Journals.

  2. Current Status and Future Prospects to Achieve Foot-and-Mouth Disease Eradication in South America.

    Science.gov (United States)

    Clavijo, A; Sanchez-Vazquez, M J; Buzanovsky, L P; Martini, M; Pompei, J C; Cosivi, O

    2017-02-01

    South America has a favourable position with respect to foot-and-mouth disease (FMD) compared with other FMD-affected regions due to the elimination of endemic clinical presentation of the disease. South America has reached the final stage of control and aims to eradicate the disease in the region under the provisions of the Hemispheric Program for the Eradication of FMD 2011-2020 (PHEFA). This programme aims at bringing eradication to completion, thereby eliminating the pool of foot-and-mouth disease genotypes active in South America. This plan includes a regional political agreement that provides strategies and technical guidelines for the eradication of foot-and-mouth disease from South America. It incorporates knowledge and experience regarding the disease's history and its connection with the different production systems, animal movement and trade. The Pan American Foot and Mouth Disease Center has led the control and eradication programmes, providing the framework for designing national and subregional programmes that have led to significant progress in controlling the disease in South America. The current situation is the result of several factors, including the proper implementation of a national control programmes, good veterinary infrastructure in most countries and public-private participation in the process of eradicating the disease. Notwithstanding the favourable health status, there are significant challenges for the goal of eradication. At this stage, South American countries should enhance their surveillance strategies particularly through the use of target or risk-based surveys that contribute to increase the degree of sensitivity in the search for viral circulation in the context of absence of clinical occurrence of FMD. © 2015 Blackwell Verlag GmbH.

  3. Non-Polio Enterovirus

    Science.gov (United States)

    ... Photos Related Links Water-related Hygiene Viral Conjunctivitis Hand, Foot, and Mouth Disease Viral Meningitis What is Polio? About Non-Polio ... illness... Related Links Water-related Hygiene Viral Conjunctivitis Hand, Foot, and Mouth Disease Viral Meningitis What is Polio? File Formats Help: ...

  4. Estimating the risk of re-emergence after stopping polio vaccination

    Directory of Open Access Journals (Sweden)

    Akira eSasaki

    2012-05-01

    Full Text Available Live vaccination against polio has effectively prevented outbreaks in most developed countries for more than 40 years, and there remain only a few countries where outbreaks of poliomyelitis by the wild strain still threaten the community. It is expected that worldwide eradication will be eventually achieved through careful surveillance and a well-managed immunization program. The present paper argues, however, that based on a simple stochastic model the risk of outbreak by a vaccine-derived strain after the cessation of vaccination is quite high, even if many years have passed since the last confirmed case. As vaccinated hosts are natural reservoirs for virulent poliovirus, the source of the risk is the vaccination itself, employed to prevent the outbreaks. The crisis after stopping vaccination will emerge when the following two conditions are met: the susceptible host density exceeds the threshold for epidemics and the vaccinated host density remains large enough to ensure the occurrence of virulent mutants in the population. Our estimates for transmission, recovery, and mutation rates, show that the probability of an outbreak of vaccine-derived virulent viruses easily exceeds 90%. Moreover, if a small fraction of hosts have a longer infectious period, as observed in individuals with innate immunodeficiency, the risk of an outbreak rises significantly. Under such conditions, successful global eradication of polio is restricted to a certain range of parameters even if inactive polio vaccine (IPV is extensively used after the termination of live vaccination.

  5. Living with polio and postpolio syndrome in the United Kingdom.

    Science.gov (United States)

    Atwal, Anita; Giles, Amy; Spiliotopoulou, Georgia; Plastow, Nicola; Wilson, Lesley

    2013-06-01

    The term Postpolio Syndrome (PPS) is used to describe new and late manifestations of poliomyelitis that occur later in life in polio survivors. Polio had been eradicated in the United Kingdom (UK) and most of Europe, although this is not the case in all countries. Research in this area has tended to focus upon the impact of polio and PPS on health status and functional health rather than its overall effect on people's lives. This study's two main aims were to explore the ways in which polio and PPS in the UK has affected the respondents' lives and to ascertain their views about how the quality of life could be improved. The two questions were as follows: (1) How has the health of people with polio and PPS affected their quality of life? (2) What would people with polio and PPS change to improve their quality of life? Deductive content analysis using existing qualitative data from a cross-sectional survey of 336 returned questionnaires from persons with polio and PPS was carried out. The average age of the participants was 54 years. Our research found that polio survivors valued social occupations and participation in family life. Our research has also shown that healthcare professionals still do not understand polio and PPS and this lack of understanding influences their clients' quality of life. Finances and accessibility of environments also influence participation in chosen occupations. Rehabilitation programmes for people with polio and PPS need to be targeted towards maintaining and improving accessible environments and participation in chosen occupations, and healthcare professionals need to ensure that persons with polio and PPS are referred to persons with specific expertise in this area. © 2012 Nordic College of Caring Science.

  6. Smallpox and polio eradication in India: comparative histories and lessons for contemporary policy Erradicação da varíola e da pólio na Índia: histórias comparativas e lições para políticas contemporâneas

    Directory of Open Access Journals (Sweden)

    Sanjoy Bhattacharya

    2011-02-01

    Full Text Available This article argues that a detailed examination of factors contributing to the development of complex structures and strategies for smallpox eradication in South Asia in the 1970s can provide fruitful indications for the reformulation of the national chapters of the global polio eradication programme in this region. There is a magnificent archive in the WHO's Geneva offices, which details how smallpox eradication outbreaks were located and then contained in cities, small towns and remote rural areas in this region, by teams of international workers working closely with local officials. A systematic assessment of the global smallpox eradication efforts indicates parallels between the early stages of the global smallpox eradication programme and the present situation of the polio campaign; as we will see here, it can also provide useful indicators for future action in South Asia and beyond.O artigo argumenta que um exame detalhado dos fatores que contribuíram para o desenvolvimento de estruturas e estratégias complexas para a erradicação da varíola no Sul da Ásia nos anos 70 pode fornecer indicações proveitosas para a reformulação dos capítulos nacionais do programa global de erradicação da pólio nesta região. Existe um impressionante arquivo nos escritórios da OMS em Genebra que detalha como os ataques para a erradicação da varíola foram localizados e então contidos em cidades, pequenas vilas e áreas rurais remotas desta região, por equipes de profissionais internacionais trabalhando em conjunto com as autoridades locais. Uma avaliação sistemática dos esforços globais de erradicação da varíola indicam paralelos entre os estágios iniciais do programa global de erradicação da varíola e a atual situação da campanha contra a pólio. Como veremos aqui, o artigo também pode fornecer indicadores úteis para ações futuras no Sul da Ásia e em outros locais.

  7. Biological feasibility of measles eradication.

    Science.gov (United States)

    Bellini, William J; Rota, Paul A

    2011-12-01

    Because of the success of global measles control programs, the World Health Organization (WHO), along with its partner agencies, is once again considering the possibility of setting a target date for measles eradication. Measles would be the fourth viral agent to be eradicated joining the successful programs to eradicate smallpox and rinderpest virus, and the continuing effort to eradicate polio virus. A description of the recent progress toward measles eradication was recently published as a supplement in the Journal of Infectious Diseases (15 July, 2011, 204 (Suppl. 1)) and the reader is referred to this document for a detailed summary of the global status of measles control. This review will focus on the biologic and virologic aspects of measles eradication. Published by Elsevier B.V.

  8. Addressing the Challenges and Opportunities of the Polio Endgame: Lessons for the Future.

    Science.gov (United States)

    Patel, Manish; Cochi, Stephen

    2017-07-01

    The Global Commission for the Certification of the Eradication of Poliomyelitis certified the eradication of type 2 poliovirus in September 2015, making type 2 poliovirus the first human pathogen to be eradicated since smallpox. The eradication of type 2 poliovirus, the absence of detection of type 3 poliovirus worldwide since November 2012, and cornering type 1 poliovirus to only a few geographic areas of 3 countries has enabled implementation of the endgame of polio eradication which calls for a phased withdrawal of oral polio vaccine beginning with the type 2 component, introduction of inactivated poliovirus vaccine, strengthening of routine immunization in countries with extensive polio resources, and initiating activities to transition polio resources, program experience, and lessons learned to other global health initiatives. This supplement focuses on efforts by global partners to successfully launch polio endgame activities to permanently secure and sustain the enormous gains of polio eradication forever. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  9. The polio endgame: rationale behind the change in immunisation.

    Science.gov (United States)

    Garon, Julie; Patel, Manish

    2017-04-01

    The decades long effort to eradicate polio is nearing the final stages and oral polio vaccine (OPV) is much to thank for this success. As cases of wild poliovirus continue to dwindle, cases of paralysis associated with OPV itself have become a concern. As type-2 poliovirus (one of three) has been certified eradicated and a large proportion of OPV-related paralysis is caused by the type-2 component of OPV, the World Health Assembly endorsed the phased withdrawal of OPV and the introduction of inactivated polio vaccine (IPV) into routine immunisation schedules as a crucial step in the polio endgame plan. The rapid pace of IPV scale-up and uptake required adequate supply, planning, advocacy, training and operational readiness. Similarly, the synchronised switch from trivalent OPV (all three types) to bivalent OPV (types 1 and 3) involved an unprecedented level of global coordination and country commitment. The important shift in vaccination policy seen through global IPV introduction and OPV withdrawal represents an historical milestone reached in the polio eradication effort. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. An optimized clarithromycin-free 14-day triple therapy for Helicobacter pylori eradication achieves high cure rates in Uruguay.

    Science.gov (United States)

    Dacoll, Cristina; Sánchez-Delgado, Jordi; Balter, Henia; Pazos, Ximena; Di Pace, María; Sandoya, Gabriela; Cohen, Henry; Calvet, Xavier

    Strong acid inhibition increases cure rates with triple therapy and 14-day are more effective than 7-day treatments. The combination of amoxicillin plus metronidazole at full doses has been shown to overcome metronidazole resistance and to achieve good eradication rates even in patients harboring resistant strains. No previous studies have been reported in Latin-America with this optimized triple-therapy scheme. The aim of the present study was to assess the eradication rate and tolerance of a new first-line treatment regimen associating strong acid inhibition, amoxicillin and metronidazole. Patients from the Clínica de Gastroenterología of the Hospital de Clínicas (Montevideo, Uruguay) were included. Hp status was mainly assessed by at least one of the following: histologyor urea breath test (UBT). A 14-day treatment was prescribed comprising esomeprazole 40mg twice a day plus amoxicillin 1g and metronidazole 500mg, both three times a day. H. pylori cure was assessed by UBT. Forty-one patients were enrolled. Mean age was 53.3±13 years and 17.1% of patients were male. Main indications for treatment were: functional dyspepsia (27.5%), gastritis (45%), gastric or duodenal erosions (20%), gastric ulcer (5%) and intestinal metaplasia (2.5%). H. pylori eradication was achieved in 33 of the 37 patients who returned for follow-up. Eradication rates were 80.5% (95% CI: 68.4-92.6) by intention-to-treat (ITT) analysis and 89.2% (95% CI; 79.2-99.2) per protocol (PP). No major side effects were reported; 26 patients (65.8%) complained of mild side effects (nausea, diarrhea and headache). Cure rates of this triple therapy including esomeprazole, amoxicillin and metronidazole were 81% per ITT and the treatment was well tolerated. These optimal results with a simple clarithromycin-free triple therapy are better than described for standard triple therapy but there is still room for improvement to reach the desired target of 90% per ITT. Copyright © 2017 Elsevier España, S

  11. Implementing the Synchronized Global Switch from Trivalent to Bivalent Oral Polio Vaccines-Lessons Learned From the Global Perspective.

    Science.gov (United States)

    Ramirez Gonzalez, Alejandro; Farrell, Margaret; Menning, Lisa; Garon, Julie; Everts, Hans; Hampton, Lee M; Dolan, Samantha B; Shendale, Stephanie; Wanyoike, Sarah; Veira, Chantal Laroche; Châtellier, Gaël Maufras du; Kurji, Feyrouz; Rubin, Jennifer; Boualam, Liliane; Chang Blanc, Diana; Patel, Manish

    2017-07-01

    In 2015, the Global Commission for the Certification of Polio Eradication certified the eradication of type 2 wild poliovirus, 1 of 3 wild poliovirus serotypes causing paralytic polio since the beginning of recorded history. This milestone was one of the key criteria prompting the Global Polio Eradication Initiative to begin withdrawal of oral polio vaccines (OPV), beginning with the type 2 component (OPV2), through a globally synchronized initiative in April and May 2016 that called for all OPV using countries and territories to simultaneously switch from use of trivalent OPV (tOPV; containing types 1, 2, and 3 poliovirus) to bivalent OPV (bOPV; containing types 1 and 3 poliovirus), thus withdrawing OPV2. Before the switch, immunization programs globally had been using approximately 2 billion tOPV doses per year to immunize hundreds of millions of children. Thus, the globally synchronized withdrawal of tOPV was an unprecedented achievement in immunization and was part of a crucial strategy for containment of polioviruses. Successful implementation of the switch called for intense global coordination during 2015-2016 on an unprecedented scale among global public health technical agencies and donors, vaccine manufacturers, regulatory agencies, World Health Organization (WHO) and United Nations Children's Fund (UNICEF) regional offices, and national governments. Priority activities included cessation of tOPV production and shipment, national inventories of tOPV, detailed forecasting of tOPV needs, bOPV licensing, scaling up of bOPV production and procurement, developing national operational switch plans, securing funding, establishing oversight and implementation committees and teams, training logisticians and health workers, fostering advocacy and communications, establishing monitoring and validation structures, and implementing waste management strategies. The WHO received confirmation that, by mid May 2016, all 155 countries and territories that had used OPV in

  12. Rapid assessment as an evaluation tool for polio national ...

    African Journals Online (AJOL)

    ... timely intervention in covering missed children and helps in careful interpretation of the usual over 100% coverage often recorded during NIDs. It is recommended that this be practiced widely to improve quality of NIDs for early global eradication of poliomyelitis. Keywords: rapid assessment, evaluation, polio immunization

  13. Reducing resistance to polio immunisation with free health camps and Bluetooth messaging: An update from Kaduna, Northern, Nigeria.

    Science.gov (United States)

    Birukila, Gerida; Babale, Sufiyan M; Epstein, Helen; Gugong, Victor; Anger, Robert; Corkum, Melissa; Jehoshaphat Nebanat, Albarka; Musoke, Fredrick; Alabi, Olaniran

    2017-01-01

    Since 1997, the Global Polio Eradication Initiative has sponsored regular door-to-door polio immunisation campaigns in northern Nigeria. On 30 July 2015, the country was finally declared poliofree, a hard won success. At various times, polio eradication has been threatened by rumours and community tensions. For example, in 2003, local Imams, traditional leaders and politicians declared a polio campaign boycott, due to the concerns about the safety of the polio vaccine. Although the campaigns resumed in 2004, many parents continued to refuse vaccination because of the persistence of rumours of vaccine contamination, and anger about the poor state of health services for conditions other than polio. To address this, UNICEF and Nigerian Government partners piloted two interventions: (1) mobile 'health camps' to provide ambulatory care for conditions other than polio and (2) an audiovisual clip about vaccine safety and other health issues, shareable on multimedia mobile phones via Bluetooth pairing. The mobile phone survey found that Bluetooth compatible messages could rapidly spread behavioural health messages in low-literacy communities. The health camps roughly doubled polio vaccine uptake in the urban ward where it was piloted. This suggests that polio eradication would have been accelerated by improving primary health care services.

  14. ORIGINAL ARTICLES Eradication of disease -— the case study of ...

    African Journals Online (AJOL)

    Launched in October 1988 by the 41st World Health. Assembly (WHA Resolution 41.28), the Global Polio. Eradication Initiative aimed to eradicate poliomyelitis from the planet by the year 2000' It is the largest international public health initiative ever undertaken, costing several billion dollars and immunising billions of ...

  15. Knowledge, attitudes and perceptions towards polio immunization among residents of two highly affected regions of Pakistan.

    Science.gov (United States)

    Khan, Muhammad Umair; Ahmad, Akram; Aqeel, Talieha; Salman, Saad; Ibrahim, Qamer; Idrees, Jawaria; Khan, Muhammad Ubaid

    2015-11-05

    Despite the efforts of national and international organizations, polio has not been eradicated from Pakistan. The prevalence of polio in Pakistan is exceptional in global context. Quetta and Peshawar divisions are amongst the most affected regions hit by polio in Pakistan. This study was carried out to assess the knowledge, attitudes and perceptions towards polio immunization among residents of Quetta and Peshawar divisions in Pakistan. A descriptive, cross-sectional study involving 768 participants was conducted from August to December, 2014 in Quetta and Peshawar divisions in Pakistan. Multistage sampling technique was used to draw a sample of residents from each division. A pre-tested, self-administered questionnaire was used to collect the data from eligible participants. Descriptive and logistic regression analyses were used to express the results. A total of 38.8 % participants exhibited good knowledge about polio. Mean knowledge score of the participants was 7.35 ± 2.54 (based on 15 knowledge questions). Older age (p attitudes towards polio immunization (84.8 %), with a mean score of 19.19 ± 2.39 (based on 8 attitude statements). Lack of education (p attitudes of participants towards polio immunization. False religious beliefs (39.06 %), lack of knowledge (33.7 %), fear of infertility by polio vaccines (32.16 %) and security issues (29.42 %) were reported by the participants as the main barriers towards polio immunization. The findings of this study showed poor knowledge and negative attitudes of participants towards polio immunizations. Religious beliefs and lack of knowledge about polio immunization were reported as the major barriers towards polio immunization.

  16. Polio Endgame: Lessons Learned From the Immunization Systems Management Group.

    Science.gov (United States)

    Zipursky, Simona; Vandelaer, Jos; Brooks, Alan; Dietz, Vance; Kachra, Tasleem; Farrell, Margaret; Ottosen, Ann; Sever, John L; Zaffran, Michel J

    2017-07-01

    The Immunization Systems Management Group (IMG) was established to coordinate and oversee objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018, namely, (1) introduction of ≥1 dose of inactivated poliovirus vaccine in all 126 countries using oral poliovirus vaccine (OPV) only as of 2012, (2) full withdrawal of OPV, starting with the withdrawal of its type 2 component, and (3) using polio assets to strengthen immunization systems in 10 priority countries. The IMG's inclusive, transparent, and partnership-focused approach proved an effective means of leveraging the comparative and complementary strengths of each IMG member agency. This article outlines 10 key factors behind the IMG's success, providing a potential set of guiding principles for the establishment and implementation of other interagency collaborations and initiatives beyond the polio sphere. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  17. Response to a Large Polio Outbreak in a Setting of Conflict - Middle East, 2013-2015.

    Science.gov (United States)

    Mbaeyi, Chukwuma; Ryan, Michael J; Smith, Philip; Mahamud, Abdirahman; Farag, Noha; Haithami, Salah; Sharaf, Magdi; Jorba, Jaume C; Ehrhardt, Derek

    2017-03-03

    As the world advances toward the eradication of polio, outbreaks of wild poliovirus (WPV) in polio-free regions pose a substantial risk to the timeline for global eradication. Countries and regions experiencing active conflict, chronic insecurity, and large-scale displacement of persons are particularly vulnerable to outbreaks because of the disruption of health care and immunization services (1). A polio outbreak occurred in the Middle East, beginning in Syria in 2013 with subsequent spread to Iraq (2). The outbreak occurred 2 years after the onset of the Syrian civil war, resulted in 38 cases, and was the first time WPV was detected in Syria in approximately a decade (3,4). The national governments of eight countries designated the outbreak a public health emergency and collaborated with partners in the Global Polio Eradication Initiative (GPEI) to develop a multiphase outbreak response plan focused on improving the quality of acute flaccid paralysis (AFP) surveillance* and administering polio vaccines to >27 million children during multiple rounds of supplementary immunization activities (SIAs).(†) Successful implementation of the response plan led to containment and interruption of the outbreak within 6 months of its identification. The concerted approach adopted in response to this outbreak could serve as a model for responding to polio outbreaks in settings of conflict and political instability.

  18. Intranasal and sublingual delivery of inactivated polio vaccine.

    Science.gov (United States)

    Kraan, Heleen; Soema, Peter; Amorij, Jean-Pierre; Kersten, Gideon

    2017-05-09

    Polio is on the brink of eradication. Improved inactivated polio vaccines (IPV) are needed towards complete eradication and for the use in the period thereafter. Vaccination via mucosal surfaces has important potential advantages over intramuscular injection using conventional needle and syringe, the currently used delivery method for IPV. One of them is the ability to induce both serum and mucosal immune responses: the latter may provide protection at the port of virus entry. The current study evaluated the possibilities of polio vaccination via mucosal surfaces using IPV based on attenuated Sabin strains. Mice received three immunizations with trivalent sIPV via intramuscular injection, or via the intranasal or sublingual route. The need of an adjuvant for the mucosal routes was investigated as well, by testing sIPV in combination with the mucosal adjuvant cholera toxin. Both intranasal and sublingual sIPV immunization induced systemic polio-specific serum IgG in mice that were functional as measured by poliovirus neutralization. Intranasal administration of sIPV plus adjuvant induced significant higher systemic poliovirus type 3 neutralizing antibody titers than sIPV delivered via the intramuscular route. Moreover, mucosal sIPV delivery elicited polio-specific IgA titers at different mucosal sites (IgA in saliva, fecal extracts and intestinal tissue) and IgA-producing B-cells in the spleen, where conventional intramuscular vaccination was unable to do so. However, it is likely that a mucosal adjuvant is required for sublingual vaccination. Further research on polio vaccination via sublingual mucosal route should include the search for safe and effective adjuvants, and the development of novel oral dosage forms that improve antigen uptake by oral mucosa, thereby increasing vaccine immunogenicity. This study indicates that both the intranasal and sublingual routes might be valuable approaches for use in routine vaccination or outbreak control in the period after

  19. Defining Polio: Closing the Gap in Global Surveillance.

    Science.gov (United States)

    Tajaldin, Bachir; Almilaji, Khaled; Langton, Paul; Sparrow, Annie

    2015-01-01

    By late 2012 the Global Polio Eradication Initiative (GPEI) had nearly eradicated this ancient infectious disease. Successful surveillance programs for acute flaccid paralysis however rely on broad governmental support for implementation. With the onset of conflict, public health breakdown has contributed to the resurgence of polio in a number of regions. The current laboratory based case definition may be a contributory factor in these regions. We sought to compare case definition rates using strict laboratory based criteria to rates obtained using the clinical criteria in modern day Syria. We also sought to examine this distribution of cases by sub-region. We examined the World Health Organization (WHO) reported figures for Syria from 2013-2014 using laboratory based criteria. We compared these with cases obtained when clinical criteria were applied. In addition we sought data from the opposition controlled Assistance Coordination Unit which operates in non-Government controlled areas where WHO data maybe incomplete. Cases were carefully examined for potential overlap to avoid double reporting. Whilst the WHO data clearly confirmed the polio outbreak in Syria, it did so with considerable delay and with under reporting of cases, particularly from non-government controlled areas. In addition, laboratory based case definition led to a substantial underestimate of polio (36 cases) compared with those found with the clinically compatible definition (an additional 46 cases). Rates of adequate diagnostic specimens from suspected cases are well below target, no doubt reflecting the effect of conflict in these areas. We have identified a gap in the surveillance of polio, a global threat. The current laboratory based definition, in the setting of conflict and insecurity, leads to under diagnosis of polio with potential delays and inadequacies in coordinating effective responses to contain outbreaks and eradicate polio. Breakdown in public health measures as a contributing

  20. Ten-day Quadruple therapy comprising proton-pump inhibitor, bismuth, tetracycline, and levofloxacin achieves a high eradication rate for Helicobacter pylori infection after failure of sequential therapy.

    Science.gov (United States)

    Hsu, Ping-I; Chen, Wen-Chi; Tsay, Feng-Woei; Shih, Chih-An; Kao, Sung-Shuo; Wang, Huay-Min; Yu, Hsien-Chung; Lai, Kwok-Hung; Tseng, Hui-Hwa; Peng, Nan-Jing; Chen, Angela; Kuo, Chao-Hung; Wu, Deng-Chyang

    2014-02-01

    Sequential therapy has been recommended in the Maastricht IV/Florence Consensus Report as the first-line treatment for Helicobacter pylori eradication in regions with high clarithromycin resistance. However, it fails in 5-24% of infected subjects, and the recommended levofloxacin-containing triple rescue therapy only achieves a 77% eradication rate after failure of sequential therapy. To investigate the efficacy of a novel quadruple therapy comprising proton-pump inhibitor, bismuth, tetracycline, and levofloxacin for rescue treatment of sequential therapy. This was a multicenter study in which H. pylori-infected patients who had failed sequential therapy received a 10-day quadruple therapy (esomeprazole (40 mg b.d), tripotassium dicitrato bismuthate (120 mg q.d.s.), tetracycline (500 mg q.d.s.), and levofloxacin (500 mg o.d.) for 10 days). H. pylori status was examined 6 weeks after the end of treatment. From July 2007 to June 2012, twenty-four subjects received 10-day quadruple therapy. The eradication rates according to intention-to-treat and per-protocol analyses were both 95.8% (23 of 24; 95% confidence interval, 87.8-103.8%). Adverse events were seen in 25.0% (6 of 24) of the patients. Drug compliance was 100.0% (24/24). The 10-day quadruple therapy comprising proton-pump inhibitor, bismuth, tetracycline, and levofloxacin achieves a very high eradication rate for H. pylori infection after failure of sequential therapy. It is well tolerated and has great potential to become a good choice of rescue treatment following non-bismuth-containing quadruple therapy in regions with high clarithromycin resistance. © 2013 John Wiley & Sons Ltd.

  1. Experiences from polio supplementary immunization activities in ...

    African Journals Online (AJOL)

    The proportion of zero‑dose children decreased from 6% to 4.7%, and the vaccine wastage rate ranged from 6% to 6.6%. In that same year, the state did not achieve the target coverage of >80% for routine oral polio vaccine (OPV3) immunization in any of the months and only 29% of the LGAs exceeded the routine OPV3 ...

  2. Breaking community barriers to polio vaccination in Northern Nigeria: the impact of a grass roots mobilization campaign (Majigi).

    Science.gov (United States)

    Nasiru, Sani-Gwarzo; Aliyu, Gambo G; Gasasira, Alex; Aliyu, Muktar H; Zubair, Mahmud; Mandawari, Sunusi U; Waziri, Hassana; Nasidi, Abdulsalami; El-Kamary, Samer S

    2012-07-01

    This paper examines the impact of a community-based intervention on the trends in the uptake of polio vaccination following a community mobilization campaign for polio eradication in northern Nigeria. Uptake of polio vaccination in high-risk communities in this region has been considerably low despite routine and supplemental vaccination activities. Large numbers of children are left unvaccinated because of community misconceptions and distrust regarding the cause of the disease and the safety of the polio vaccine. The Majigi polio campaign was initiated in 2008 as a pilot trial in Gezawa, a local council with very low uptake of polio vaccination. The average monthly increase in the number of vaccinated children over the subsequent six months after the pilot trial was 1,047 [95% confidence interval (CI): 647-2045, P = 0·001]. An increasing trend in uptake of polio vaccination was also evident (P = 0·001). The outcome was consistent with a decrease or no trend in the detection of children with zero doses. The average monthly decrease in the number of children with zero doses was 6·2 (95% CI: -21 to 24, P = 0·353). Overall, there was a relative increase of approximately 310% in the polio vaccination uptake and a net reduction of 29% of never vaccinated children. The findings of this pilot test show that polio vaccination uptake can be enhanced by programs like Majigi that promote effective communication with the community.

  3. Polio, terror and the immunological worldview.

    Science.gov (United States)

    Peckham, Robert

    2016-07-22

    This paper adopts a socio-historical perspective to explore when, how and why the eradication of poliomyelitis has become politicised to the extent that health workers and security personnel are targeted in drive-by shootings. Discussions of the polio crisis in Afghanistan and Pakistan have tended to focus on Taliban suspicions of a US-led public health intervention and the denunciation of 'modernity' by Islamic 'extremists'. In contrast, this paper considers a broader history of indigenous hostility and resistance to colonial immunisation on the subcontinent, suggesting how interconnected public health and political crises today have reactivated the past and created a continuity between events. The paper explores how the biomedical threat posed by polio has become intertwined with military and governmental discourses premised on the 'preemptive strike'. Here, the paper tracks the connections between biological immunity and a postcolonial politics that posits an immunological rationale for politico-military interventions. The paper concludes by reflecting on the consequences for global public health of this entanglement of infectious disease with terror.

  4. Between East and West: polio vaccination across the Iron Curtain in Cold War Hungary.

    Science.gov (United States)

    Vargha, Dora

    2014-01-01

    In 1950s Hungary, with an economy and infrastructure still devastated from World War II and facing further hardships, thousands of children became permanently disabled and many died in the severe polio epidemic that shook the globe. The relatively new communist regime invested significantly in solving the public health crisis, initially importing a vaccine from the West and later turning to the East for a new solution. Through the history of polio vaccination in Hungary, this article shows how Cold War politics shaped vaccine evaluation and implementation in the 1950s. On the one hand, the threat of polio created a safe place for hitherto unprecedented, open cooperation among governments and scientific communities on the two sides of the Iron Curtain. On the other hand, Cold War rhetoric influenced scientific evaluation of vaccines, choices of disease prevention, and ultimately the eradication of polio.

  5. Applying the Concept of Peptide Uniqueness to Anti-Polio Vaccination

    Directory of Open Access Journals (Sweden)

    Darja Kanduc

    2015-01-01

    Full Text Available Background. Although rare, adverse events may associate with anti-poliovirus vaccination thus possibly hampering global polio eradication worldwide. Objective. To design peptide-based anti-polio vaccines exempt from potential cross-reactivity risks and possibly able to reduce rare potential adverse events such as the postvaccine paralytic poliomyelitis due to the tendency of the poliovirus genome to mutate. Methods. Proteins from poliovirus type 1, strain Mahoney, were analyzed for amino acid sequence identity to the human proteome at the pentapeptide level, searching for sequences that (1 have zero percent of identity to human proteins, (2 are potentially endowed with an immunologic potential, and (3 are highly conserved among poliovirus strains. Results. Sequence analyses produced a set of consensus epitopic peptides potentially able to generate specific anti-polio immune responses exempt from cross-reactivity with the human host. Conclusion. Peptide sequences unique to poliovirus proteins and conserved among polio strains might help formulate a specific and universal anti-polio vaccine able to react with multiple viral strains and exempt from the burden of possible cross-reactions with human proteins. As an additional advantage, using a peptide-based vaccine instead of current anti-polio DNA vaccines would eliminate the rare post-polio poliomyelitis cases and other disabling symptoms that may appear following vaccination.

  6. Development of thermostable lyophilized inactivated polio vaccine.

    Science.gov (United States)

    Kraan, Heleen; van Herpen, Paul; Kersten, Gideon; Amorij, Jean-Pierre

    2014-10-01

    The aim of current study was to develop a dried inactivated polio vaccine (IPV) formulation with minimal loss during the drying process and improved stability when compared with the conventional liquid IPV. Extensive excipient screening was combined with the use of a Design of Experiment (DoE) approach in order to achieve optimal results with high probability. Although it was shown earlier that the lyophilization of a trivalent IPV while conserving its antigenicity is challenging, we were able to develop a formulation that showed minimal loss of potency during drying and subsequent storage at higher temperatures. This study showed the potential of a highly stable and safe lyophilized polio vaccine, which might be used in developing countries without the need of a cold-chain.

  7. Eradication and Current Status of Poliomyelitis in Pakistan: Ground Realities

    Directory of Open Access Journals (Sweden)

    Shazia Ghafoor

    2016-01-01

    Full Text Available Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan.

  8. Violence, insecurity, and the risk of polio: A systematic analysis.

    Science.gov (United States)

    Guarino, Kia; Voorman, Arend; Gasteen, Maxime; Stewart, Donte; Wenger, Jay

    2017-01-01

    Since the introduction of polio vaccines in the 1950's and 60's, eradication of poliovirus from the world has been technically feasible. Progress towards this goal, however, has been uneven and influenced by social and political factors that challenge the implementation of robust immunization programs. While violence and insecurity are often cited as barriers to eradication, current global risk models are largely based on virologic and immunologic indicators measured at national levels. In this manuscript, we quantify the relevance of indicators of violence and insecurity on the risk of polio spread. Using logistic regression models and public data sources, we evaluate the relationship between measures of violence and instability and the location of poliomyelitis cases between 2006 and 2015 at the country-level, both individually and after controlling for more proximal determinants of disease, such as nearby circulating poliovirus and vaccination rates. We found that increases in a country's Fragile States Index (FSI) and Global Peace Index (GPI), aggregate indicators of violence and instability, were associated with the occurrence of poliovirus cases in the subsequent year (pviolence and insecurity must be mediated through immunity and exposure to poliovirus, coarse measures of which are included in our model. This also implies that in our study, and in risk models in general, the interpretation depends on the quality and granularity of available data. National virologic and immunologic indicators understate the risk of poliovirus spread in areas with violence and insecurity, and the inclusion of such factors improves precision. In addition, the link between violence and incidence of disease highlights the broader challenge of implementing health interventions in conflict areas. We discuss practical implications of this work in understanding and measuring the risks to polio eradication and other global health initiatives, and the policy implications of the need to

  9. Polio eradication efforts in regions of geopolitical strife: the Boko ...

    African Journals Online (AJOL)

    , 24–48 hours apart, and arrival at the laboratory in "good" condition). .... veillance Performance in the Security-Challenged Nige- rian States of Adamawa, Borno, and Yobe During 2009-. 2014. The Journal of infectious diseases. 2015. 11.

  10. National immunisation days for polio eradication in Uganda: Did ...

    African Journals Online (AJOL)

    Objective: To analyse the effect of cards and of vitamin A supplementation on coverage for National Immunisation Days (NIDs). Design: A retrospective ecological study. Setting: A countrywide NIDs coverage before and after introduction of the NIDs cards and vitamin A supplementation in all districts of Uganda. Methods: ...

  11. Communications, Immunization, and Polio Vaccines: Lessons From a Global Perspective on Generating Political Will, Informing Decision-Making and Planning, and Engaging Local Support.

    Science.gov (United States)

    Menning, Lisa; Garg, Gaurav; Pokharel, Deepa; Thrush, Elizabeth; Farrell, Margaret; Kodio, Frederic Kunjbe; Veira, Chantal Laroche; Wanyoike, Sarah; Malik, Suleman; Patel, Manish; Rosenbauer, Oliver

    2017-07-01

    The requirements under objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018-to introduce at least 1 dose of inactivated poliomyelitis vaccine (IPV); withdraw oral poliomyelitis vaccine (OPV), starting with the type 2 component; and strengthen routine immunization programs-set an ambitious series of targets for countries. Effective implementation of IPV introduction and the switch from trivalent OPV (containing types 1, 2, and 3 poliovirus) to bivalent OPV (containing types 1 and 3 poliovirus) called for intense global communications and coordination on an unprecedented scale from 2014 to 2016, involving global public health technical agencies and donors, vaccine manufacturers, World Health Organization and United Nations Children's Fund regional offices, and national governments. At the outset, the new program requirements were perceived as challenging to communicate, difficult to understand, unrealistic in terms of timelines, and potentially infeasible for logistical implementation. In this context, a number of core areas of work for communications were established: (1) generating awareness and political commitment via global communications and advocacy; (2) informing national decision-making, planning, and implementation; and (3) in-country program communications and capacity building, to ensure acceptance of IPV and continued uptake of OPV. Central to the communications function in driving progress for objective 2 was its ability to generate a meaningful policy dialogue about polio vaccines and routine immunization at multiple levels. This included efforts to facilitate stakeholder engagement and ownership, strengthen coordination at all levels, and ensure an iterative process of feedback and learning. This article provides an overview of the global efforts and challenges in successfully implementing the communications activities to support objective 2. Lessons from the achievements by countries and partners will likely be drawn upon when

  12. Nonparalytic polio and postpolio syndrome.

    Science.gov (United States)

    Halstead, L S; Silver, J K

    2000-01-01

    We describe four cases of postpolio syndrome with typical histories, physical examination results, and electrodiagnostic evidence of extensive anterior horn cell disease, as well as the putative pathophysiology of postpolio syndrome in persons with histories of nonparalytic polio and the diagnostic implications for individuals older than 40 yr of age who are experiencing unexplained new weakness, fatigue, and muscle or joint pain. Although the diagnosis of postpolio syndrome traditionally has required a remote history of paralytic polio, many persons such as the ones described here with typical symptoms of postpolio syndrome have no clear history of paralytic disease and are being misdiagnosed. With this in mind, we believe that the diagnostic criteria for postpolio syndrome should be modified to include the following: a history of remote paralytic polio or findings on history, physical examination results, and laboratory studies compatible with poliovirus damage of the central nervous system earlier in life.

  13. Seven-Day Nonbismuth Containing Quadruple Therapy Could Achieve a Grade “A” Success Rate for First-Line Helicobacter pylori Eradication

    Directory of Open Access Journals (Sweden)

    Wei-Chen Tai

    2015-01-01

    Full Text Available This prospective study was to assess the efficacy of nonbismuth containing quadruple therapy as first-line H. pylori treatment and to determine the clinical factors influencing patient outcome. We enrolled 200 H. pylori-infected naïve patients. They were prescribed either a 7-day nonbismuth containing quadruple therapy group (EACM, esomeprazole 40 mg twice daily, amoxicillin 1 g twice daily, metronidazole 500 mg twice daily, and clarithromycin 500 mg twice daily or a 7-day standard triple therapy group (EAC, esomeprazole 40 mg twice daily, amoxicillin 1 g twice daily, and clarithromycin 500 mg twice daily. Follow-up studies to assess treatment responses were carried out 8 weeks later. The eradication rates attained by EACM and EAC groups were 95.6% (95% confidence interval [CI] = 89.4%–98.3% and 79.3% (95% CI = 70%–86.4% in the per-protocol analysis (P < 0.001 and 88% (95% CI = 80.2%–93.0% and 73% (95% I = 63.6%–80.3% in the intention-to-treat analysis (P = 0.007. Clarithromycin resistance, metronidazole resistance, and dual clarithromycin and metronidazole resistances were the clinical factors influencing H. pylori eradication in EACM group. Clarithromycin resistance and dual clarithromycin and metronidazole resistances were the influential factor for EAC treatment. In conclusion, the results suggest that 7-day nonbismuth containing quadruple therapy could achieve a grade “A” report card for first-line H. pylori treatment.

  14. Role of Global Alliance for Vaccines and Immunization (GAVI) in Accelerating Inactivated Polio Vaccine Introduction.

    Science.gov (United States)

    Thacker, Naveen; Thacker, Deep; Pathak, Ashish

    2016-08-07

    Global Alliance for Vaccines and Immunization (GAVI, the Vaccine Alliance) is an international organization built through public-private partnership. GAVI has supported more than 200 vaccine introductions in the last 5 years by financing major proportion of costs of vaccine to 73 low-income countries using a co-financing model. GAVI has worked in close co-ordination with Global Polio Eradication Initiative (GPEI) since 2013, to strengthen health systems in countries so as to accelerate introduction of inactivated polio vaccine (IPV). GAVI is involved in many IPV related issues like demand generation, supply, market shaping, communications, country readiness etc. Most of the 73 GAVI eligible countries are also high priority countries for GPEI. GAVI support has helped India to accelerate introduction of IPV in all its states. However, GAVI faces challenges in IPV supply-related issues in the near future. It also needs to play a key role in global polio legacy planning and implementation.

  15. Social determinants and polio 'endgame': a qualitative study in high risk districts of India.

    Science.gov (United States)

    Dasgupta, Rajib; Chaturvedi, Sanjay; Adhish, S Vivek; Ganguly, Kalyan K; Rai, Sanjay; Sushant, Leena; Arora, N K

    2008-05-01

    To understand the perceptions and likely determinants that facilitate or act as barriers in implementing additional strategies for polio eradication: (a) accelerated delivery of mOPV1 (monovalent polio vaccine type 1); (b) use of IPV (inactivated polio vaccine); and (c) provision of incentives. QUALITATIVE. Rapid appraisal procedures (RAP) were adopted to derive the reality by synthesizing multiple sources of information; search for opinions, motivations, behaviors and attitudes of key stakeholders within their organizational and socio-cultural matrix. Two districts of Uttar Pradesh - Moradabad and J P Nagar. Total 244 interactions were conducted; 33 interviews and 4 focussed group discussions (FGD) conducted with providers; 33 mothers (media), mobilizers, vaccinators and supervisors. Providers expressed reservation regarding accelerated rounds of OPV; scientific rationale of accelerated rounds is not clear to parents and leaders. Although technical advantages of introducing IPV exist, issues of logistical difficulties and injection safety emerged strongly. Providers and communities indicated a clear 'no' to the cash incentives but argued for developmental issues. Resistance to the program has declined over time but still the program is perceived as the "government's need, not ours". The polio eradication program is critically poised, an opportunity to intensify efforts for reducing inequities in health services and improve access of all children to the PHC services. Ongoing dialogue with local communities and strong political commitment would be essential to translate the technological innovations into a sustainable program.

  16. A study of the knowledge and attitude towards pulse polio immunization in semi urban areas of South India

    Directory of Open Access Journals (Sweden)

    Joseph N

    2011-02-01

    Full Text Available BackgroundThe government of India launched the pulse polioimmunization (PPI programme in 1995 with the aim oferadicating poliomyelitis by the end of 2000. Despite this,733 children with polio were reported in 2009 alone.Therefore, there is a need to understand the reasonunderlying such high numbers of cases after so many yearsof programme implementation. This study was performedto assess the knowledge of the general population aboutpoliomyelitis and PPI and their attitude and practicetowards PPI.MethodThis cross-sectional study was undertaken in two semiurbanareas of Mangalore city. Only houses in whichchildren under five lived were included in the study. Datawas collected by interviewing any adult member of thehousehold using a pretested questionnaire.ResultsThe literacy rate of study participants was 99%. Only35(10.9% participants knew the correct mode oftransmission of polio. More than one quarter of the studypopulation were under the misconception that polio is acurable disease. The primary source of information aboutPPI in majority of participants was the television (n = 192;60%. Two-hundred and eighty eight (90% participantsknew that the purpose of PPI was to eradicate polio. Only128 (40% participants knew that polio drops can be givento children with mild illnesses and an identical number ofparticipants knew that hot food stuff should not be givenfor at least half an hour following vaccinationadministration. Misconceptions such as PPI causing vaccineoverdose was identified among 7 (2.2% participants, it is asubstitute for routine immunization was believed among 30(9.4% participants and that oral polio vaccine preventsother diseases was seen among 76 (23.7% participants. Theeducational status of the participants was significantlyassociated with their awareness level (χ2 =13.668, DF=6,P=0.033.ConclusionThis study identified a few important misconceptionsassociated with polio and PPI which need to be addressedby large scale awareness

  17. Budget impact of polio immunization strategy for India: introduction of one dose of inactivated poliomyelitis vaccine and reductions in supplemental polio immunization.

    Science.gov (United States)

    Khan, M M; Sharma, S; Tripathi, B; Alvarez, F P

    2017-01-01

    To conduct a budget impact analysis (BIA) of introducing the immunization recommendations of India Expert Advisory Group (IEAG) for the years 2015-2017. The recommendations include introduction of one inactivated poliomyelitis vaccine (IPV) dose in the regular child immunization programme along with reductions in oral polio vaccine (OPV) doses in supplemental programmes. This is a national level analysis of budget impact of new polio immunization recommendations. Since the states of India vary widely in terms of size, vaccine coverage and supplemental vaccine needs, the study estimated the budget impact for each of the states of India separately to derive the national level budget impact. Based on the recommendations of IEAG, the BIA assumes that all children in India will get an IPV dose at 14 weeks of age in addition to the OPV and DPT (or Pentavalent-3) doses. Cost of introducing the IPV dose was estimated by considering vaccine price and vaccine delivery and administration costs. The cost savings associated with the reduction in number of doses of OPV in supplemental immunization were also estimated. The analysis used India-specific or international cost parameters to estimate the budget impact. Introduction of one IPV dose will increase the cost of vaccines in the regular immunization programme from $20 million to $47 million. Since IEAG recommends lower intensity of supplemental OPV vaccination, polio vaccine cost of supplemental programme is expected to decline from $72 million to $53 million. Cost of administering polio vaccines will also decline from $124 million to $105 million mainly due to the significantly lower intensity of supplemental polio vaccination. The net effect of adopting IEAG's recommendations on polio immunization turns out to be cost saving for India, reducing total polio immunization cost by $6 million. Additional savings could be achieved if India adopts the new policy regarding the handling of multi-dose vials after opening

  18. The reappearance of polio. Postpolio syndrome.

    Science.gov (United States)

    Tillett, S G; Mozena, J D

    1999-04-01

    Although polio is often considered a disease of the past, new symptoms are appearing in patients infected with the polio virus many years ago. Many patients who contracted a paralytic form of poliomyelitis 3, 4, or even 7 decades ago are now relieving their childhood symptoms in what is known as postpolio syndrome.

  19. Frequency of isolation of polioviruses and non polio enteroviruses from patients with acute flaccid paralysis, enterovirus infection and children from groups at risk

    Directory of Open Access Journals (Sweden)

    N. I. Romanenkova

    2012-01-01

    Full Text Available The article describes the frequency of isolation of polioviruses and non polio enteroviruses from different categories of the investigated children. The percentage of detection of polioviruses from the patients with acute flaccid paralysis was lower than that from the children from groups at risk. Among the patients with the enterovirus infection the polioviruses were rarely revealed. The frequency of isolation of non polio enteroviruses from these patients was significantly higher than that from the other categories of investigated persons. The improvement of poliomyelitis surveillance and the reinforcement of virological surveillance of children from groups at risk and those with enterovirus infection will provide the important data for Global Polio Eradication Initiative and the maintenance of polio free status of the Russian Federation.

  20. Is EU/EEA population protected against polio?

    NARCIS (Netherlands)

    Nijsten, D.R.E.; Carrilo-Santisteve, P.; Miglietta, A.; Ruitenberg, E.J.; Lopalco, P.L.

    2015-01-01

    The WHO European Region has been declared polio-free since 2002. By 2010, inactivated polio vaccine (IPV) was the only polio vaccine in use in the EU/EEA for the primary vaccination of children. A systematic review of the literature on polio seroprevalence studies, complemented by the analysis of

  1. Introduction of Inactivated Poliovirus Vaccine in National Immunization Program and Polio Endgame Strategy.

    Science.gov (United States)

    Vashishtha, Vipin M; Choudhary, Jaydeep; Yadav, Sangeeta; Unni, Jeeson C; Jog, Pramod; Kamath, Sachidanand S; Sachdeva, Anupam; Srirampur, Sanjay; Prajapati, Baldev; Parekh, Bakul J

    2016-08-08

    The World Health Organization declared India among other 10 countries in South East Region - as 'polio-free' in 2014. Since then, the Government of India (GoI) has scaled up its initiatives against polio endgame which targets virus eradication and sequential withdrawal of type 2 virus from oral polio vaccine (OPV). However, prior to choosing the switch from trivalent OPV (t-OPV) to bivalent OPV (b-OPV), it was suggested to include inactivated poliovirus vaccine (IPV) in the national immunization schedule to protect vaccine naïve population against type 2 poliovirus. The GoI declared introduction of single dose of intramuscular IPV at 14 weeks since October 2015. In addition, anticipating the scarcity of IPV at present in India, GoI also recommended two intradermal doses of IPV in few states since April 2016. This review discusses the programmatic implications of these strategies along with recommendations by the Advisory Committee on Vaccines and Immunization Practices of Indian Academy of Pediatrics (IAP-ACVIP) on polio endgame strategy.

  2. Use of Dedicated Mobile Teams and Polio Volunteer Community Mobilizers to Increase Access to Zero-Dose Oral Poliovirus Vaccine and Routine Childhood Immunizations in Settlements at High Risk for Polio Transmission in Northern Nigeria.

    Science.gov (United States)

    Ongwae, Kennedy M; Bawa, Samuel B; Shuaib, Faisal; Braka, Fiona; Corkum, Melissa; Isa, Hammanyero K

    2017-07-01

    The Polio Eradication Initiative in Nigeria, which started >20 years ago, faced many challenges, including initial denial, resistance from communities, and prolonged regional safety concerns. These challenges led into the structuring of the response including the development of the National Emergency Action Plan, improved partner coordination and government engagement, and the establishment of a Polio Emergency Operations Centre. Although monthly supplementary immunization activities (SIAs) continued, the targeting of settlements at high risk for polio transmission with routine immunization (RI) and other selected primary healthcare (PHC) services using dedicated mobile teams and volunteer community mobilizers (VCMs) became a key strategy for interrupting polio transmission in the high-risk areas. These efforts could have contributed to the wild poliovirus-free 2-year period between 24 July 2014 and 11 August 2016, when 2 cases of the virus were reported from Borno State, Northern Nigeria. A narrative analysis of polio-related program and other official documents was conducted to identify the relevant human resources and their role in the Polio Eradication Initiative and in RI. The data used in the article was obtained from United Nations Children's Fund (UNICEF) and World Health Organization project reports and a draft evaluation report of the dedicated mobile teams approach in Northern Nigeria. The data from 6 of the states that commenced the provision of polio, RI, and other selected PHC services using the dedicated mobile teams approach in 2014 showed an overall increase in the percentage of children aged 12-23 months in the settlements at high risk for polio transmission with a RI card seen, from 23% to 56%, and an overall increase in fully immunized children aged 12-23 months, from 19% to 55%. The number of newborns given the first dose of oral poliovirus vaccine (OPV) according to the RI schedule and the number of children given zero-dose OPV with the

  3. Non-polio enteroviruses serotypes circulating in Nigeria.

    Science.gov (United States)

    Oyero, O G; Adu, F D

    2010-12-01

    Enteroviruses is one of the most common group of human pathogens, causing a wide range of acute symptoms involving the cardiac and skeletal muscles, central nervous system, pancreas,skin and mucous membranes. In spite of the success recorded in polio eradication globally, infections with other enteroviruses remain frequent and sometimes very serious, requiring hospitalization. In this study we determined the various circulating serotypes of non-polio enteroviruses (NPEVs) with a view to providing information on the activity of these viruses among the Nigerian children, who usually are the most affected. Stool samples were obtained from hospitalized children at two major secondary community hospitals in Ibadan and acute flaccid paralysis (AFP) cases from 26 states ofNigeria. A presumptive identification of NPEVs was based on growth in RD cells. Isolates were identified by neutralization assay using sera obtained from the Institute for Public Health and the Environment, the Netherlands. The problems associated with this assay prompted the use of genotypic method developed at the Centers for Disease Control, Atlanta, USA for the final identification of isolates. Neutralization assay identified the 138 isolates into echoviruses (43.5%), coxsackie B viruses (29.7%) and untypeable isolates (26.8%). Finally genotyping identified echoviruses (E3, E6, E7, E11, E12, E13, E14, E19, E20, E21, E24, E29, E30, E33), coxsackieviruses (CVA3, CVA4, CVA6, CVA17, CVB3, CVB5, CVB6) and enteroviruses (EV69, EV71). The causal association of isolates with different diseases was also established. Majority of the isolates belonged to the human enterovirus gropup B (HEV-B) specie, followed by 4 and 1 in the HEV-A and HEV-C species respectively. This study forms the basis of molecular epidemiology of NPEVs being established for the first time in Nigeria. The implication of the presence of neurotropic serotypes (E3, E6, E7, E11, E14, E20, E24, E29, E30, EV71, CVB3 and CVB5) is that AFP may

  4. Why have the majority of recent polio cases occurred in countries affected by Islamist militancy? A historical comparative analysis of the political determinants of polio in Nigeria, Somalia, Pakistan, Afghanistan and Syria.

    Science.gov (United States)

    Kennedy, Jonathan

    2016-01-01

    This article aims to understand why the last few areas where polio remains are affected by armed conflicts involving militant organizations that use Islam to legitimize their activities. The first section critically analyses the argument that Muslims' animosity towards polio vaccination programmes is a consequence of their irrational, backward, anti-Western theology. This argument is depoliticizing, ahistorical and orientalist. Moreover, it does not explain why Islamist militant groups' attitudes to polio vaccination campaigns vary between countries. The second section analyses official documents, newspaper articles, interviews and historical and ethnographic accounts to understand the relationship between Islamist militant groups and polio in five countries - Nigeria, Somalia, Pakistan, Afghanistan and Syria - that account for 95% of the world's polio cases since 2012. I demonstrate that specific political grievances related to the postcolonial state and/or foreign military intervention help to explain variations in militant groups' attitudes to polio vaccination programmes. The paper concludes by considering the policy implications of the analysis. Improved access for polio vaccinators is not predicated on military victory against the militants but securing support of de facto political leaders. This can be achieved by developing a better understanding of the specific sociopolitical contexts in which immunization programmes operate.

  5. Polio

    Science.gov (United States)

    ... and more ... Mayo Clinic Health Letter Medical Products Population Health and Wellness ... in parts of Asia and Africa. The Centers for Disease Control and Prevention (CDC) advises taking precautions to protect ...

  6. Polio

    Science.gov (United States)

    ... is a medical emergency that may result in paralysis or death (usually from respiratory problems). Disability is more common than death. Infection that is located high in the spinal cord or in the brain increases the risk of breathing problems.

  7. Evaluation of AFP surveillance indicators in polio-free Ghana, 2009-2013.

    Science.gov (United States)

    Odoom, John Kofi; Ntim, Nana Afia Asante; Sarkodie, Badu; Addo, James; Minta-Asare, Keren; Obodai, Evangeline; Eshun, Miriam; Ahove, Vincent V; Diamenu, Stanley; Adjabeng, Michael; Arthur-Quarm, Jacob; Barnor, Jacob S

    2014-07-05

    Ghana recorded the last case of indigenous wild poliovirus in 1999 but suffered two more outbreaks in 2003 and 2008. Following the World Health Organization (WHO) guidelines, transmission was interrupted through high routine immunisation coverage with live-attenuated oral polio vaccine (OPV), effective acute flaccid paralysis (AFP) surveillance and supplementary immunisation activities (SIA). This article describes the results of a five-year surveillance of AFP in polio-free Ghana, evaluate the surveillance indicators and identify areas that need improvement. We investigated 1345 cases of AFP from children aged less than 15 years reported to the Disease Surveillance Department from January 2009 to December 2013. Data on demographic characteristics, vaccination history, clinical presentation and virological investigation on stool specimens collected during investigation were analysed. Of the specimens analysed, 56% were from males and 76.3% were from children less than 5 years of age. Twenty-four percent of the children received up to 3 doses of OPV, 57% received at least 4 doses while the status of 19% was unknown. Core AFP surveillance indicators were partly met for non-polio AFP rate while the WHO target for stool adequacy and timeliness was exceeded over the period of study. All the cases were classified virologically, however no wild polio was found. Sixty-day follow-up was conducted for 56.3% of cases and 8.6% cases classified as compactible with polio. Both laboratory and epidemiological surveillance for AFP were efficient and many WHO targets were met. However, due to the risk of poliovirus importation prior to global eradication, longterm surveillance is required to provide a high degree of confidence in prevention of poliovirus infection in Ghana. Thus, efforts should be made to strengthen regional performance and to follow-up on all AFP cases in order to establish proper diagnoses for the causes of the AFP leading to proper care.

  8. The global introduction of inactivated polio vaccine can circumvent the oral polio vaccine paradox

    NARCIS (Netherlands)

    Heinsbroek, E.; Ruitenberg, E.J.

    2010-01-01

    This literature review identifies the factors that influence the decision to introduce inactivated polio vaccine (IPV) in developing countries as opposed to the policy of vaccine cessation. Attenuated viruses in the oral polio vaccine (OPV) can replicate, revert to neurovirulence and become

  9. Reaching the unreached with polio vaccine and other child survival interventions through partnership with military in Angola.

    Science.gov (United States)

    Fekadu, Lemma; Okeibunor, Joseph; Nsubuga, Peter; Kipela, Jean Marie; Mkanda, Pascal; Mihigo, Richard

    2016-10-10

    Growing conflict and insecurity played a major role in precipitating polio outbreaks in the Horn of Africa and the Middle East. In Angola, the early post-conflict situation was characterized by the presence of many inaccessible zones and districts due to insecurity and poor infrastructure. Partnership with the Angolan Army health service (AAHS) was one of the innovative strategies that the Polio Eradication Initiative (PEI) introduced into the country to support the polio vaccination campaigns in insecure and hard to reach zones. Before embarking on creating a partnership with Angolan military it was essential to make high-level advocacy with top military decision makers to engage the leadership in the process for better and sustainable support to the strategy. The principal supports provided by the AAHS were the administration of oral polio vaccine, vitamin A, deworming agents, social mobilization, monitoring campaign quality, and surveillance. Distribution of logistics using military vehicles and helicopters to hard to reach and insecure zones was also part of the support. Using this partnership it was possible to reach a significant number of children in insecure and hard to reach areas with polio vaccine and other child survival interventions. The military partnership also contributed in increasing the demand and addressing rejection for the polio vaccine. Military is a potentially productive force that can be used for any development activities in any country. The Angolan experience has demonstrated that it is possible to form a partnership with the military for basic health intervention activities with little training and investment. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. CIRCUMSTANCES AND CONSEQUENCES OF FALLS IN POLIO SURVIVORS

    NARCIS (Netherlands)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-01-01

    Objectives: Many polio survivors have symptoms that are known risk factors for falls in elderly people. This study aims to determine the: (i) frequency; (ii) consequences; (iii) circumstances; and (iv) factors associated with falls in polio survivors. Methods: A survey was conducted among 376 polio

  11. [The eradication of the poliomyelitis in the European Region of the World Health Organization].

    Science.gov (United States)

    Limia Sánchez, Aurora

    2013-01-01

    Poliomyelitis was considered an important event for the public health since the end of XIX century when this disease became epidemic. As soon as vaccines were available member states of the World Health Organization (WHO) in the European Region started to implement vaccination programmes against polio with an important impact in the incidence in this disease. In May 1988, the World Health Assembly resolution for the global eradication of poliomyelitis was adopted and the mechanisms to oversee the progress in the different WHO Regions were established. This article briefly reviews the history of polio in the WHO European Region, the process for certification and maintenance, the strategies for eradication and the current situation in the European Region and globally. The European Region was certified polio-free in 2002. Nevertheless, there are still three endemic countries in the world, some others use live attenuated vaccines as well as countries in the Horn of Africa are recently suffering the reintroduction of wild poliovirus. Considering these circumstances, the risk of reintroduction of poliovirus and the generation of outbreaks in the European Region exists, therefore high vaccination coverage against polio and good quality surveillance systems are needed to be guaranteed in every member state.

  12. Characterization of outbreak response strategies and potential vaccine stockpile needs for the polio endgame.

    Science.gov (United States)

    Duintjer Tebbens, Radboud J; Pallansch, Mark A; Wassilak, Steven G F; Cochi, Stephen L; Thompson, Kimberly M

    2016-03-24

    expect over 25% probability of a shortage of stockpiled filled mOPV vaccine, which could jeopardize the achievement of global polio eradication. For the long term, responding to any poliovirus reintroductions may require a global IPV stockpile. Despite the risks, our model suggests that good risk management and response strategies can successfully control most potential outbreaks after OPV cessation. Health leaders should carefully consider the numerous outbreak response choices that affect the probability of successfully managing poliovirus risks after OPV cessation.

  13. Oral Polio Vaccination and Hospital Admissions With Non-Polio Infections in Denmark

    DEFF Research Database (Denmark)

    Sørup, Signe; Stensballe, Lone G; Krause, Tyra Grove

    2016-01-01

    of DTaP-IPV-Hib, were observed from 24 months (first OPV dose) to 36 months of age. Results.  Oral polio vaccine was associated with a lower rate of admissions with any type of non-polio infection compared with DTaP-IPV-Hib as most recent vaccine (adjusted incidence rate ratio [IRR], 0.85; 95% confidence......Background.  Live vaccines may have nonspecific beneficial effects on morbidity and mortality. This study examines whether children who had the live-attenuated oral polio vaccine (OPV) as the most recent vaccine had a different rate of admissions for infectious diseases than children...... with inactivated diphtheria-tetanus-pertussis-polio-Haemophilus influenzae type b vaccine (DTaP-IPV-Hib) or live measles-mumps-rubella vaccine (MMR) as their most recent vaccine. Methods.  A nationwide, register-based, retrospective cohort study of 137 403 Danish children born 1997-1999, who had received 3 doses...

  14. Legacy of Polio-Use of India's Social Mobilization Network for Strengthening of the Universal Immunization Program in India.

    Science.gov (United States)

    Deutsch, Nicole; Singh, Prem; Singh, Vivek; Curtis, Rod; Siddique, Anisur Rahman

    2017-07-01

    The Social Mobilization Network (SMNet) has been lauded as one of the most successsful community engagement strategies in public health for its role in polio elimination in India. The UNICEF-managed SMNet was created as a strategy to eradicate polio by engaging >7000 frontline social mobilizers to advocate for vaccination in some of the most underserved, marginalized, and at-risk communities in India. This network focused initially on generating demand for polio vaccination but later expanded its messaging to promote routine immunization and other health and sanitation interventions related to maternal and children's health. As an impact of the network's interventions, in collaboration with other eradication efforts, these high-risk pockets witnessed an increase in full routine immunization coverage. The experience of the SMNet offers lessons for health-system strengthening for social mobilization and promoting positive health behaviors for other priority health programs like the Universal Immunization Program. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  15. Experiences from polio supplementary immunization activities in ...

    African Journals Online (AJOL)

    2014-05-31

    May 31, 2014 ... borders with other States where polio cases were previously reported.[10] The high level of commercial activities in the. State attracts people from within and outside Nigeria. The risk of importation of poliovirus from unimmunized or partially immunized children of travelers and migrants is a public health ...

  16. Information about the Late Effects of Polio

    Science.gov (United States)

    ... May Membership renewal notices are in the mail. Like us on Facebook. Want to be a sponsor? Contact director@post- ... address.) www.post-polio.org | www.polioplace.org Like us on Facebook. @polioplace Link to PHI's affiliate ... International Ventilator Users ...

  17. T he“ Virology of the Polio Virus

    African Journals Online (AJOL)

    poliovirus and in the history of poliomyelitis was the introduction of polio vaccines by Salk and Sabin. [7,8]. ' In 1981, poliovirus became the first RNA virus genome to be molecularly cloned and se— quenced. Recent development has included the clon- ing and sequencing of several strains of the three types of poliovirus [9 ...

  18. An Introduction to Poliovirus: Pathogenesis, Vaccination, and the Endgame for Global Eradication.

    Science.gov (United States)

    Minor, Philip D

    2016-01-01

    Poliomyelitis is caused by poliovirus, which is a positive strand non-enveloped virus that occurs in three distinct serotypes (1, 2, and 3). Infection is mainly by the fecal-oral route and can be confined to the gut by antibodies induced either by vaccine, previous infection or maternally acquired. Vaccines include the live attenuated strains developed by Sabin and the inactivated vaccines developed by Salk; the live attenuated vaccine (Oral Polio Vaccine or OPV) has been the main tool in the Global Program of Polio eradication of the World Health Organisation. Wild type 2 virus has not caused a case since 1999 and type 3 since 2012 and eradication seems near. However most infections are entirely silent so that sophisticated environmental surveillance may be needed to ensure that the virus has been eradicated, and the live vaccine can sometimes revert to virulent circulating forms under conditions that are not wholly understood. Cessation of vaccination is therefore an increasingly important issue and inactivated polio vaccine (IPV) is playing a larger part in the end game.

  19. Assessment of cold-chain maintenance in vaccine carriers during Pulse Polio National Immunization Day in a rural block of India.

    Science.gov (United States)

    Pakhare, Abhijit P; Bali, Surya; Pawar, Radhakishan B; Lokhande, Ganesh S

    2014-01-01

    India was certified polio free on 27 March 2014. Supplementary immunization activities, in the form of national immunization days, is one of the core strategies for eradication, where oral polio vaccine is administered to children aged under 5 years throughout the country. Oral polio vaccine is heat sensitive and requires maintenance of a stringent cold chain. Therefore, vaccine carriers with ice packs are used in the Pulse Polio Immunization (PPI) programme. This study assessed whether the cold chain is maintained during National Immunization Day in Beed district. A cross-sectional study was conducted at six randomly selected booths, one each from six primary health centres in Georai block of Beed district in Maharashtra. Electronic data loggers, configured to measure half-hourly temperatures, were kept in vaccine carriers throughout the day of PPI. The vaccine carrier temperature was below 8 °C at all six booths; minimum temperature recorded was -9.5 °C, while the maximum was 4.5 °C. The vaccine vial monitor did not reach discard point in any booth. A vaccine carrier with four ice packs very effectively maintains the cold chain required for oral polio vaccine.

  20. Crippling Violence: Conflict and Incident Polio in Afghanistan.

    Directory of Open Access Journals (Sweden)

    Alison Norris

    Full Text Available Designing effective public health campaigns in areas of armed conflict requires a nuanced understanding of how violence impacts the epidemiology of the disease in question.We examine the geographical relationship between violence (represented by the location of detonated Improvised Explosive Devices and polio incidence by generating maps of IEDs and polio incidence during 2010, and by comparing the mean number of IED detonations in polio high-risk districts with non polio high-risk districts during 2004-2009.We demonstrate a geographic relationship between IED violence and incident polio. Districts that have high-risk for polio have highly statistically significantly greater mean numbers of IEDs than non polio high-risk districts (p-values 0.0010-0.0404.The geographic relationship between armed conflict and polio incidence provides valuable insights as to how to plan a vaccination campaign in violent contexts, and allows us to anticipate incident polio in the regions of armed conflict. Such information permits vaccination planners to engage interested armed combatants to co-develop strategies to mitigate the effects of violence on polio.

  1. Willapa - Spartina Eradication 2013

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — Willapa NWR and its partners continue the ongoing and successful program aimed at eradication of the nonnative cordgrass, Spartina alterniflora (Spartina) in Willapa...

  2. Perbandingan Manfaat Vaksin Oral Polio 1 (Monovalen) dengan Vaksin Oral Polio Trivalen Terhadap Transmisi Virus Polio 1 dalam Upaya Mengatasi Kejadian Luar Biasa Polio 1 di Indonesia Tahun 2005: ditinjau melalui respons imun dan keamanannya

    OpenAIRE

    Kusnandi Rusmil

    2016-01-01

    Latar belakang. Indonesia menggunakan trivalent oral polio vaccine (tOPV) sejak tahun 1977 dan sejak tahun 1995 tidak pernah ditemukan lagi kasus poliomelitis. Pada Maret 2005 terjadi kejadian luar biasa (KLB) polio yang meluas ke seluruh pulau Jawa dan Sumatera. Berdasarkan pengalaman negara yang berhasil mengatasi KLB, penggunaan monovalent oral polio vaccine (mOPV) sesuai penyebab KLB memberikan hasil lebih cepat dibandingkan tOPV. Tujuan. Melihat manfaat pemberian mOPV1 dibandingkan de...

  3. [Polio paralytic. New problems: postpolio syndrome].

    Science.gov (United States)

    Esteban, Jesús

    2013-01-01

    In 1875 M. Raymond described a progressive muscle wasting and weakness in 3 individuals survivors of childhood acute poliomyelitis. Jean-Martin Charcot suggested that the initial injury should let these guys neurons more sensitive to develop posterior spinal diseases and new weakness was the result of overuse of the affected muscles. In 1979, after the publication of the description given by a 57 year old patient on motor difficulties that developed after suffering of polio in childhood, there was a very significant increase of comments of other individuals with similar symptoms, reaching wedged in the 80s the term of post-polio syndrome. The term is reserved for describing the development of new neurological symptoms, especially for the development of muscle weakness, muscle atrophy and new muscle fatigue not explained by other medical causes, and appear after more than 15 years of infection acute. Is estimated to affect 20 to 85% of individuals with a history of polio in childhood. In 2000 first described the diagnostic criteria. This syndrome determines a change in the functional abilities. Its pathogenesis is unknown, may be associated with aging. It could also be due to an inflammatory persistent or be influenced by genetic factors. There is no effective drug treatment, so I can only recommend symptomatic and moderate muscle training.

  4. Pharyngolaryngeal manifestations of post-polio syndrome

    Directory of Open Access Journals (Sweden)

    Biase, Noemi Grigoletto De

    2011-10-01

    Full Text Available Introduction: The post-polio syndrome (PPS is characterized by a new episod of atrophy or muscle weakness in individuals previously affected by poliomyelitis. The symptoms start from an extended period of clinical stability ranging from 20 to 40 years, after the initial chart of polio. Among the pathophysiological mechanisms, the most likely is that the syndrome represents a process of attrition and neuronal metabolic exhaustion due to a continuous process of denervation reinnervation which begins after the initial acute. Objective: Review the clinical characteristics and pathophysiological of PPS,as well as present the approach in cases with pharyngolaryngeal manifestations. Case Report: We present the clinical case of a male patient with 48 years old, with main complaints of dysphonia, dysphagia and previous history of polio. The patient underwent a diagnostic investigation, in which the voice psychoacoustic findings are described. Laringoscopic, electromyographic and the videoendoscopy of swallowing compatible with PPS. The treatment consisted in phonotherapy in a total of 11 weekly sessions and guidelines for swallowing, with satisfactory improvement of the symptoms. Final comments: The pharyngolaryngeal manifestations of PPS are susceptible to treatment, obtaining satisfactory results, with improvement of life quality of the patients.

  5. Survey of post polio syndrome in Tehran

    Directory of Open Access Journals (Sweden)

    Talebian S

    2009-04-01

    Full Text Available "nBackground: The long-term effects of poliomyelitis are known in many of countries. In despite of one accrue title for these signs and symptoms; there are similarity aspects in patients' problems. In the signs of explained, absence of strength and endurance, musculoskeletal difficulties, respiratory dysfunction, sleep disorders are more generalized. Prevalence of post polio syndrome (PPS is aim of this study. "nMethods: 150 subjects with history of poliomyelitis (80 male and 70 female in Tehran city contributes in this study and complete question forms. "nResults: Muscle pain was reported in 88% of subjects. Thigh muscle weakness was at 42/28%, also muscle spasm indicated at 66%. Recurrent falling of subjects appeared in 74/7%. Early fatigue reported 86%. Above five signs selected for PPS. In this study 85 subjects had four signs of above criteria or 56.66% of subjects had PPS. "nConclusion:  Depended of evaluation and observation there is post polio syndrome in Tehran. Recommended for physical therapy of post polio syndrome attend to stages of progression of this syndrome. In aim to this procedure, physical treatment of these patients must limit to muscle fatigue and also severe physical and exercise activities must be reduce, also some mild aerobic activities without fatigue can be useful.

  6. Post-polio syndrome: renaissance of poliomyelitis?

    Directory of Open Access Journals (Sweden)

    Claudio Andre Barbosa de Lira

    2009-03-01

    Full Text Available Poliomyelitis is an acute and infectious viral disease, transmitted primarily through oral-fecal contact or directly, person to person. Approximately 90% of the individuals infected by the polio virus do not present symptoms; however, the affected individuals can show a variety of symptoms if the virus reaches the bloodstream. In up to 2% of cases, the virus reaches the central nervous system  preferably infecting and destroying the motor neurons, resulting in muscular weakness and acute flaccid paralysis. Despite the expressive reduction in the number of cases, many people live with the consequences of the acute illness, thus representing a burden to the public healthcare systems. Many of these people present new manifestations as signs and symptoms that are called post-polio syndrome. It can be defined and characterized by new neuromuscular symptoms, which occur at least 15 years after a period of clinical and functional stability in patients with previous history of symptomatic poliomyelitis. The signs and symptoms characterizing the post-polio syndrome include new muscular weakness, muscular fatigue and atrophy, pain in joints and muscles, sleep disorders, intolerance to cold, respiratory and swallowing difficulties, and recent weight gain. Therefore, the aim of this review is to present the physiological changes caused by the new manifestation of symptoms in individuals with poliomyelitis.

  7. Deconstructing social resistance to pulse polio campaign in two North Indian districts.

    Science.gov (United States)

    Chaturvedi, Sanjay; Dasgupta, Rajib; Adhish, Vivek; Ganguly, Kalyan K; Rai, Sanjay; Sushant, Leena; Srabasti, S; Arora, Narendra K

    2009-11-01

    To gain an insight into the phenomenon of social resistance and rumors against pulse polio campaign. Qualitative, community-based investigation, mapping perceptions of various stakeholders through in-depth interviews (IDIs), focus group discussions (FGDs), non-formal interactions and observations. Moradabad and JP Nagar districts of Uttar Pradesh. IDIs (providers 33, mothers 33, community leaders 10); FGDs (providers 4, mothers 8) and non-formal interactions (156) with community leaders, parents, businessmen, journalists (Hindi and Urdu media), mobilizers, vaccinators and supervisors. A distinct machination of social resistance and rumors against oral polio vaccine during supplementary immunization activities (SIA) was observed in some minority dominated areas. The pattern can be understood through a model that emerged through qualitative evidence. Inspite of all this, most parents in minority areas supported the SIAs. Only a few clusters from extremely marginalized sections continued to evade SIAs, with an endemic pattern. Through social osmosis, these rumors reached majority community as well and some parents were affected. However, in such cases, the resistance was sporadic and transient. While the programs focus was on microbiological issues, the obstacles to polio eradication lie in the endemicity of social (and/or cultural) resistance in some pockets, leading to clustering of perpetually unimmunized children - inspite of good coverage of SIAs at macro level. This may sustain low levels of wild poliovirus transmission, and there can be exceptions to the robustness of the pulse approach. A micro level involvement of volunteers from marginalized pockets of minorities might be able to minimize or eliminate this resistance.

  8. An evaluation of community perspectives and contributing factors to missed children during an oral polio vaccination campaign--Katsina State, Nigeria.

    Science.gov (United States)

    Michael, Charles A; Ashenafi, Samra; Ogbuanu, Ikechukwu U; Ohuabunwo, Chima; Sule, Adamu; Corkum, Melissa; Mackay, Susan; Storms, Aaron D; Achari, Panchanan; Biya, Oladayo; Nguku, Patrick; Newberry, David; Bwaka, Ado; Mahoney, Frank

    2014-11-01

    Unvaccinated children contribute to accumulation of susceptible persons and the continued transmission of wild poliovirus in Nigeria. In September 2012, the Expert Review Committee (ERC) on Polio Eradication and Routine Immunization in Nigeria recommended that social research be conducted to better understand why children are missed during supplementary immunization activities (SIAs), also known as "immunization plus days (IPDs)" in Nigeria. Immediately following the SIA in October 2012, polio eradication partners and the government of Nigeria conducted a study to assess why children are missed. We used semistructured questionnaires and focus group discussions in 1 rural and 1 urban local government area (LGA) of Katsina State. Participants reported that 61% of the children were not vaccinated because of poor vaccination team performance: either the teams did not visit the homes (25%) or the children were reported absent and not revisited (36%). This lack of access to vaccine was more frequently reported by respondents from scattered/nomadic communities (85%). In 1 out of 4 respondents (25%), refusal was the main reason their child was not vaccinated. The majority of respondents reported they would have consented to their children being vaccinated if the vaccine had been offered. Poor vaccination team performance is a major contributor to missed children during IPD campaigns. Addressing such operational deficiencies will help close the polio immunity gap and eradicate polio from Nigeria. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  9. The Role of National Immunization Technical Advisory Groups (NITAGs) in the Introduction of Inactivated Polio Vaccine: Experience of the Indonesia and Uganda NITAGs.

    Science.gov (United States)

    Ba-Nguz, Antoinette; Adjagba, Alex; Wisnu Hendrarto, Toto; Sewankambo, Nelson K; Nalwadda, Celia; Kisakye, Annette

    2017-07-01

    National Immunization Technical Advisory Groups (NITAGs) are established by national authorities to provide them with independent, bias-free, objective, and evidence-based advice on vaccines and immunization challenges. As of December 2015, 125 countries have reported having set up an NITAG. The Health Policy and Institutional Development Center at the Agence de Médecine Préventive, a World Health Organization (WHO) Collaborative Center for evidence-informed immunization, through its Supporting Independent Immunization and Vaccine Advisory Committees (SIVAC) Initiative project, provides assistance to low- and middle-income countries in the establishment and strengthening of their NITAGs. The Indonesian NITAG (ITAGI) was formed in December 2006 and Uganda's (UNITAG) was formed in November 2014. Both Uganda and Indonesia have introduced inactivated polio vaccine (IPV) as part of the Global Polio Eradication and Endgame Strategic Plan (the Endgame plan). The authors reflect on the process and the role played by NITAGs in the introduction of IPV in the routine immunization program and the lessons learned. This commentary is a reflection of the authors' experience on NITAG's role as observed in 2 particular local settings and applied to a global public health issue, the polio eradication Endgame plan. The reflection is backed up by the relevant (policy and technical) documents on polio eradication, along with minutes and reports from countries' ministries of health, immunization programs, WHO, and NITAGs. NITAGs are valuable tools for ministries of health to ensure sustainable, evidence-informed immunization policies that are trusted and accepted by their communities. Early engagement with NITAGs also ensures that the adoption of strategies addressing global public health threats at the country level reinforces the national immunization programs. On the other end, when NITAGs are proactive and forward-thinking, they can contribute to a smooth and effective

  10. Post-Polio Directory 2014: Post-Polio Clinics, Health Professionals, Support Groups

    Science.gov (United States)

    ... org Greater Kansas City Post-Polio Support Group Judith Wilson 816-741-1620, jkw1620@sbcglobal.net www. ... jefferson.edu *HealthSouth Rehab Hospital-Reading Patti J. Brown, MD 1623 Morgantown Rd Reading, PA 19607-9455 ...

  11. Poverty eradication in a carbon constrained world.

    Science.gov (United States)

    Hubacek, Klaus; Baiocchi, Giovanni; Feng, Kuishuang; Patwardhan, Anand

    2017-10-24

    The UN Framework Convention on Climate Change aims to keep warming below 2 °C while recognizing developing countries' right to eradicate extreme poverty. Poverty eradication is also the first of the Sustainable Development Goals. This paper investigates potential consequences for climate targets of achieving poverty eradication. We find that eradicating extreme poverty, i.e., moving people to an income above $1.9 purchasing power parity (PPP) a day, does not jeopardize the climate target even in the absence of climate policies and with current technologies. On the other hand, bringing everybody to a still modest expenditure level of at least $2.97 PPP would have long-term consequences on achieving emission targets. Compared to the reference mitigation pathway, eradicating extreme poverty increases the effort by 2.8% whereas bringing everybody to at least $2.97 PPP would increase the required mitigation rate by 27%. Given that the top 10% global income earners are responsible for 36% of the current carbon footprint of households; the discourse should address income distribution and the carbon intensity of lifestyles.

  12. Polio endgame: the global switch from tOPV to bOPV.

    Science.gov (United States)

    Garon, Julie; Seib, Katherine; Orenstein, Walter A; Ramirez Gonzalez, Alejandro; Chang Blanc, Diana; Zaffran, Michel; Patel, Manish

    2016-06-01

    Globally, polio cases have reached an all-time low, and type 2 poliovirus (one of three) is eradicated. Oral polio vaccine (OPV) has been the primary tool, however, in rare cases, OPV induces paralysis. In 2013, the World Health Assembly endorsed the phased withdrawal of OPV and introduction of inactivated poliovirus vaccine (IPV) into childhood routine immunization schedules. Type 2 OPV will be withdrawn through a globally synchronized "switch" from trivalent OPV (all three types) to bivalent OPV (types 1 and 3). The switch will happen in 155 OPV-using countries between April 17(th) and May 1(st), 2016. Planned activities to reduce type 2 outbreak risks post-switch include the following: tOPV campaigns to increase type 2 immunity prior to the switch, monovalent OPV2 stockpiling to respond to outbreaks should they occur, containment of both wild and vaccine type 2 viruses, enhanced acute flaccid paralysis (AFP) and environmental surveillance, outbreak response protocols, and ensured access to IPV and bivalent OPV.

  13. Eradikasi dan Babak Akhir Polio: Peran Tenaga Kesehatan Indonesia

    Directory of Open Access Journals (Sweden)

    Hartono Gunardi

    2017-01-01

    Full Text Available Poliomielitis adalah penyakit menular yangditandai dengan kelumpuhan akibat kerusakanmotor neuron di kornu anterior sumsum tulangbelakang; disebabkan oleh tiga serotipe virus polioyaitu serotipe 1 (brunhilde, serotipe 2 (lansig danserotipe 3 (leon.1 Poliomielitis ditularkan secarafekal-oral atau oral-oral.Sebelum vaksin polio ditemukan, semua anakyang terinfeksi virus polio dan sekitar 1 dari 200anak yang terinfeksi akan menderita kelumpuhan.Setelah ditemukan vaksin polio inaktivasi (IPV,salk pada tahun 1955, vaksin polio oral monovalen(mOPV, sabin tahun 1961 dan vaksin polio oraltrivalen (tOPV pada tahun 1963, program imunisasipolio berlangsung di seluruh dunia. Vaksin IPVdiganti dengan tOPV karena pemberiannyamudah, lebih unggul dalam merangsang kekebalanmukosa usus, dan lebih murah. Vaksin tOPV masukdalam Program Pengembangan Imunisasi/PPI diIndonesia sejak tahun 1978. Normal 0 false false false IN X-NONE X-NONE A Review on Malaria Eradication: What hope for Nigeria? * AMADI ...

    African Journals Online (AJOL)

    ADOWIE PERE

    times, wrongful orientation of control efforts or eradication plans, programmes and effective operations. There is need to involve experts to achieve proper eradication of the disease. In conclusion, the fight against malaria, receives attention by the day. More innovative tool for control or management skill still utilizes the ...

  14. Eradicating statelessness in the Americas

    Directory of Open Access Journals (Sweden)

    Juan Ignacio Mondelli

    2017-10-01

    Full Text Available Considerable progress has been made towards eradicating statelessness in Latin America and the Caribbean since 2014 but there is still work to be done if it is to become the first world region to eradicate statelessness.

  15. Polio survivors perceptions of a multi-disciplinary rehabilitation programme.

    Science.gov (United States)

    Atwal, Anita; Duncan, Helen; Queally, Claire; Cedar, S H

    2017-10-03

    Post-polio syndrome refers to a late complication of the poliovirus infection. Management of post-polio syndrome is complex due to the extensive symptomology. European and United Kingdom guidelines have advised the use of rehabilitation programmes to manage post-polio syndrome. There is a paucity of research in relation to the effectiveness of rehabilitation interventions. The objective of this study is to explore polio survivor's perceptions of an in-patient multi-disciplinary rehabilitation programme. Semi-structured interviews of community dwelling polio survivors who attended in-patient rehabilitation programme in the United Kingdom. Thematic analysis was used to describe and interpret interview data. Participants' experiences were influenced by past experiences of polio and their self-concept. Participants generally had a positive experience and valued being with other polio survivors. Positive strategies, such as pacing and reflection changed their mind-sets into their lives after the programme, though they still faced challenges in daily living. Some participants supported others with post-polio syndrome after completing the programme. Our research identified that participants experienced long term positive benefits from attending a rehabilitation programme. Strategies that users found helpful that explored the effectiveness of interventions to manage polio are not cited within a Cochrane review. If we are to recognise the lived experience and service user empowerment within a model of co- production it is essential that patient preferences are evaluated and used as evidence to justify service provision. Further research is required with polio survivors to explore how best rehabilitation programmes can adopt the principles of co-production. Implications for Rehabilitation The patients' expertise and lived experience must be at the centre of a rehabilitation programme. Strategies such as pacing and reflection are perceived as important strategies to enable

  16. Engineering Enhanced Vaccine Cell Lines To Eradicate Vaccine-Preventable Diseases: the Polio End Game

    NARCIS (Netherlands)

    van der Sanden, Sabine M. G.; Wu, Weilin; Dybdahl-Sissoko, Naomi; Weldon, William C.; Brooks, Paula; O'Donnell, Jason; Jones, Les P.; Brown, Cedric; Tompkins, S. Mark; Oberste, M. Steven; Karpilow, Jon; Tripp, Ralph A.

    2016-01-01

    Vaccine manufacturing costs prevent a significant portion of the world's population from accessing protection from vaccine-preventable diseases. To enhance vaccine production at reduced costs, a genome-wide RNA interference (RNAi) screen was performed to identify gene knockdown events that enhanced

  17. Pylera for the eradication of Helicobacter pylori infection.

    LENUS (Irish Health Repository)

    Saleem, Aamir

    2012-02-01

    An ideal antibiotic regimen for Helicobacter pylori should achieve eradication rates of approximately 90%. Current 7-day triple therapy is successful in about two-thirds of patients. A novel treatment is required to achieve higher eradication with minimal induction of bacterial resistance. The aim of this article is to evaluate the safety and efficacy of a single triple capsule (Pylera) containing bismuth, metronidazole and tetracycline, given with omeprazole for the eradication of H. pylori infection. Extensive literature searches were conducted using PubMed data from 1982 to 2007. This search included headings of H. pylori, bismuth and eradication therapy. The triple capsule Pylera, when given with omeprazole, achieved eradication rates ranging between 84 and 97%. Eradication rates were similar for clarithromycin- and metronidazole-resistant strains. Eradication rates with an omeprazole, bismuth, metronidazole and tetracycline regimen appeared comparable for metronidazole-resistant and -sensitive strains. This effect is not seen with the use of triple therapy in cases of clarithromycin resistance. Clinical trials did not report any serious side effects from bismuth-based regimens and compliance was similar to standard triple therapy. Bismuth-based triple therapy using Pylera is a simplified, effective and well-tolerated regimen achieving cure rates of above 90%.

  18. Analysis of Activity Patterns and Performance in Polio Survivors

    National Research Council Canada - National Science Library

    Klein, Mary

    2006-01-01

    The goals of this project were: 1) to study the temporal relationship between activity level and health status in polio survivors and to compare the results with those obtained from an age-matched control population and 2...

  19. Analysis of Activity Patterns and Performance in Polio Survivors

    National Research Council Canada - National Science Library

    Klein, Mary

    2004-01-01

    The goals of this project are: 1) to study the temporal relationship between activity level and health status in polio survivors and to compare the results with those obtained from an age-matched control population and 2...

  1. Polio and the Vaccine (Shot) to Prevent It

    Science.gov (United States)

    ... Immunizations Polio and the Vaccine (Shot) to Prevent It Language: English (US) Español (Spanish) Format: Select ... paralysis or weakness can last a lifetime. Is it serious? The risk of lifelong paralysis is very ...

  2. The ethics of disease eradication.

    Science.gov (United States)

    Wilson, James

    2014-12-12

    This paper provides an examination of the ethics of disease eradication policies. It examines three arguments that have been advanced for thinking that eradication is in some way ethically exceptional as a policy goal. These are (1) global eradication has symbolic importance, (2) disease eradication is a global public good and (3) disease eradication is a form of rescue. It argues that none of these provides a good reason to think that individuals have special duties to facilitate eradication campaigns, or that public health authorities have special permissions to pursue them. But the fact that these arguments fail does not entail that global disease eradication is ethically problematic, or that it should not be undertaken. Global eradication of a disease, if successful, is a way of providing an enormous health benefit that stretches far into the future. There is no need to reach for the idea that there is a special duty to eradicate disease; the same considerations that are in play in ordinary public health policy--of reducing the burden of disease equitably and efficiently--suffice to make global disease eradication a compelling goal where doing so is feasible. Copyright © 2014 The Author. Published by Elsevier Ltd.. All rights reserved.

  3. Life Satisfaction in Persons with Late Effects of Polio

    OpenAIRE

    Lund, Maria Larsson; Lexell, Jan

    2011-01-01

    To assess satisfaction with life as a whole and with ten domains of life satisfaction in Swedish persons with late effects of polio, to describe the relationship with sex, age, marital status, use of mobility aids and self-perceived needs of instrumental support, and to compare the level of life satisfaction with a Swedish reference sample. A cross-sectional study of 160 persons with verified late effects of polio answered a postal questionnaire including the Life Satisfaction Questionnaire (...

  4. 2. Review of the Oral Polio

    African Journals Online (AJOL)

    Esem

    feasible. It also prevents the re-establishment of poliovirus if it is re-introduced from other countries, through international travelers and migrant populations from conflict areas. INTRODUCTION. The origin of the global eradication of poliomyelitis is conventionally attributed to Albert Sabin and his colleagues in the frequently ...

  5. Eradication of poliomyelitis in South Africa

    African Journals Online (AJOL)

    Several countries use inactivated polio vaccine (IPV) and some favour the combined use of IPV followed by OPV. Vaccine efficacy and the OPV versus IPV debate are discussed in more detail elsewhere.37.36 Polio vaccine is the most heat-sensitive of all the Expanded. Programme for Immunisation (EPI) vaccines and this.

  6. Sleep disorders frequency in post-polio syndrome patients caused by periodic limb movements

    National Research Council Canada - National Science Library

    Araujo, Maria Auxiliadora de Paiva; Silva, Tatiana Mesquita e; Moreira, Gustavo Antonio; Pradella-Hallinan, Márcia; Tufik, Sergio; Oliveira, Acary Souza Bulle

    2010-01-01

    Post-polio syndrome (PPS) in individuals with polio longer than 15 years is characterized by weakness and/or muscle fatigue, deficit of deglutition and breath and periodic limb movements (PLM) during sleep...

  7. Guardians of the ERAD Galaxy.

    Science.gov (United States)

    Sun, Zhihao; Brodsky, Jeffrey L

    2017-10-05

    The endoplasmic reticulum-associated degradation (ERAD) pathway facilitates the disposal of terminally misfolded proteins in the early secretory pathway yet spares folding intermediates from being destroyed. Zhang et al. report on a protein complex that acts as a guardian to protect these folding intermediates from being targeted for ERAD. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Expansion of syndromic vaccine preventable disease surveillance to include bacterial meningitis and Japanese encephalitis: evaluation of adapting polio and measles laboratory networks in Bangladesh, China and India, 2007-2008.

    Science.gov (United States)

    Cavallaro, Kathleen F; Sandhu, Hardeep S; Hyde, Terri B; Johnson, Barbara W; Fischer, Marc; Mayer, Leonard W; Clark, Thomas A; Pallansch, Mark A; Yin, Zundong; Zuo, Shuyan; Hadler, Stephen C; Diorditsa, Serguey; Hasan, A S M Mainul; Bose, Anindya S; Dietz, Vance

    2015-02-25

    Surveillance for acute flaccid paralysis with laboratory confirmation has been a key strategy in the global polio eradication initiative, and the laboratory platform established for polio testing has been expanded in many countries to include surveillance for cases of febrile rash illness to identify measles and rubella cases. Vaccine-preventable disease surveillance is essential to detect outbreaks, define disease burden, guide vaccination strategies and assess immunization impact. Vaccines now exist to prevent Japanese encephalitis (JE) and some etiologies of bacterial meningitis. We evaluated the feasibility of expanding polio-measles surveillance and laboratory networks to detect bacterial meningitis and JE, using surveillance for acute meningitis-encephalitis syndrome in Bangladesh and China and acute encephalitis syndrome in India. We developed nine syndromic surveillance performance indicators based on international surveillance guidelines and calculated scores using supervisory visit reports, annual reports, and case-based surveillance data. Scores, variable by country and targeted disease, were highest for the presence of national guidelines, sustainability, training, availability of JE laboratory resources, and effectiveness of using polio-measles networks for JE surveillance. Scores for effectiveness of building on polio-measles networks for bacterial meningitis surveillance and specimen referral were the lowest, because of differences in specimens and techniques. Polio-measles surveillance and laboratory networks provided useful infrastructure for establishing syndromic surveillance and building capacity for JE diagnosis, but were less applicable for bacterial meningitis. Laboratory-supported surveillance for vaccine-preventable bacterial diseases will require substantial technical and financial support to enhance local diagnostic capacity. Published by Elsevier Ltd.

  9. Rinderpest: the veterinary perspective on eradication.

    Science.gov (United States)

    Roeder, Peter; Mariner, Jeffrey; Kock, Richard

    2013-08-05

    Rinderpest was a devastating disease of livestock responsible for continent-wide famine and poverty. Centuries of veterinary advances culminated in 2011 with the UN Food and Agriculture Organization and the World Organization for Animal Health declaring global eradication of rinderpest; only the second disease to be eradicated and the greatest veterinary achievement of our time. Conventional control measures, principally mass vaccination combined with zoosanitary procedures, led to substantial declines in the incidence of rinderpest. However, during the past decades, innovative strategies were deployed for the last mile to overcome diagnostic and surveillance challenges, unanticipated variations in virus pathogenicity, circulation of disease in wildlife populations and to service remote and nomadic communities in often-unstable states. This review provides an overview of these challenges, describes how they were overcome and identifies key factors for this success.

  10. Lot quality assurance sampling to monitor supplemental immunization activity quality: an essential tool for improving performance in polio endemic countries.

    Science.gov (United States)

    Brown, Alexandra E; Okayasu, Hiromasa; Nzioki, Michael M; Wadood, Mufti Z; Chabot-Couture, Guillaume; Quddus, Arshad; Walker, George; Sutter, Roland W

    2014-11-01

    Monitoring the quality of supplementary immunization activities (SIAs) is a key tool for polio eradication. Regular monitoring data, however, are often unreliable, showing high coverage levels in virtually all areas, including those with ongoing virus circulation. To address this challenge, lot quality assurance sampling (LQAS) was introduced in 2009 as an additional tool to monitor SIA quality. Now used in 8 countries, LQAS provides a number of programmatic benefits: identifying areas of weak coverage quality with statistical reliability, differentiating areas of varying coverage with greater precision, and allowing for trend analysis of campaign quality. LQAS also accommodates changes to survey format, interpretation thresholds, evaluations of sample size, and data collection through mobile phones to improve timeliness of reporting and allow for visualization of campaign quality. LQAS becomes increasingly important to address remaining gaps in SIA quality and help focus resources on high-risk areas to prevent the continued transmission of wild poliovirus. © Crown copyright 2014.

  11. Characteristics of Patients at First Visit to a Polio Clinic in Sweden.

    Directory of Open Access Journals (Sweden)

    Katarina Skough Vreede

    Full Text Available Describe polio patients visiting a polio clinic in Sweden, a country where vaccination was introduced in 1957.A consecutive cohort study.Prior polio patients.All patients (n = 865 visiting the polio clinic at Sahlgrenska University Hospital, Gothenburg Sweden, between 1994 and 2012 were included in this study. Data at first visit regarding patient characteristics, polio classification, data of electromyography, origin, assistive devices and gait speed as well as muscle strength were collected for these patients. Twenty-three patients were excluded because no polio diagnosis could be established. A total of 842 patients with confirmed polio remained in the study.More than twenty percent of the patients were from countries outside the Nordic region and considerably younger than those from the Nordic region. The majority of the emigrants were from Asia and Africa followed by Europe (outside the Nordic region. Of all patients included ninety-seven percent (n = 817 had polio in the lower extremity and almost 53% (n = 444 had polio in the upper extremity while 28% (n = 238 had polio in the trunk, according to clinical classification of polio. Compared with a sample of the normal population, the polio patients walked 61-71% slower, and were 53-77% weaker in muscle strength of the knee and foot as well as grip strength.The younger patients with polio emigrating from countries with different cultures may lead to a challenge for the multi professional teams working with post-polio rehabilitation and are of importance when planning for the care of polio patients the coming years.

  12. Would it be legally justified to impose vaccination in Israel? Examining the issue in light of the 2013 detection of polio in Israeli sewage.

    Science.gov (United States)

    Kamin-Friedman, Shelly

    2017-10-30

    The detection of wild poliovirus in Israeli sewage in May 2013 led the health authorities to decide that children who had been vaccinated with IPV would also be vaccinated with OPV. The decision sought to protect vulnerable Israeli individuals who were either not vaccinated with IPV or who suffered from an immune deficiency, to preserve Israel's status as a polio-free country, to prevent the virus' "exportation" into vulnerable polio-free countries, and to participate in the global efforts toward the eradication of polio. After a massive public persuasion campaign, 79% of the children born after 2004 were vaccinated as well as 69% of the children residing in central Israel. A 2014 State Comptroller Report stated that the Ministry of Health should draw conclusions from the low compliance rates in certain Israeli regions. The article seeks to examine the legal legitimacy of mandatory vaccination in the service of eradicating a contagious disease (as opposed to preventing a pandemic outbreak), which was one of the objectives in the 2013 Polio case. It more specifically relates to current Israeli law as well as to a hypothetical new public health law which would authorize health officials to oblige vaccination and enforce this through the use of criminal sanctions. Qualitative content analysis through the interpretation of court judgements, laws, legislative protocols, health ministry guidelines and documented discussions of the Advisory Committee on Infectious Diseases and Immunization. A mandatory vaccination backed by criminal sanctions in the service of the eradication of contagious diseases would probably be perceived as infringing on the constitutional right to autonomy to a greater extent than necessary according to Israeli law and case law precedents. There may be some added value inherent in a new public health law which would authorize health officials to oblige vaccination where nonrestrictive measures have been ineffective. However, the law should also

  13. Mankind's Magnificent Milestone: Smallpox Eradication.

    Science.gov (United States)

    Small, Parker A., Jr.; Small, Natalie S.

    1996-01-01

    Illustrates the complex interactions between disease, societal attitudes, and technology by looking at the history of smallpox. Describes one of mankind's most magnificent accomplishments--the eradication of smallpox from the earth. (JRH)

  14. Inactivated polio vaccine development for technology transfer using attenuated Sabin poliovirus strains to shift from Salk-IPV to Sabin-IPV.

    Science.gov (United States)

    Bakker, Wilfried A M; Thomassen, Yvonne E; van't Oever, Aart G; Westdijk, Janny; van Oijen, Monique G C T; Sundermann, Lars C; van't Veld, Peter; Sleeman, Eelco; van Nimwegen, Fred W; Hamidi, Ahd; Kersten, Gideon F A; van den Heuvel, Nico; Hendriks, Jan T; van der Pol, Leo A

    2011-09-22

    Industrial-scale inactivated polio vaccine (IPV) production dates back to the 1960s when at the Rijks Instituut voor de Volksgezondheid (RIV) in Bilthoven a process was developed based on micro-carrier technology and primary monkey kidney cells. This technology was freely shared with several pharmaceutical companies and institutes worldwide. In this contribution, the history of one of the first cell-culture based large-scale biological production processes is summarized. Also, recent developments and the anticipated upcoming shift from regular IPV to Sabin-IPV are presented. Responding to a call by the World Health Organization (WHO) for new polio vaccines, the development of Sabin-IPV was continued, after demonstrating proof of principle in the 1990s, at the Netherlands Vaccine Institute (NVI). Development of Sabin-IPV plays an important role in the WHO polio eradication strategy as biocontainment will be critical in the post-OPV cessation period. The use of attenuated Sabin strains instead of wild-type Salk polio strains will provide additional safety during vaccine production. Initially, the Sabin-IPV production process will be based on the scale-down model of the current, and well-established, Salk-IPV process. In parallel to clinical trial material production, process development, optimization and formulation research is being carried out to further optimize the process and reduce cost per dose. Also, results will be shown from large-scale (to prepare for future technology transfer) generation of Master- and Working virus seedlots, and clinical trial material (for phase I studies) production. Finally, the planned technology transfer to vaccine manufacturers in low and middle-income countries is discussed. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. A Research Agenda for Malaria Eradication: Vaccines

    Science.gov (United States)

    2011-01-01

    Vaccines could be a crucial component of efforts to eradicate malaria. Current attempts to develop malaria vaccines are primarily focused on Plasmodium falciparum and are directed towards reducing morbidity and mortality. Continued support for these efforts is essential, but if malaria vaccines are to be used as part of a repertoire of tools for elimination or eradication of malaria, they will need to have an impact on malaria transmission. We introduce the concept of “vaccines that interrupt malaria transmission” (VIMT), which includes not only “classical” transmission-blocking vaccines that target the sexual and mosquito stages but also pre-erythrocytic and asexual stage vaccines that have an effect on transmission. VIMT may also include vaccines that target the vector to disrupt parasite development in the mosquito. Importantly, if eradication is to be achieved, malaria vaccine development efforts will need to target other malaria parasite species, especially Plasmodium vivax, where novel therapeutic vaccines against hypnozoites or preventive vaccines with effect against multiple stages could have enormous impact. A target product profile (TPP) for VIMT is proposed and a research agenda to address current knowledge gaps and develop tools necessary for design and development of VIMT is presented. PMID:21311586

  16. Community engagement and integrated health and polio immunisation campaigns in conflict-affected areas of Pakistan: a cluster randomised controlled trial.

    Science.gov (United States)

    Habib, Muhammad Atif; Soofi, Sajid; Cousens, Simon; Anwar, Saeed; Haque, Najib Ul; Ahmed, Imran; Ali, Noshad; Tahir, Rehman; Bhutta, Zulfiqar A

    2017-06-01

    Pakistan faces huge challenges in eradicating polio due to widespread poliovirus transmission and security challenges. Innovative interventions are urgently needed to strengthen community buy-in, to increase the coverage of oral polio vaccine (OPV) and other routine immunisations, and to enhance immunity through the introduction of inactivated polio vaccine (IPV) in combination with OPV. We aimed to evaluate the acceptability and effect on immunisation coverage of an integrated strategy for community engagement and maternal and child health immunisation campaigns in insecure and conflict-affected polio-endemic districts of Pakistan. We did a community-based three-arm cluster randomised trial in healthy children aged 1 month to 5 years that resided within the study sites in three districts of Pakistan at high risk of polio. Clusters were randomly assigned by a computer algorithm using restricted randomisation in blocks of 20 by an external statistician (1:1:1) to receive routine polio programme activities (control, arm A), additional interventions with community outreach and mobilisation using an enhanced communication package and provision of short-term preventive maternal and child health services and routine immunisation (health camps), including OPV (arm B), or all interventions of arm B with additional provision of IPV delivered at the maternal and child health camps (arm C). An independent team conducted surveys at baseline, endline, and after each round of supplementary immunisation activity for acceptability and effect. The primary outcome measures for the study were coverage of OPV, IPV, and routine extended programme on immunisation vaccines and changes in the proportion of unvaccinated and fully vaccinated children. This trial is registered with ClinicalTrials.gov, number NCT01908114. Between June 4, 2013, and May 31, 2014, 387 clusters were randomised (131 to arm A, 127 to arm B, and 129 to arm C). At baseline, 28 760 children younger than 5 years were

  17. Aerobic exercise capacity in post-polio syndrome

    NARCIS (Netherlands)

    Voorn, E.L.

    2015-01-01

    The aim of this thesis was to expand the body of knowledge on the diminished aerobic capacity of individuals with post-polio syndrome (PPS). The studies described in this thesis were based on the assumption that, besides a reduced muscle mass, deconditioning contributes to the severely diminished

  18. rapid assessment of polio virus antibodies prevalence amongst ...

    African Journals Online (AJOL)

    northern Nigeria. There is paucity of information as it relates to polio antibody prevalence amongst children in the state. Periodic serologic assessment is needed to determine the quality and effectiveness of routine vaccination campaigns carried in the state to rapidly build immunity against poliovirus. Children were.

  19. Production and potential use of monoclonal antibodies against polio viruses.

    NARCIS (Netherlands)

    A.D.M.E. Osterhaus (Albert); A.L. van Wezel; G. van Steenis (Bert); A.G. Hazendonk

    1982-01-01

    textabstractLymphocyte hybridomas secreting monoclonal antibodies against different strains of polio virus type 1, 2, or 3 have been produced. For this purpose Balb/C mice were immunized with purified and inactivated virus suspensions and their splenocytes were fused with P3X63Ag8 mouse myeloma

  20. Polio Outbreak Response in Ethiopia | Mesfin | East African Medical ...

    African Journals Online (AJOL)

    Background: Ethiopia had been polio-free for almost four years until December 2004. However, between December 2004 and February 2006, 24 children were paralysed as a result of infection with wild poliovirus imported from the neighbouring country of Sudan. In response, the country has attempted to document the ...

  1. Polio outbreak resPonse in ethioPia

    African Journals Online (AJOL)

    2008-05-05

    May 5, 2008 ... Background: ethiopia had been polio-free for almost four years until December 2004. however, between December 2004 and February 2006, 24 children were paralysed as a result of infection with wild poliovirus imported from the neighbouring country of sudan. in response, the country has attempted to ...

  2. Circumstances and consequences of falls in polio survivors.

    Science.gov (United States)

    Bickerstaffe, Alice; Beelen, Anita; Nollet, Frans

    2010-11-01

    Many polio survivors have symptoms that are known risk factors for falls in elderly people. This study aims to determine the: (i) frequency; (ii) consequences; (iii) circumstances; and (iv) factors associated with falls in polio survivors. A survey was conducted among 376 polio survivors. Participants completed a falls history questionnaire and additional information was obtained from their medical files. Of the 305 respondents, 74% reported at least one fall in the past year and 60% two or more. Sixteen percent of fallers described a major injury after a fall in the last year and 69% reported fear of falling. One-third of fallers had reduced the amount they walked because of their fear of falling. Most reported falls in a familiar environment (86%), during ambulation (72%) and in the afternoon (50%). Quadriceps weakness of the weakest leg (Medical Research Council (MRC) ≤ 3), fear of falling and complaints of problems maintaining balance were independently associated with both falls and recurrent falls, while increasing age and medication use were not. The high rate of falls and consequences thereof, merit the implementation of fall intervention strategies. To maximize effect, they should be tailor-made and target the fall mechanisms specific to polio survivors.

  3. Patients with post-polio syndrome are more likely to have subclinical involvement as compared to polio survivors without new symptoms

    Directory of Open Access Journals (Sweden)

    Arzu Yagiz On

    2016-01-01

    Full Text Available Background: Post-polio syndrome (PPS is a condition that affects polio survivors decades after recovery from an initial acute attack. It is a well-known entity that limbs thought to be nonaffected by polio survivors commonly demonstrate electromyography (EMG evidence of prior polio. Although the diagnosis of PPS requires a remote history of acute paralytic polio, clinically unapparent damage caused by poliovirus can be associated with PPS later in life. Objective: To evaluate EMG abnormalities and late progressive symptoms in limbs thought to be nonaffected by polio survivors, in order to determine the prevalence of subclinical motor neuron involvement in those fulfilling criteria for PPS comparing to those without such symptoms. Materials and Methods: Clinical and EMG findings of 464 limbs in 116 polio survivors who had been admitted to our clinic were analyzed. Affection of the limbs by polio was classified based on the patient′s self-report on remote weakness during the acute phase of poliomyelitis, muscle strength measured by manual muscle testing, and four-limb needle EMG. Results: Seventy-six of the patients (65.5% met the criteria of PPS. Needle EMG studies revealed subclinical involvement in 122 out of 293 (42% limbs with no history of remote weakness during the acute phase of poliomyelitis. Prevalence of subclinical involvement was found 47% in polio survivors who met the criteria of PPS compared to 33% in those without PPS (P = 0.013. Among the limbs that had developed new weakness in PPS patients, 33.5% had subclinical involvement. Discussion and Conclusion: Subclinical involvement is common in limbs thought to be nonaffected by polio survivors, and this is especially present in those fulfilling criteria for PPS. New muscle weakness may develop in apparently nonaffected, subclinically involved muscles. Thus we believe that four-limb EMG studies should be performed in all polio survivors, especially in those with the symptoms of PPS.

  4. Race and the politics of polio: Warm Springs, Tuskegee, and the March of Dimes.

    Science.gov (United States)

    Rogers, Naomi

    2007-05-01

    The Tuskegee Institute opened a polio center in 1941, funded by the March of Dimes. The center's founding was the result of a new visibility of Black polio survivors and the growing political embarrassment around the policy of the Georgia Warm Springs polio rehabilitation center, which Franklin Roosevelt had founded in the 1920s before he became president and which had maintained a Whites-only policy of admission. This policy, reflecting the ubiquitous norm of race-segregated health facilities of the era, was also sustained by a persuasive scientific argument about polio itself: that Blacks were not susceptible to the disease. After a decade of civil rights activism, this notion of polio as a White disease was challenged, and Black health professionals, emboldened by a new integrationist epidemiology, demanded that in polio, as in American medicine at large, health care should be provided regardless of race, color, or creed.

  5. [Polio, the long walk to the endgame].

    Science.gov (United States)

    García-Sánchez, José Elías; García-Sánchez, Enrique; García-Merino, Enrique; Fresnadillo-Martínez, María José

    2015-12-01

    Although the WHO original target date for the global eradication of poliomyelitis was the year 2000 -thanks to vaccination and institutional, public and private, resources for that purpose-, in 2013 the disease remained endemic in three countries, Afghanistan, Pakistan and Nigeria, and some cases were described in five others. The circulation of wild type 1 poliovirus in Israel, Gaza and the West Bank and the cases in Syria were a wakeup call, as at that time there were polioviruses derived from the oral vaccine that are still circulating among the human population and can cause the development of the disease. Travelling "from" and "to" endemic areas are factors to consider in poliovirus exportation and in its spread when it reaches areas with poor immunogenicity. Wars, terrorism, intolerance, lack of culture and proliferation of anti-vaccine groups and the rise of the anti-vaccination movement are important factors in the maintenance and expansion of the virus and in the "non-vaccination" against it. Based on the international situation to date, the Emergency Committee of WHO met in May 2014 to address the problem. It is still necessary to enhance the knowledge of the disease and its agent. In the first case to perform a differential diagnosis of flaccid paralysis and to continue vaccination programs, and in the second case to keep studying and looking for the poliovirus in environmental samples, which is a model for the study of many other viruses. Copyright © 2014 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  6. The Efficacy of Sequential Therapy in Eradication of Helicobacter ...

    African Journals Online (AJOL)

    2017-05-22

    May 22, 2017 ... second arm of sequential treatment regimen had consisted ... [9,10] A dual therapy. (PPI plus amoxicillin) administered for less than 7 days was able to achieve a cure rate of up to 50%, and that the efficacy of a triple therapy (PPI, clarithromycin, and ... The eradication rate of the arm of clarithromycin-based.

  7. Fetal damage after accidental polio vaccination of an immune mother.

    Science.gov (United States)

    Burton, A E; Robinson, E T; Harper, W F; Bell, E J; Boyd, J F

    1984-07-01

    Irreparable damage to the anterior horn cells of the cervical and thoracic cord was found in a 20-week-old fetus whose mother was immune to poliomyelitis before conceiving but who was inadvertently given oral polio vaccine at 18 weeks gestation. Polio neutralizing antibody titres in sera, taken before and after pregnancy, were identical and were at levels normally regarded as providing protection. Unsuccessful attempts were made to isolate poliovirus from extracts of fetal brain, lung, liver and placenta. Fluorescent antibody tests were performed on various levels of the central nervous system and on the left and right extensor forearm muscles. Specific positive fluorescence to poliovirus 2 and 3 antigens was detected at dorsal spinal cord level only. One positive result was seen with Coxsackie A9 antiserum and fresh guinea-pig complement in the inflammatory cells in the right extensor forearm muscles.This experience, as yet unexplained, underlines the importance of ensuring that women are not pregnant prior to oral polio vaccination.

  8. Efficacy of tailored Helicobacter pylori eradication treatment based on clarithromycin susceptibility and maintenance of acid secretion.

    Science.gov (United States)

    Sugimoto, Mitsushige; Uotani, Takahiro; Sahara, Shu; Ichikawa, Hitomi; Yamade, Mihoko; Sugimoto, Ken; Furuta, Takahisa

    2014-08-01

    Insufficient acid inhibition during Helicobacter pylori eradication treatment and bacterial resistance to antibiotics often causes eradication failure. Four times daily dosing (q.i.d.) of a proton-pump inhibitor (PPI) achieves potent acid inhibition, suggesting its potential usefulness as a regimen for eradicating H. pylori infection. Therefore, a tailored eradication regimen based on antibiotic susceptibility and maintenance of acid inhibition should have a high success rate. We investigated the efficacy of such treatment based on clarithromycin (CAM) susceptibility. Using 153 H. pylori-positive Japanese patients, we investigated the efficacy of tailored eradication strategy: (1) Patients infected with CAM-sensitive H. pylori were treated with a PPI (rabeprazole 10 mg q.i.d.), amoxicillin 500 mg q.i.d., and CAM 200 mg b.i.d. (n = 89), and (2) patients infected with CAM-resistant were given the same doses of rabeprazole and amoxicillin and metronidazole 250 mg b.i.d. (n = 64) for 1 week. In the tailored regimen group, the overall eradication rate was 96.7% (95% CI: 92.5-98.9%, 148/153) in the intention-to-treat (ITT) analysis and 97.4% (93.4-99.3%, 148/152) in the PP analysis. The eradication rates for the CAM- and metronidazole-based treatments were similar (95.5% and 98.4%, respectively, p = .400). The tailored treatment achieved a high eradication rate in CYP2C19 rapid metabolizers who were a resistance genotype for PPI treatment (94.3% (86.0-98.4%, 66/70)). A tailored H. pylori eradication regimen based on CAM susceptibility and maintaining acid secretion (rabeprazole 10 mg q.i.d.) is useful because it can achieve an eradication rate exceeding 95%, irrespective of eradication history, thus overcoming differences among CYP2C19 genotypes. © 2014 John Wiley & Sons Ltd.

  9. "The Impact of Malaria Eradication on Fertility"

    OpenAIRE

    Adrienne M. Lucas

    2011-01-01

    The malaria eradication campaign that started in Sri Lanka in the late 1940s virtually eliminated malaria transmission on the island. I use the pre-eradication differences in malaria endemicity within Sri Lanka to identify the effect of malaria eradication on fertility and child survival. Malaria eradication increased the number of live births through increasing age specific fertility and causing an earlier first birth. The effect of malaria on the transition time to higher order births is in...

  10. Undiagnosed Hoffa fracture of medial femoral condyle presenting as chronic pain in a post-polio limb

    Directory of Open Access Journals (Sweden)

    Mootha Aditya Krishna

    2014-06-01

    Full Text Available Isolated coronal fracture of medial femoral condyle with intact lateral femoral condyle is extremely rare. A high index of suspicion is necessary for early diagnosis especially in cases of undisplaced fractures. Here we report a case of medial Hoffa fracture in a post-polio limb presenting as chronic pain. Management of such fractures in limbs affected by late sequelae of poliomyelitis is particularly problematic in was approached through medial parapatellar arthrotomy and fi xation was done with cannulated cancellous screws in anteroposterior direction. Union was achieved at 16 weeks. Key words: Femoral fractures; Poliomyelitis; Fracture fi xation, internal

  11. Eradication of Helicobacter pylori Infection.

    Science.gov (United States)

    Marcus, Elizabeth A; Sachs, George; Scott, David R

    2016-07-01

    Helicobacter pylori infects about 50 % of the world's population, causing at a minimum chronic gastritis. A subset of infected patients will ultimately develop gastric or duodenal ulcer disease, gastric adenocarcinoma, or MALT (mucosa-associated lymphoid tissue) lymphoma. Eradication of H. pylori requires complex regimens that include acid suppression and multiple antibiotics. The efficacy of treatment using what were once considered standard regimens have declined in recent years, mainly due to widespread development of antibiotic resistance. Addition of bismuth to standard triple therapy regimens, use of alternate antibiotics, or development of alternative regimens using known therapies in novel combinations have improved treatment efficacy in specific populations, but overall success of eradication remains less than ideal. Novel regimens under investigation either in vivo or in vitro, involving increased acid suppression ideally with fewer antibiotics or development of non-antibiotic treatment targets, show promise for future therapy.

  12. The March of Dimes and Polio: Lessons in Vaccine Advocacy for Health Educators

    Science.gov (United States)

    Larsen, Dawn

    2012-01-01

    The polio vaccine became available in 1955, due almost entirely to the efforts of the March of Dimes. In 1921, Franklin Roosevelt gave a public face to polio and mounted a campaign to prevent it, establishing the National Foundation for Infantile Paralysis in 1938. During the Depression, U.S. citizens were asked to contribute one dime. Entertainer…

  13. Post Polio Paralysis: A Clarion Call For Surgical Re-Awakening ...

    African Journals Online (AJOL)

    Back ground. Post polio paralysis is a grave complication if poliomyelitis. The victims can be rehabilitated to ambulate erect by reconstructive operations, use of orthosis and physiotherapy. This study assesses the problems of post polio paralysis, rehabilitative interventions and calls for a surgical reawakening in this regard.

  14. Studies on the potency of oral polio vaccine using RD cell line and ...

    African Journals Online (AJOL)

    PRECIOUS

    2009-11-16

    Nov 16, 2009 ... The potency of vaccines was tested using the Karber's Formula. Key words: Oral polio vaccine, rhabdomyosarcoma, thermostability, potency. INTRODUCTION. Poliomyelitis, often called polio or infantile paralysis, is an acute viral infectious disease spread from person to person, primarily via the faecal-oral ...

  15. Muslim Scholars' Knowledge, Attitudes and Perceived Barriers Towards Polio Immunization in Pakistan.

    Science.gov (United States)

    Khan, Muhammad Umair; Ahmad, Akram; Salman, Saad; Ayub, Maria; Aqeel, Talieha; Haq, Noman-Ul; Saleem, Fahad; Khan, Muhammad Ubaid

    2017-04-01

    Pakistan is one of the two countries where polio remains endemic. Among multiple reasons of polio prevalence, false religious beliefs are accounted as major barriers towards polio immunization in Pakistan. Within this context, religious scholars are now engaged in polio immunization campaigns to dismantle the myths and battle the resurgence of polio in Pakistan. The objective of this study was to assess knowledge, attitudes and perceived barriers of Muslim scholars towards polio immunization in Pakistan. A descriptive, cross-sectional survey of Muslim scholars was conducted in Quetta and Peshawar divisions of Pakistan. From October to December 2015, a convenience sample of 770 Muslim scholars was recruited from the local mosques and religious institutions to participate in this study. Knowledge, attitudes, and perceived barriers were assessed by using self-administered, anonymous and pretested questionnaire. Descriptive and regression analyses were used to express the results with p Pakistan. The findings showed poor knowledge of Muslim scholars towards polio; however, their attitudes were positive towards polio immunization. More studies are required to assess the knowledge and attitudes of Muslim scholars at the national level to validate the findings of this study.

  16. Tracking the polio virus down the Congo River: a case study on the use of Google Earth™ in public health planning and mapping

    Science.gov (United States)

    Kamadjeu, Raoul

    2009-01-01

    Background The use of GIS in public health is growing, a consequence of a rapidly evolving technology and increasing accessibility to a wider audience. Google Earth™ (GE) is becoming an important mapping infrastructure for public health. However, generating traditional public health maps for GE is still beyond the reach of most public health professionals. In this paper, we explain, through the example of polio eradication activities in the Democratic Republic of Congo, how we used GE Earth as a planning tool and we share the methods used to generate public health maps. Results The use of GE improved field operations and resulted in better dispatch of vaccination teams and allocation of resources. It also allowed the creation of maps of high quality for advocacy, training and to help understand the spatiotemporal relationship between all the entities involved in the polio outbreak and response. Conclusion GE has the potential of making mapping available to a new set of public health users in developing countries. High quality and free satellite imagery, rich features including Keyhole Markup Language or image overlay provide a flexible but yet powerful platform that set it apart from traditional GIS tools and this power is still to be fully harnessed by public health professionals. PMID:19161606

  17. Lessons learnt to keep Europe polio-free: a review of outbreaks in the European Union, European Economic Area, and candidate countries, 1973 to 2013.

    Science.gov (United States)

    Derrough, Tarik; Salekeen, Alexandra

    2016-04-21

    Between 1973 and 2013, 12 outbreaks of paralytic poliomyelitis with a cumulative total of 660 cases were reported in the European Union, European Economic Area and candidate countries. Outbreaks lasted seven to 90 weeks (median: 24 weeks) and were identified through the diagnosis of cases of acute flaccid paralysis, for which infection with wild poliovirus was subsequently identified. In two countries, environmental surveillance was in place before the outbreaks, but did not detect any wild strain before the occurrence of clinical cases. This surveillance nonetheless provided useful information to monitor the outbreaks and their geographical spread. Outbreaks were predominantly caused by poliovirus type 1 and typically involved unvaccinated or inadequately vaccinated groups within highly immunised communities. Oral polio vaccine was primarily used to respond to the outbreaks with catch-up campaigns implemented either nationwide or in restricted geographical areas or age groups. The introduction of supplementary immunisation contained the outbreaks. In 2002, the European region of the World Health Organization was declared polio-free and it has maintained this status since. However, as long as there are non-vaccinated or under-vaccinated groups in European countries and poliomyelitis is not eradicated, countries remain continuously at risk of reintroduction and establishment of the virus. Continued efforts to reach these groups are needed in order to ensure a uniform and high vaccination coverage.

  18. Tracking the polio virus down the Congo River: a case study on the use of Google Earth™ in public health planning and mapping

    Directory of Open Access Journals (Sweden)

    Kamadjeu Raoul

    2009-01-01

    Full Text Available Abstract Background The use of GIS in public health is growing, a consequence of a rapidly evolving technology and increasing accessibility to a wider audience. Google Earth™ (GE is becoming an important mapping infrastructure for public health. However, generating traditional public health maps for GE is still beyond the reach of most public health professionals. In this paper, we explain, through the example of polio eradication activities in the Democratic Republic of Congo, how we used GE Earth as a planning tool and we share the methods used to generate public health maps. Results The use of GE improved field operations and resulted in better dispatch of vaccination teams and allocation of resources. It also allowed the creation of maps of high quality for advocacy, training and to help understand the spatiotemporal relationship between all the entities involved in the polio outbreak and response. Conclusion GE has the potential of making mapping available to a new set of public health users in developing countries. High quality and free satellite imagery, rich features including Keyhole Markup Language or image overlay provide a flexible but yet powerful platform that set it apart from traditional GIS tools and this power is still to be fully harnessed by public health professionals.

  19. Successful polio eradication in Uttar Pradesh, India: the pivotal contribution of the Social Mobilization Network, an NGO/UNICEF collaboration.

    Science.gov (United States)

    Coates, Ellen A; Waisbord, Silvio; Awale, Jitendra; Solomon, Roma; Dey, Rina

    2013-03-01

    In Uttar Pradesh, India, in response to low routine immunization coverage and ongoing poliovirus circulation, a network of U.S.-based CORE Group member and local nongovernmental organizations partnered with UNICEF, creating the Social Mobilization Network (SMNet). The SMNet's goal was to improve access and reduce family and community resistance to vaccination. The partners trained thousands of mobilizers from high-risk communities to visit households, promote government-run child immunization services, track children's immunization history and encourage vaccination of children missing scheduled vaccinations, and mobilize local opinion leaders. Creative behavior change activities and materials promoted vaccination awareness and safety, household hygiene, sanitation, home diarrheal-disease control, and breastfeeding. Program decision-makers at all levels used household-level data that were aggregated at community and district levels, and senior staff provided rapid feedback and regular capacity-building supervision to field staff. Use of routine project data and targeted research findings offered insights into and informed innovative approaches to overcoming community concerns impacting immunization coverage. While the SMNet worked in the highest-risk, poorly served communities, data suggest that the immunization coverage in SMNet communities was often higher than overall coverage in the district. The partners' organizational and resource differences and complementary technical strengths posed both opportunities and challenges; overcoming them enhanced the partnership's success and contributions.

  20. Myotonic dystrophy mimicking postpolio syndrome in a polio survivor.

    Science.gov (United States)

    Lim, Jae-Young; Kim, Kyoung-Eun; Choe, Gheeyoung

    2009-02-01

    We describe a 38-yr-old polio survivor with newly developed weakness from myotonic dystrophy. He suffered muscle atrophy and weakness in his legs as a result of poliomyelitis at the age of 3 yrs. After a stable interval of about 30 yrs, he felt new weakness and fatigue in his legs. Electromyography revealed generalized myotonic discharges, early recruitment, and findings of chronic denervation in his left leg. Genetic testing was consistent with myotonic dystrophy type 1. A biopsy from the right gastrocnemius revealed findings of both myotonic dystrophy and chronic denervation. This case report shows the importance of considering other uncommon conditions in the differential diagnoses of postpolio syndrome.

  1. A polio intervention in East African refugees to NSW.

    Science.gov (United States)

    Smith, Mitchell M; Vagholkar, Sanjyot

    2009-01-01

    This paper summarises a public health intervention in Sydney, NSW in late 2006 that resulted from the potential exposure of a number of refugees to polio virus while in transit in Nairobi, Kenya. The intervention involved the attempted follow-up of 113 persons at risk, assessment for symptoms and immunisation where indicated. No symptomatic cases were found. Seventy-five people were immunised with inactivated poliomyelitis vaccine. The intervention highlighted the importance of close collaboration between health services, the Department of Immigration and Citizenship and settlement service agencies, and provided several lessons to consider when assessing newly arrived refugees.

  2. Establishment of realtime RT-PCR assay to detect polio virus in the Acute Flaccid Paralysis laboratory surveillance

    Directory of Open Access Journals (Sweden)

    Nike Susanti

    2016-07-01

    Full Text Available AbstrakLatar belakang: Virus polio indigenous terakhir ditemukan di Indonesia tahun 1995 tetapi ancaman viruspolio impor dan mutasi virus dari Oral Polio Vaccine (OPV menjadi Vaccine Derived Poliovirus (VDPVmasih berlanjut. Tahun 1991 WHO mengembangkan Surveilans Acute Flaccid Paralysis (AFP dan tahun2014, identifikasi virus polio dengan real-time reverse transcriptase Polymerase Chain Reaction (rRTPCRmulai digunakan di Laboratorium Nasional Polio Pusat Biomedis dan Teknologi Dasar Kesehatan.Tujuan dari penggunaan rRT-PCR untuk mendapatkan metode yang cepat dan lebih baik dalam memantausirkulasi dan mutasi virus polio.Metode: Isolat polio positif diidentifikasi menggunakanan rRT PCR dengan kombinasi primer dan probeyang ditetapkan WHO. RNA virus di konversi ke cDNA menggunakan reverse transcriptase lalu diamplifikasimenggunakan taq polymerase. Produk PCR di deteksi dan diidentifikasi dengan hibridisasi menggunakanprobe spesifik. Sintesis cDNA dan reaksi PCR menggunakan primer yang dilekatkan di probe. Kombinasiprimer dan probe menghasilkan identifikasi serotipe dan intratypic differentiation (ITD dari isolat virus.Hasil: Selama tahun 2014, NPL Jakarta menerima 604 kasus AFP dari surveilans dan lima kasusterdeteksi positif mengandung virus polio. Semua spesimen positif mengandung virus polio yang berasaldari vaksin. Dua kasus positif virus polio tipe P2 (40%, satu kasus jenis virus polio P1 (20%, 1 kasusjenis virus polio P3 (20% dan satu kasus virus polio campuran jenis P1 + P2 (20%.Kesimpulan: Real-time PCR dapat digunakan di Laboratorium Polio Jakarta untuk membantu identifikasivirus Polio secara cepat. Tes ini dapat digunakan untuk memantau sirkulasi virus polio pada populasiyang rutin diimunisasi dengan OPV. (Health Science Journal of Indonesia 2016;7:27-31Kata kunci: ITD, Poliovirus, Identification, rRT-PCR AbstractBackground: The last indigenous polio was detected in 1995 but the threat of wild type polio viruses and themutation of Oral

  3. High incidence of osteoporosis and fractures in an aging post-polio population.

    LENUS (Irish Health Repository)

    Mohammad, Ausaf F

    2009-01-01

    Since the polio epidemic in Ireland in the 1950s, most polio survivors are approaching into the 6th and 7th decade of their lives. There is little data about bone density and risk of fractures in these patients. In 2006, we undertook an audit of post-polio patients attending rheumatology and neurology outpatient clinics in a university teaching hospital. Our aim was to determine the prevalence of osteoporosis (OP), falls and fractures and to evaluate the association of bone density with other potential contributing factors to OP.

  4. Dracunculiasis eradication: delayed, not denied.

    Science.gov (United States)

    Hopkins, D R; Ruiz-Tiben, E; Ruebush, T K; Diallo, N; Agle, A; Withers, P C

    2000-02-01

    By the end of 1998, Asia was free of dracunculiasis (Guinea worm disease), with Pakistan, India, and Yemen having interrupted transmission in 1993, 1996, and 1997, respectively. Transmission of the disease was also interrupted in Cameroon and Senegal during 1997. Chad reported only 3 cases during 1998. Dracunculiasis is now confined to only 13 countries in Africa. The overall number of cases has been reduced by more than 97% from the 3.2 million cases estimated to have occurred in 1986 to 78,557 cases reported in 1998. Because the civil war in Sudan remains the major impediment to eradication of dracunculiasis, the interim goal is to stop all transmission outside that country by the end of 2000. The most important operational need now is for national programs to improve the frequency and quality of supervision of village-based health workers in order to enhance the sensitivity of surveillance and effectiveness of case containment.

  5. Achieving Standard in Secondary Education through the Eradication ...

    African Journals Online (AJOL)

    This hydra-headed monster has eaten deep intothe bone marrows of Nigerians even from primary school levels to tertiaryinstitutions. No wonder, the researchers sought to find out the opinions ofprincipals, teachers and students in Nigeria about examination malpractices.They also attempted to ascertain strategies for the ...

  6. The safety and efficacy of ranitidine bismuth citrate in combination with antibiotics for the eradication of Helicobacter pylori

    NARCIS (Netherlands)

    Wyeth, J. W.; Pounder, R. E.; Duggan, A. E.; O'Morain, C. A.; Schaufelberger, H. D.; de Koster, E. H.; Rauws, E. A.; Bardhan, K. D.; Gilvarry, J.; Buckley, M. J.; Gummett, P. A.; Logan, R. P.

    1996-01-01

    Ranitidine bismuth citrate is a novel salt of ranitidine and a bismuth citrate complex. It has intrinsic antisecretory and anti-Helicobacter pylori activity, but monotherapy rarely eradicates H. pylori infection in man. A pilot study to investigate rates of H. pylori eradication achieved by

  7. Viral Aetiology of Acute Flaccid Paralysis Surveillance Cases, before and after Vaccine Policy Change from Oral Polio Vaccine to Inactivated Polio Vaccine

    Directory of Open Access Journals (Sweden)

    T. S. Saraswathy Subramaniam

    2014-01-01

    Full Text Available Since 1992, surveillance for acute flaccid paralysis (AFP cases was introduced in Malaysia along with the establishment of the National Poliovirus Laboratory at the Institute for Medical Research. In 2008, the Ministry of Health, Malaysia, approved a vaccine policy change from oral polio vaccine to inactivated polio vaccine (IPV. Eight states started using IPV in the Expanded Immunization Programme, followed by the remaining states in January 2010. The objective of this study was to determine the viral aetiology of AFP cases below 15 years of age, before and after vaccine policy change from oral polio vaccine to inactivated polio vaccine. One hundred and seventy-nine enteroviruses were isolated from the 3394 stool specimens investigated between 1992 and December 2012. Fifty-six out of 107 virus isolates were polioviruses and the remaining were non-polio enteroviruses. Since 2009 after the sequential introduction of IPV in the childhood immunization programme, no Sabin polioviruses were isolated from AFP cases. In 2012, the laboratory AFP surveillance was supplemented with environmental surveillance with sewage sampling. Thirteen Sabin polioviruses were also isolated from sewage in the same year, but no vaccine-derived poliovirus was detected during this period.

  8. Vaccination ecosystem health check: achieving impact today and sustainability for tomorrow.

    Science.gov (United States)

    Saadatian-Elahi, Mitra; Bloom, David; Plotkin, Stanley; Picot, Valentina; Louis, Jacques; Watson, Michael

    2017-01-01

    Vaccination is a complex ecosystem with several components that interact with one another and with the environment. Today's vaccine ecosystem is defined by the pursuit of polio eradication, the drive to get as many of the new vaccines to as many people as possible and the research and development against immunologically challenging diseases. Despite these successes, vaccine ecosystem is facing keys issues with regard to supply/distribution and cost/profitability asymmetry that risk slowing its global growth. The conference "Vaccination ecosystem health check: achieving impact today and sustainability for tomorrow" held in Annecy-France (January 19-21, 2015) took stock of the health of today's vaccination ecosystem and its ability to reliably and sustainably supply high-quality vaccines while investing in tomorrow's needed innovation. Small and decreasing numbers of suppliers/manufacturing facilities; paucity of research-driven companies; regulatory pressures; market uncertainties; political prioritization; anti-vaccine movements/complacency; and technological and programmatic issues were acknowledged as the major challenges that could weaken today's vaccination ecosystem. The expert panel discussed also drivers and barriers to a sustainable vaccination ecosystem; the metrics of a vaccination ecosystem; and what should be added, removed, increased, or reduced to maintain the health of the vaccination ecosystem.

  9. Repeater F-waves are signs of motor unit pathology in polio survivors.

    Science.gov (United States)

    Hachisuka, Akiko; Komori, Tetsuo; Abe, Tatsuya; Hachisuka, Kenji

    2015-05-01

    The purpose of this study was to determine whether F-waves reveal electrophysiological features of anterior horn cells in polio survivors. Forty-three polio survivors and 20 healthy controls underwent motor nerve conduction studies of the median and tibial nerves bilaterally, including sampling of F-waves elicited by 100 stimuli and the determination of motor unit number estimation (MUNE). A significant increase in abnormally stereotyped ("repeater") F-waves and a reduction of F-wave persistence were observed in both nerves in the polio group as compared with the control group. Repeater F-waves had a negative correlation with MUNE. These trends in F-wave persistence and repeater F-waves after motor unit loss are characteristic findings in polio survivors. Repeater F-waves are a sign of motor unit pathology. © 2014 The Authors. Muscle & Nerve Published by Wiley Periodicals, Inc.

  10. Childhood mortality after oral polio immunisation campaign in Guinea-Bissau

    DEFF Research Database (Denmark)

    Aaby, Peter; Hedegaard, Kathryn; Sodemann, Morten

    2005-01-01

    Though previous studies have suggested a non-specific beneficial effect of oral polio vaccine (OPV), there has been no evaluation of the mortality impact of national polio immunization days. On the other hand, studies examining the effect of OPV and diphtheria-tetanus-pertussis (DTP) vaccines...... for the 6103 children less than 5 years of age in the Bandim Health Project's study area in Guinea-Bissau. Survival was ascertained through regular surveillance from March 1998 until the beginning of the war on June 7, 1998, the end of 1998, or the end of 1999, respectively. The child register was linked...... with a register for the only paediatric ward in Bissau to determine the risk of hospitalisations. Among children under 5 years of age, 82% had received 1 or 2 doses of polio vaccines during the campaign. Though polio vaccination during the campaign was associated with slightly lower mortality, this difference...

  11. Incompatibility of lyophilized inactivated polio vaccine with liquid pentavalent whole-cell-pertussis-containing vaccine

    NARCIS (Netherlands)

    Kraan, H.; Have, Ten R.; Maas, van der L.; Kersten, G.F.A.; Amorij, J.P.

    2016-01-01

    A hexavalent vaccine containing diphtheria toxoid, tetanus toxoid, whole cell pertussis, Haemophilius influenza type B, hepatitis B and inactivated polio vaccine (IPV) may: (i) increase the efficiency of vaccination campaigns, (ii) reduce the number of injections thereby reducing needlestick

  12. Uso universal da vacina inativada contra poliomielite Universal use of inactivated polio vaccine

    Directory of Open Access Journals (Sweden)

    Luiza Helena Falleiros Carvalho

    2006-07-01

    terms of worldwide eradication and the World Health Organization.s (WHO proposals in this transition period between global eradication and the post-eradication period. SOURCES OF DATA: Data for the period from 1955 to 2005 were searched in MEDLINE, LILACS, The Web, Doctor's Guide, WHO website and Pan American Health Organization (PAHO website and text book. SUMMARY OF THE FINDINGS: In 1988, the WHO established the goal of eradicating the disease and interrupting transmission of the wild virus globally. Since then, there has been a dramatic decline of the disease, although in 2005 there were still some countries considered endemic and others where polio returned on account of imported viruses. The vaccines used worldwide are the classical tOPV and IPV, and in this eradication process, the use of mOPV vaccines has been encouraged in places where only one type of poliovirus circulates. In addition to spreading the virus in the community, the OPV vaccines may, however, cause paralyses by reversal of the neurovirulence process. CONCLUSIONS: For a world free of poliomyelitis disease, it would be necessary to interrupt circulation of the virus, which will only be possible if the OPV virus were to be discontinued, in accordance with the WHO proposals for this transition period and the post-eradication period.

  13. Prioritizing islands for the eradication of invasive vertebrates in the United Kingdom overseas territories.

    Science.gov (United States)

    Dawson, Jeffrey; Oppel, Steffen; Cuthbert, Richard J; Holmes, Nick; Bird, Jeremy P; Butchart, Stuart H M; Spatz, Dena R; Tershy, Bernie

    2015-02-01

    Invasive alien species are one of the primary threats to native biodiversity on islands worldwide. Consequently, eradicating invasive species from islands has become a mainstream conservation practice. Deciding which islands have the highest priority for eradication is of strategic importance to allocate limited resources to achieve maximum conservation benefit. Previous island prioritizations focused either on a narrow set of native species or on a small geographic area. We devised a prioritization approach that incorporates all threatened native terrestrial vertebrates and all invasive terrestrial vertebrates occurring on 11 U.K. overseas territories, which comprise over 2000 islands ranging from the sub-Antarctic to the tropics. Our approach includes eradication feasibility and distinguishes between the potential and realistic conservation value of an eradication, which reflects the benefit that would accrue following eradication of either all invasive species or only those species for which eradication techniques currently exist. We identified the top 25 priority islands for invasive species eradication that together would benefit extant populations of 155 native species including 45 globally threatened species. The 5 most valuable islands included the 2 World Heritage islands Gough (South Atlantic) and Henderson (South Pacific) that feature unique seabird colonies, and Anegada, Little Cayman, and Guana Island in the Caribbean that feature a unique reptile fauna. This prioritization can be rapidly repeated if new information or techniques become available, and the approach could be replicated elsewhere in the world. © 2014 Crown copyright. Conservation Biology © 2014 Society for Conservation Biology.

  14. Logistics of Guinea worm disease eradication in South Sudan.

    Science.gov (United States)

    Jones, Alexander H; Becknell, Steven; Withers, P Craig; Ruiz-Tiben, Ernesto; Hopkins, Donald R; Stobbelaar, David; Makoy, Samuel Yibi

    2014-03-01

    From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Program logistics have played a key role in program achievements to date. The program uses disease surveillance and program performance data and integrated technical-logistical staffing to maintain flexible and effective logistical support for active community-based surveillance and intervention delivery in thousands of remote communities. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical diseases and other disease eradication programs. Logistical challenges in various public health scenarios and the pivotal contribution of logistics to Guinea worm case reductions in South Sudan underscore the need for additional inquiry into the role of logistics in public health programming in low-income countries.

  15. Eradication of HIV and Cure of AIDS, Now and How?

    Directory of Open Access Journals (Sweden)

    Jie Lin eZhang

    2013-10-01

    Full Text Available Recent studies have highlighted the importance of eradication of human immunodeficiency virus (HIV and cure of acquired immunodeficiency syndrome (AIDS. However, a pivotal point that the patient immunity controls HIV reactivation after highly active anti-retroviral therapy (HAART, or combination anti-retroviral therapy, cART remains less well addressed. In spite of the fact that both innate and adaptive immunities are indispensable and numerous cells participate in the anti-HIV immunity, memory CD4 T-cells are indisputably the key cells organizing all immune actions against HIV while being the targets of HIV. Here we present a view and multidisciplinary approaches to HIV/AIDS eradication and cure. We aim at memory CD4 T-cells, utilizing the stem cell properties of these cells to reprogram an anti-HIV memory repertoire to eliminate the viral reservoir, toward achieving an AIDS-free world.

  16. Logistics of Guinea Worm Disease Eradication in South Sudan

    Science.gov (United States)

    Jones, Alexander H.; Becknell, Steven; Withers, P. Craig; Ruiz-Tiben, Ernesto; Hopkins, Donald R.; Stobbelaar, David; Makoy, Samuel Yibi

    2014-01-01

    From 2006 to 2012, the South Sudan Guinea Worm Eradication Program reduced new Guinea worm disease (dracunculiasis) cases by over 90%, despite substantial programmatic challenges. Program logistics have played a key role in program achievements to date. The program uses disease surveillance and program performance data and integrated technical–logistical staffing to maintain flexible and effective logistical support for active community-based surveillance and intervention delivery in thousands of remote communities. Lessons learned from logistical design and management can resonate across similar complex surveillance and public health intervention delivery programs, such as mass drug administration for the control of neglected tropical diseases and other disease eradication programs. Logistical challenges in various public health scenarios and the pivotal contribution of logistics to Guinea worm case reductions in South Sudan underscore the need for additional inquiry into the role of logistics in public health programming in low-income countries. PMID:24445199

  17. Global Campaign to Eradicate Insecurity of Tenure by 2030

    DEFF Research Database (Denmark)

    Enemark, Stig; McLaren, Robin

    2017-01-01

    The global eradication of infectious diseases through highly coordinated campaigns has been successful. Although insecurity of tenure is not a disease, its impact is devastating in terms of trapping people in poverty, displacing communities and making them homeless, and reducing food security...... and creating hunger. Only about 30% of the world’s population are covered by official land administration systems while the rest potentially suffer from insecurity of tenure. This is a human rights issue. Therefore, should a global campaign to achieve 80% global security of tenure by 2030 be planned....... This proposed global campaign could well be the necessary catalyst for change. The paper initially investigates the drivers that are emerging at the highest levels to raise the necessity and urgency to initiate a scalable, global campaign to eradicate insecurity of tenure. The paper then discusses how...

  18. Development and factor analysis of an index of post-polio sequelae.

    Science.gov (United States)

    Kalpakjian, Claire Z; Toussaint, Loren L; Klipp, David A; Forchheimer, Martin B

    2005-10-30

    This present study describes the development, factor structure and initial validation of the Index of Post-Polio Sequelae (IPPS). The IPPS was tested on a sample of 849 community-dwelling polio survivors between the ages of 40 and 93 years old who participated in a large, national study of menopause and aging in late polio. Items from the IPPS were submitted to a factor analysis using principal components extraction and rotated to oblique simple structure using promax rotation. Convergent validity was assessed using bivariate correlation. Three factors were extracted that accounted for approximately 53% of the variance in the original IPPS items. Factor 1 (Pain) was loaded most heavily by two items referring to muscle and joint pain. Factor 2 (Atrophy) was loaded by items referring to muscle atrophy, involved muscle weakness, and fatigue. Factor 3 (Bulbar) was comprised of two items referring to breathing and swallowing problems. Bivariate correlations between health and psychosocial variables and each of the factors all were significant and in expected directions. This first validation of a standardized scale to assess the severity of post-polio sequelae in polio survivors suggests a psychometrically sound instrument whose factor structure represents commonly reported problems in the extant post-polio literature.

  19. Dracunculiasis eradication--finishing the job before surprises arise.

    Science.gov (United States)

    Visser, Benjamin Jelle

    2012-07-01

    Dracunculiasis (Guinea worm disease) is a preventable waterborne parasitic disease that affects the poorest people living in remote rural areas in sub-Saharan African countries, who do not have access to safe drinking water. The Guinea Worm Eradication Program, a 25-year old campaign to rid the world of Guinea Worm disease has now reached its final stage accelerating to zero cases in all endemic countries. During the 19th and 20th centuries, dracunculiasis was common in much of Southern Asia and the African continent. The overall number of cases has been reduced tremendously by ≥99%, from the 3.32 million cases estimated to have occurred in 1986 in Africa to only 1,797 cases reported in 2010 reported in only five countries (Sudan, Mali, Ethiopia, Chad and Ghana) and Asia free of the disease. This achievement is unique in its kind--the only previously eradicated disease is smallpox, a viral infection for which vaccination was possible--and it has been achieved through primary community-based prevention and health education programs. Most efforts need to be taken in two countries, South Sudan (comprising 94% or 1,698 out of 1,797 of the cases reported world-wide in 2010) and Mali because of frequent movements of nomads in a vast area inside and outside Mali's borders. All factors favourable to dracunculiasis eradication are available including adequate financial resources, community and political support and high levels of advocacy. Thus there is no reason that this disabling parasitic disease cannot be eradicated soon before surprises arise such as new civil conflicts in currently endemic countries. Copyright © 2012 Hainan Medical College. Published by Elsevier B.V. All rights reserved.

  20. Poverty eradication: a new paradigm.

    Science.gov (United States)

    Pethe, V P

    1998-08-01

    This article offers a new paradigm for eradicating poverty in India. It was assumed incorrectly by Mahatma Gandhi that a good society without mass poverty would follow after independence. India copied Western models of development and developed giant factories, big dams, and megacities. Agriculture did not expand the number of jobs for people. The Western paradigm failed in India because of the false assumption of "trickle down" of income to the masses. The targeted programs to the poor did not directly benefit enough of the poor. Mega-industrialization led to reduced employment and higher skill needs. The model failed mainly because it was a proxy and relied on indirect ways of reaching the poor. The models failed to be adapted to conditions in India. The Swadeshi paradigm is a direct model for addressing mass poverty. Poverty is affected by immediate, intermediate, and ultimate determinants. Poverty begets social and economic problems, such as ignorance, ill health, high fertility, unemployment, and crime. In India and developing countries, mass poverty results from under use of human resources; lack of equal opportunities; and an outdated non-egalitarian social structure, an unjust global economic order, human cruelty, and erosion of ethical values. Indians are squandering their precious resources mimicking Western consumerism. Poverty leads to rapid population growth. People become productive assets with universal literacy, compulsory and free education, health services and sanitation, vocational training, and work ethics. India needs people-oriented policies with less emphasis on capital accumulation.

  1. Willapa - Spartina Mapping and Eradication 2014

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continued a successful program aimed at eradicating the non-native cordgrass, Spartina alterniflora (Spartina)...

  2. Eradication of infectious diseases in heterogeneous populations

    Energy Technology Data Exchange (ETDEWEB)

    Travis, C.C.; Lenhart, S.M.

    1987-04-01

    A model is presented of infectious disease in heterogeneous populations, which allows for variable intra- to intergroup contact ratios. The authors give necessary and sufficient conditions for disease eradication by means of vaccination. Smallpox is used as an illustrative example.

  3. Willapa - Spartina Mapping and Eradication 2015

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Willapa National Wildlife Refuge (Willapa NWR) continues to work toward the eradication of the non-native cordgrass, Spartina alterniflora (Spartina) from...

  4. Reinforcement Tool of Whistleblowing to Eradicate Fraud in Public Sector

    Directory of Open Access Journals (Sweden)

    Basri Siti Aisyah

    2017-01-01

    Full Text Available Whistleblowing is an internal control system that be a way to reduce or eradicate fraud. This paper focuses on investigating the reasons for whistleblowing is not a preferred method to eradicate fraud. This paper starts with defining the term “whistleblowing”. In its simplest form, whistleblowing involves the act of reporting improper conduct within an organisation to internal or external parties. This paper explains the issues and effects concerning whistleblowing. One of the issues is the violation of public trust. Lastly, this paper will describe the reasons for resistance of people to blow the whistle. Among the reasons is the fear of reprisal. This is a concept paper and it aims to conduct interview session with the Head for every local authority in Melaka. The findings of this paper can be used by the Government to create a new model related to whistleblowing to eradicate fraud in public sector. The Government could use this paper as the support to enhance the achievement of National Key Result Areas (NKRAs Against Corruption.

  5. Celebrating 50 years of polio elimination in New Zealand: but inadequate progress in eliminating other vaccine-preventable diseases.

    Science.gov (United States)

    Wilson, Nick; Baker, Michael G

    2012-11-09

    New Zealanders can now reflect on and celebrate 50 years of polio elimination in this country. This success was followed by eliminating two other infectious diseases, brucellosis and hydatids, and an imported potential disease vector, the southern saltmarsh mosquito. However, this country has made inadequate progress in eliminating several other vaccine-preventable diseases. These include measles, mumps, and rubella, which are priority candidates for elimination, and potentially Hib disease and rotavirus infection. To achieve such successes almost certainly requires that the country: (i) builds national leadership for elimination goals; (ii) develops detailed plans; (iii) continues recent successes in enhancing routine vaccination coverage; (iv) introduces rotavirus vaccine into the childhood immunisation schedule; and (v) strengthens surveillance and research (on such questions as the cost-effectiveness of new vaccines, measures to enhance uptake, and effective border controls to reduce the risk of disease importation).

  6. Dynamics affecting the risk of silent circulation when oral polio vaccination is stopped

    Directory of Open Access Journals (Sweden)

    J.S. Koopman

    2017-09-01

    Full Text Available Waning immunity could allow transmission of polioviruses without causing poliomyelitis by promoting silent circulation (SC. Undetected SC when oral polio vaccine (OPV use is stopped could cause difficult to control epidemics. Little is known about waning. To develop theory about what generates SC, we modeled a range of waning patterns. We varied both OPV and wild polio virus (WPV transmissibility, the time from beginning vaccination to reaching low polio levels, and the infection to paralysis ratio (IPR. There was longer SC when waning continued over time rather than stopping after a few years, when WPV transmissibility was higher or OPV transmissibility was lower, and when the IPR was higher. These interacted in a way that makes recent emergence of prolonged SC a possibility. As the time to reach low infection levels increased, vaccine rates needed to eliminate polio increased and a threshold was passed where prolonged low-level SC emerged. These phenomena were caused by increased contributions to the force of infection from reinfections. The resulting SC occurs at low levels that would be difficult to detect using environmental surveillance. For all waning patterns, modest levels of vaccination of adults shortened SC. Previous modeling studies may have missed these phenomena because (1 they used models with no or very short duration waning and (2 they fit models to paralytic polio case counts. Our analyses show that polio case counts cannot predict SC because nearly identical polio case count patterns can be generated by a range of waning patterns that generate different patterns of SC. We conclude that the possibility of prolonged SC is real but unquantified, that vaccinating modest fractions of adults could reduce SC risk, and that joint analysis of acute flaccid paralysis and environmental surveillance data can help assess SC risks and ensure low risks before stopping OPV.

  7. Smallpox: can we still learn from the journey to eradication?

    Science.gov (United States)

    Smith, Kendall A

    2013-05-01

    One of the most celebrated achievements of immunology and modern medicine is the eradication of the dreaded plague smallpox. From the introduction of smallpox vaccination by Edward Jenner, to its popularization by Louis Pasteur, to the eradication effort led by Donald Henderson, this story has many lessons for us today, including the characteristics of the disease and vaccine that permitted its eradication, and the obviousness of the vaccine as a vector for other intractable Infectious diseases. The disease itself, interpreted in the light of modern molecular immunology, is an obvious immunopathological disease, which occurs after a latent interval of 1-2 weeks, and manifests as a systemic cell-mediated delayed type hypersensitivity (DTH) syndrome. The vaccine that slayed this dragon was given the name vaccinia, and was thought to have evolved from cowpox virus, but is now known to be most closely related to a poxvirus isolated from a horse. Of interest is the fact that of the various isolates of orthopox viruses, only variola, vaccinia and monkeypox viruses can infect humans. In contrast to the systemic disease of variola, vaccinia only replicates locally at the site of inoculation, and causes a localized DTH response that usually peaks after 7-10 days. This difference in the pathogenicity of variola vs. vaccinia is thought to be due to the capacity of variola to circumvent innate immunity, which allows it to disseminate widely before the adaptive immune response occurs. Thus, the fact that vaccinia virus is attenuated compared to variola, but is still replication competent, makes for its remarkable efficacy as a vaccine, as the localized infection activates all of the cells and molecules of both innate and adaptive immunity. Accordingly vaccinia itself, and not modified replication incompetent vaccina, is the hope for use as a vector in the eradication of additional pathogenic microbes from the globe.

  8. [Socio-medical profile of post-polio syndrome patients in center east of Tunisia].

    Science.gov (United States)

    Zorgati, Asma; Maaref, Khaled; Naouar, Nader; Zaoui, Afif; Ghannouchi, Slaheddine

    2014-01-01

    The diagnosis of the post polio syndrome is purely clinic. It occurs few decade after poliomyelitis. It associates recent appearance or progressive worsening of muscular weakness, pain, muscular fatigue or atrophy. It remains not recognized in Tunisia. of our study is to identify the socio-medical profile of the postpolio population in the Tunisian east central region through a check of the risk factors and the clinical characteristics of these patients. Descriptive study analyzing 32 files (medical expertise) of post polio syndrome patients The risk factors of post polio syndrome such us female gender, obesity, low educational level, early age of poliomyelitis appearance and the importance of physical effort at work, were observed in our study and are in agreement with the literature data. Average delay of post polio syndrome occurrence was 40 years. Most Disturbing symptom was the muscular pain. All our patients indicated negative impact on their everyday life and their work. They all asked for their right for incapacity or long-term disease beside the National health insurance fund (CNAM). Recognition of patients affected by the Post polio syndrome and their social and medical needs are necessary.

  9. Factors Associated with Reduced Quality of Life in Polio Survivors in Korea.

    Directory of Open Access Journals (Sweden)

    Eun Joo Yang

    Full Text Available The purpose of this study is to assess health-related quality of life in polio survivors (PS compared with that in the general population in Korea. Polio survivors (n = 120 from outpatient clinics at two hospitals, healthy controls (HC, n = 121 and members of the general population with activity limitations (AL, n = 121 recruited through a proportional-allocation, systematic sampling strategy from the Fourth Korean National Health and Nutrition Examination Survey were surveyed with self-rated health-related quality of life (Euro QoL five-dimensions. The proportion of participants who reported problems in mobility, usual activity, and symptoms of anxiety/depression were higher in the PS group compared with the HC and AL groups. There was no significant difference in the self-care dimension across the groups. Polio-specific questionnaire, pain, depression, fatigue, Modified Barthel Index (K-MBI and Short Physical Performance Battery (SPPB were assessed in the PS group. Those with post-poliomyelitis syndrome had greater problems in mobility, usual activity, and depression/anxiety. Polio survivors, especially those with more pain and fatigue symptoms, and those who did not have access to medical services had poorer health-related quality of life. These findings afford useful information for potential intervention improving quality of life in polio survivors.

  10. Currents issues in cardiorespiratory care of patients with post-polio syndrome

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    Marco Orsini

    2016-07-01

    Full Text Available ABSTRACT Post-polio syndrome (PPS is a condition that affects polio survivors years after recovery from an initial acute attack of the poliomyelitis virus. Most often, polio survivors experience a gradual new weakening in muscles that were previously affected by the polio infection. The actual incidence of cardiovascular diseases (CVDs in individuals suffering from PPS is not known. However, there is a reason to suspect that individuals with PPS might be at increased risk. Method A search for papers was made in the databases Bireme, Scielo and Pubmed with the following keywords: post polio syndrome, cardiorespiratory and rehabilitation in English, French and Spanish languages. Although we targeted only seek current studies on the topic in question, only the relevant (double-blind, randomized-controlled and consensus articles were considered. Results and Discussion Certain features of PPS such as generalized fatigue, generalized and specific muscle weakness, joint and/or muscle pain may result in physical inactivity deconditioning obesity and dyslipidemia. Respiratory difficulties are common and may result in hypoxemia. Conclusion Only when evaluated and treated promptly, somE patients can obtain the full benefits of the use of respiratory muscles aids as far as quality of life is concerned.

  11. Esomeprazole versus omeprazole for the eradication of Helicobacter pylori infection: results of a randomized controlled study.

    Science.gov (United States)

    Anagnostopoulos, George K; Tsiakos, Stavros; Margantinis, George; Kostopoulos, Panagiotis; Arvanitidis, Dimitrios

    2004-07-01

    Esomeprazole has higher oral bioavailability and increased antimicrobial activity against Helicobacter pylori than omeprazole. To compare 7 days esomeprazole with 7 days of omeprazole based triple therapies for the eradication of H. pylori, and to assess whether the administration of higher dose of esomeprazole leads to improved eradication rates. One hundred and fifty-six dyspeptic patients with H. pylori received either: (1) 1-week treatment including esomeprazole 40 mg once daily, amoxicillin 1 g, and clarithromycin 500 mg, both twice daily (EAC1 group, n = 52); (2) 1-week treatment of omeprazole 20 mg, amoxicillin 1 g, and clarithromycin 500 mg, all administered twice daily (OAC group, n = 52); or (3) 1-week treatment with esomeprazole 40 mg, amoxicillin 1 g, and clarithromycin 500 mg, all given twice daily (EAC2 group, n = 52). H. pylori was eradicated in 37 of 52 patients in the OAC group (Intension to treat [ITT] 71%), and in 42 patients in the EAC1 group (ITT 81%). High eradication rate was achieved by the EAC2 regimen (ITT; 96%), but more patients reported unwanted effects. Seven days of esomeprazole based triple therapy is a satisfactory eradication regimen for H. pylori infection. Higher doses of esomeprazole have excellent eradication rates, but they may lead to increased side effects.

  12. A short-term eradication therapy for Helicobacter pylori acute gastritis.

    Science.gov (United States)

    Nomura, H; Miyake, K; Kashiwagi, S; Sugiyama, T; Asaka, M

    2000-12-01

    Acute gastritis, caused by an initial infection of Helicobacter pylori (H. pylori), may resolve spontaneously, but the infection sometimes becomes chronic. We examined the efficacy of a short-term H. pylori eradication therapy on acute gastritis. Among the 15 patients with hemorrhagic acute gastritis who were randomly allocated to group A (eradication therapy) or group B (Lansoprazole, LPZ), 10 of them started to receive treatment within 1 day after the disease onset. The other five patients began the eradication therapy 4-6 days after disease onset (group C). Eradication therapy consisted of a daily oral administration of each of 30 mg lansoprazole (LPZ), once a day; 400 mg clarithromycin, twice a day; 1000 mg amoxicillin, twice a day; and 300 mg rebamipide, three times a day, for one week. If the endoscopy was normal, medication was stopped for the following 4 weeks before gastric endoscopy was performed again in order to assess H. pylori eradication. All group A patients were cured after the 1-week treatment and therefore, they became H. pylori negative. Group B and C patients had erosions or ulcers after the 1-week treatment and so received an additional 3-week administration of LPZ. Four weeks later, their gastritis was cured and except for one group B patient, they became H. pylori-negative. In patients with acute gastritis, caused by an initial H. pylori infection, eradication therapy was efficacious in achieving early healing. This therapy should be started as soon as possible after disease onset.

  13. Leprosy - evolution of the path to eradication

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    Sunil Dogra

    2013-01-01

    Full Text Available Leprosy is among the world′s oldest and most dreaded diseases and it has been synonymous with stigma and discrimination due to the hideous deformities it produced, mystery around its aetiology and transmission and lack of any effective remedy till recently. Leprosy control started with the use of chaulmoogra oil and for the last three decades, multi drug therapy (MDT has been our main tool against leprosy. In the last two decades, the reported global prevalence of active leprosy infection has dropped by almost 90 per cent by the combined efforts of the World Health Organization (WHO, local governments, health professionals, and non-governmental organizations (NGOs, however, a parallel drop in the incidence or new case detection rate (NCDR has not occurred. From 1994 through 2011, more than 100,000 new cases are being detected annually, of whom maximum case load is from India. There is need for research on tools for early diagnosis, short and effective treatment, and prevention of deformities and disabilities. Evaluating the role of immunotherapy and immunoprophylaxis will also lead us to better understanding of their mode of action. Further molecular analysis of Mycobacterium leprae genome may provide the requisite basis for all this. The current reality is that there is a need to sustain and provide quality leprosy services to all persons through general health services, including good referral system. All these provisions in the integrated health care approach will go a long way in further reducing the stigma. Efforts need to be made to reduce deformity through early detection, self care, physiotherapy and reconstructive surgery and developing sound surveillance systems. With all the remarkable achievements in the fight against leprosy, the stage is now set for the final assault. It is hoped that with the efforts of all the stake holders and strong political will, the disease will be eradicated in the near future.

  14. Leprosy - evolution of the path to eradication

    Science.gov (United States)

    Dogra, Sunil; Narang, Tarun; Kumar, Bhushan

    2013-01-01

    Leprosy is among the world's oldest and most dreaded diseases and it has been synonymous with stigma and discrimination due to the hideous deformities it produced, mystery around its aetiology and transmission and lack of any effective remedy till recently. Leprosy control started with the use of chaulmoogra oil and for the last three decades, multi drug therapy (MDT) has been our main tool against leprosy. In the last two decades, the reported global prevalence of active leprosy infection has dropped by almost 90 per cent by the combined efforts of the World Health Organization (WHO), local governments, health professionals, and non-governmental organizations (NGOs), however, a parallel drop in the incidence or new case detection rate (NCDR) has not occurred. From 1994 through 2011, more than 100,000 new cases are being detected annually, of whom maximum case load is from India. There is need for research on tools for early diagnosis, short and effective treatment, and prevention of deformities and disabilities. Evaluating the role of immunotherapy and immunoprophylaxis will also lead us to better understanding of their mode of action. Further molecular analysis of Mycobacterium leprae genome may provide the requisite basis for all this. The current reality is that there is a need to sustain and provide quality leprosy services to all persons through general health services, including good referral system. All these provisions in the integrated health care approach will go a long way in further reducing the stigma. Efforts need to be made to reduce deformity through early detection, self care, physiotherapy and reconstructive surgery and developing sound surveillance systems. With all the remarkable achievements in the fight against leprosy, the stage is now set for the final assault. It is hoped that with the efforts of all the stake holders and strong political will, the disease will be eradicated in the near future. PMID:23481049

  15. Life purpose: effect on functional decline and quality of life in polio survivors.

    Science.gov (United States)

    Harrison, Tracie C; Stuifbergen, Alexa K

    2006-01-01

    This article explores the protective effects that finding a purpose in life has on the level of physical and mental impairment and overall quality of life. Results were gathered from a national sample of 2,153 polio survivors. Although the combined social and physical experience of living with the disabling effects of polio has been associated with accelerated aging due to an increased allostatic load, finding a purpose in life may diminish these effects. The findings of this study indicate that purpose in life is associated with less perceived decline in health. Moreover, purpose in life is predictive of better quality of life despite levels of physical and mental impairment. Rehabilitation nurses should consider ways to help persons with polio maintain activities and interests that promote their sense of purpose in life.

  16. Recent plant eradications on the islands of Maui County, Hawai'i

    Science.gov (United States)

    Penniman, Teya M.; Buchanan, Lori; Loope, Lloyd L.; Veitch, C.R.; Clout, Mike N.; Towns, D. R.

    2011-01-01

    The state of Hawai'i (USA) has few regulations to limit plant introductions. A network of interagency islandbased invasive species committees has evolved over the past decade to address this vulnerability, with the aim of stopping invasions before they threaten natural areas. On Maui, Moloka‘i, and Lāna‘i, which comprise three of the four islands of Maui County, single-island eradications have been achieved for 12 plant species and eradication is likely imminent for an additional eight species. The islands vary in size, population, and land ownership. We explore the relative importance of those variables in achieving successful eradications along with target species selection, detection strategies, and public support

  17. Elevated blood lipids are uncommon in patients with post-polio syndrome--a cross sectional study.

    Science.gov (United States)

    Melin, Eva; Kahan, Thomas; Borg, Kristian

    2015-04-29

    The post-polio syndrome occurs in people who previously have had poliomyelitis. After the initial recovery, new or increasing neurologic symptoms occur. Inflammation and dyslipidaemia may play an important role in the development of atherosclerotic complications, for example myocardial infarction and angina pectoris. Previous studies on cardiovascular risk factors in the post-polio syndrome have found a higher prevalence of hypertension, ischemic heart disease, hyperlipidaemia, and stroke in these patients. The present study was undertaken in order to evaluate whether post-polio patients have elevated lipid values, and if blood lipid abnormalities could be correlated to signs of inflammation. Cross-sectional study of 89 consecutive post-polio patients, (53 women, mean age 65 years) from the Post-Polio Outpatient Clinic, Danderyd University Hospital, Stockholm, Sweden. The lipid profiles of post-polio patients were compared to age and sex matched reference values from two earlier studies. Statistical analyses were performed by the Student's t-test, and linear regression analyses were assessed by Pearson's correlation coefficient. Mean total cholesterol levels (5.7 mmol/L) were low or normal in post-polio patients, whereas low density lipoprotein levels (3.6 mmol/L) were normal, and high density lipoprotein (1.5 mmol/L) and triglycerides (1.4 mmol/L) lower than reference values. The prevalence of diabetes (7%), hypertension (38%), concomitant cardiovascular disease, (including angina pectoris, myocardial infarction, heart failure, atrial fibrillation and stroke) (7%), and calculated 10 year risk of coronary heart disease according to Framingham risk score algorithm (8%) was not increased in post-polio patients. Compared to reference populations, post-polio patients in Sweden appear to have low or normal total cholesterol and low density lipoprotein levels, whereas high density lipoprotein and triglyceride levels are low. Hence, a possible persisting inflammatory

  18. A Cross-Sectional Survey of Healthcare Workers on the Knowledge and Attitudes towards Polio Vaccination in Pakistan.

    Directory of Open Access Journals (Sweden)

    Muhammad Umair Khan

    Full Text Available Pakistan accounts for 85.2% of the total polio cases reported worldwide. Healthcare workers (HCWs are an integral part of immunization campaigns and source of education for the general public. This study aimed to assess the knowledge and attitudes towards polio vaccination among HCWs providing immunisation and education to general public in Quetta and Peshawar divisions of Pakistan.A cross-sectional survey of 490 HCWs was conducted in two major referral public teaching hospitals of Quetta and Peshawar divisions. During February to April, 2015, a random sample of 490 HCWs was invited to participate in this study. Knowledge and attitudes were assessed by using self-administered, anonymous and pretested questionnaire. Descriptive and logistic regression analyses were used to express the results.A total of 468 participants responded to the questionnaire, giving a response rate of 95.5%. Overall, participants demonstrated good knowledge and positive attitudes towards polio vaccination. The mean knowledge score of HCWs about polio was 13.42 ± 2.39 (based on 18 knowledge questions while the mean attitude score was 28.75 ± 5.5 (based on 9 attitudes statements. Knowledge gaps were identified about the incubation period of poliovirus (19.5%, management issues (31.9%, use of polio vaccine in mild illnesses (34.7% and the consequences of the polio virus (36.9%. The majority of participants agreed that all children should be vaccinated for polio (95.1%, while reservations were noted about the need of a booster (38.9%, and sterility issues associated with polio vaccines (43.6%. Internet (n = 167, 37% and Posters (n = 158, 35% were the main sources used by HCWs to educate themselves about polio.Participants in this study had good knowledge and positive attitudes towards polio vaccination. Although the data are indicative of gaps in the knowledge of HCWs, the findings may not be generalized to other hospitals in Pakistan.

  19. Edward Jenner and the eradication of smallpox.

    Science.gov (United States)

    Willis, N J

    1997-08-01

    Edward Jenner's careful investigations into the usefulness of cowpox vaccination for the prevention of smallpox during the late 1790s, and his enthusiastic and continued advocation of vaccination despite the scepticism of critics, laid the foundations for the growth of understanding about the nature of infectious disease and the development of immunity during the 19th century. He began the long process which resulted in the successful eradication of the smallpox virus in 1980. His life story remains an inspiration to physicians facing an uncertain future as viruses and bacteria not yet eradicated adapt to the antibiotic age.

  20. Eradication of Ebola Based on Dynamic Programming

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    Jia-Ming Zhu

    2016-01-01

    Full Text Available This paper mainly studies the eradication of the Ebola virus, proposing a scientific system, including three modules for the eradication of Ebola virus. Firstly, we build a basic model combined with nonlinear incidence rate and maximum treatment capacity. Secondly, we use the dynamic programming method and the Dijkstra Algorithm to set up M-S (storage and several delivery locations in West Africa. Finally, we apply the previous results to calculate the total cost, production cost, storage cost, and shortage cost.

  1. Global eradication of measles: Are we poised?

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    Raghavendra D Kulkarni

    2017-01-01

    Full Text Available Measles, a highly infectious viral disease is the next target for eradication following poliovirus. Decades of experience with highly effective vaccination has invigorated us to take on this virus. The task is not only Titanic but is laced with intricate issues. Recently, an outbreak of fever with rash occurred on a tertiary care teaching hospital campus and was confirmed serologically as measles outbreak by IgMELISA. Therefore, we searched the literature related to outbreaks, transmission of the measles virus, age groups involved, vaccination strategies, vaccination failure and epidemiological features of the disease and reviewed the possible reasons for such outbreaks and problems in the global eradication of the virus.

  2. Incompatibility of lyophilized inactivated polio vaccine with liquid pentavalent whole-cell-pertussis-containing vaccine.

    Science.gov (United States)

    Kraan, Heleen; Ten Have, Rimko; van der Maas, Larissa; Kersten, Gideon; Amorij, Jean-Pierre

    2016-08-31

    A hexavalent vaccine containing diphtheria toxoid, tetanus toxoid, whole cell pertussis, Haemophilius influenza type B, hepatitis B and inactivated polio vaccine (IPV) may: (i) increase the efficiency of vaccination campaigns, (ii) reduce the number of injections thereby reducing needlestick injuries, and (iii) ensure better protection against pertussis as compared to vaccines containing acellular pertussis antigens. An approach to obtain a hexavalent vaccine might be reconstituting lyophilized polio vaccine (IPV-LYO) with liquid pentavalent vaccine just before intramuscular delivery. The potential limitations of this approach were investigated including thermostability of IPV as measured by D-antigen ELISA and rat potency, the compatibility of fluid and lyophilized IPV in combination with thimerosal and thimerosal containing hexavalent vaccine. The rat potency of polio type 3 in IPV-LYO was 2 to 3-fold lower than standardized on the D-antigen content, suggesting an alteration of the polio type 3 D-antigen particle by lyophilization. Type 1 and 2 had unaffected antigenicity/immunogenicity ratios. Alteration of type 3 D-antigen could be detected by showing reduced thermostability at 45°C compared to type 3 in non-lyophilized liquid controls. Reconstituting IPV-LYO in the presence of thimerosal (TM) resulted in a fast temperature dependent loss of polio type 1-3 D-antigen. The presence of 0.005% TM reduced the D-antigen content by ∼20% (polio type 2/3) and ∼60% (polio type 1) in 6h at 25°C, which are WHO open vial policy conditions. At 37°C, D-antigen was diminished even faster, suggesting that very fast, i.e., immediately after preparation, intramuscular delivery of the conceived hexavalent vaccine would not be a feasible option. Use of the TM-scavenger, l-cysteine, to bind TM (or mercury containing TM degradation products), resulted in a hexavalent vaccine mixture in which polio D-antigen was more stable. Copyright © 2016 The Authors. Published by Elsevier

  3. [Poliovirus immunology: vaccines, problems for the prevention/eradication and future interventions].

    Science.gov (United States)

    Fernández-Cruz Pérez, Eduardo; Rodríguez-Sainz, Carmen

    2013-01-01

    Polio is a contagious disease that is caused by the poliovirus, an enterovirus in the family Picornaviridae. The virus enters through the oral mucosa and multiplies in epithelial cells of both the oropharynx as the gastrointestinal tract, releasing virus in oropharyngeal secretions and through the stool. The mode of transmission is fecal-oral and/or oral-oral. The virus preferentially infects children under 5 years. Most infections are asymptomatic and self-limiting gastrointestinal tract. Eventually it spreads to the central nervous system and affects the anterior horn motor neurons of the spinal cord causing paralysis and even death. We will describe host-virus interaction and the natural history of infection which depends on many factors, including the type of viral inoculum (serotypes VP1, 2 and 3) and host factors, such as nutritional status, concurrent infections and the ability to induce protective immune responses, such as, humoral anti-viral antibody responses with neutralizing antibodies, mucosal immunity and systemic adaptative immune responses. We will discuss the relevant aspects of the immuno-pathogenesis of the infection by poliovirus and the problems related to the host-virus interactions in the subjects vaccinated, with the latest advances in the strategies to develop optimal protection with the different poliovirus vaccines that could allow the development of a more effective immunization with induction of the effect or mechanisms that would prevent development of the disease, transmission of the virus, out-breaks and eventually the poliovirus eradication.

  4. Influence of Macchia eradication techniques on botanical ...

    African Journals Online (AJOL)

    Downing B.H., Robinson E.R., Trollope W.S.W., Morris J.W. ... burning; cliffortia linearifolia; cliffortia paucistaminea; competition; control; cutting; dohne sourveld; elyonurus argenteus; eradication; erica brownleeae; grass sward; grasses; grazing; gxulu kop; harpechloa falx; heteropogon contortus; keiskammahoek; macchia; ...

  5. The screwworm eradication program: From an unlikely dream to an outstanding reality

    Science.gov (United States)

    The screwworm, Cochliomyia hominivorax (Coquerel) (Diptera: Calliphoridae), was a devastating pest to all warm blooded animals in the United States and the rest of North America. Successful eradication of the screwworm was achieved by using the unique approach called the sterile insect technique. He...

  6. Combining tactics to exploit allee effects for eradication of alien insect populations

    Science.gov (United States)

    David Maxwell Suckling; Patrick C. Tobin; Deborah G. McCullough; Daniel A. Herms

    2012-01-01

    Invasive species increasingly threaten ecosystems, food production, and human welfare worldwide. Hundreds of eradication programs have targeted a wide range of nonnative insect species to mitigate the economic and ecological impacts of biological invasions. Many such programs used multiple tactics to achieve this goal, but interactions between tactics have received...

  7. Vacina contra poliomielite: um novo paradigma Polio vaccines: a new paradigma

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    Lucia Ferro Bricks

    2007-06-01

    , from January 2000 to December 2006. DATA SYNTHESIS: Acknowledgement of vaccine-associated paralysis and oral vaccine-derived circulating viruses’ paralysis shall certainly require discontinuation of oral vaccination for poliomyelitis use in a short time. After eradication of the wild viruses, oral vaccination for poliomyelitis should be discontinued, preferably in a synchronized manner in all the countries. After termination of vaccination programs, people will become susceptible again to poliomyelitis virus and disease outbreaks caused by wild viruses may occur (accidental escape from laboratories or bioterrorism. In countries already using inactivated poliovirus vaccine, it is unlikely that vaccination will be interrupted. Countries that currently use exclusively oral poliovirus vaccine will have to rely on epidemiological surveillance and on oral vaccine inventories to control potential polio outbreaks. If the oral poliovirus vaccine is reintroduced in those populations, there will be again a risk for vaccine-associated paralysis and oral vaccine-derived circulating viruses’ that may spread rapidly to other regions and to nearby countries. CONCLUSIONS: Inactivated poliovirus vaccine introduction in the routine Brazilian vaccination calendar should be programmed as well as acquisition of technology for inactivated poliovirus vaccine production since the latter is currently insufficient to cover global demand.

  8. Disability and functional assessment in former polio patients with and without postpolio syndrome

    NARCIS (Netherlands)

    Nollet, F.; Beelen, A.; Prins, M. H.; de Visser, M.; Sargeant, A. J.; Lankhorst, G. J.; de Jong, B. A.

    1999-01-01

    OBJECTIVES: To compare perceived health problems and disability in former polio subjects with postpolio syndrome (PPS) and those without postpolio syndrome (non-PPS), and to evaluate perceived health problems, disability, physical performance, and muscle strength. DESIGN: Cross-sectional survey;

  9. [40 years after the last polio epidemic. Postpolio syndrome as a cause of "weaning failure"].

    Science.gov (United States)

    Gaul, C; Winterholler, M

    2002-05-01

    About 80,000 polio survivors are still living 40 years after the last polio epidemics in Germany. Of these 40-70% have developed the so called post-polio syndrome (PPS) decades after the infection. The main symptoms of PPS are decreasing strength in voluntary muscles, pain and fatigue which occur spontaneously but may also be induced by physical stress and general illness. We report the case of a 79-year-old male who developed hypercapnia due to ventilatory failure which necessitated reintubation several times after cholecystectomy. The medical history revealed that he had had poliomyelitis at the age of 8 years. There was only a slight residual handicap from this infection which included mild pareses of the left limbs but had remained stable for about 70 years. Electromyography revealed signs of chronic neurogenic changes in muscles of the left upper limb as well as in the pectoralis major. The diagnostic criteria of a post-polio syndrome were fulfilled and other neuromuscular diseases were excluded. The patient could be discharged from intensive care only after treatment by intermittent positive pressure ventilation via a facial mask. This case report shows that even patients who have a mild handicap after poliomyelitis can develop weaning problems. A PPS can exacerbate with inclusion of respiratory muscles in critically ill patients.

  10. Quantitative muscle ultrasound and quadriceps strength in patients with post-polio syndrome

    NARCIS (Netherlands)

    Bickerstaffe, Alice; Beelen, Anita; Zwarts, Machiel J.; Nollet, Frans; van Dijk, Johannes P.

    2015-01-01

    We investigated whether muscle ultrasound can distinguish muscles affected by post-polio syndrome (PPS) from healthy muscles and whether severity of ultrasound abnormalities is associated with muscle strength. Echo intensity, muscle thickness, and isometric strength of the quadriceps muscles were

  11. Loss of motor unit size and quadriceps strength over 10 years in post-polio syndrome

    NARCIS (Netherlands)

    Bickerstaffe, A.; van Dijk, J. P.; Beelen, A.; Zwarts, M. J.; Nollet, F.

    2014-01-01

    To investigate whether strength decline in post-polio syndrome (PPS) results from excessive distal axonal degeneration of enlarged motor units. We assessed changes over 10 years in isometric quadriceps strength, mean motor unit action potential (MUAP) size, root mean squared (RMS) amplitude, and

  12. Studies on the potency of oral polio vaccine using RD cell line and ...

    African Journals Online (AJOL)

    Oral polio vaccine (OPV) proved to be superior in administration eliminating the need of sterile syringes and making the vaccine more suitable for mass vaccination campaigns. Poliovirus is heat sensitive in nature, and thus OPV is stored at low temperature (frozen). The growth medium containing varying concentration of ...

  13. The impact of the Iraq War on neonatal polio immunisation coverage: a quasi-experimental study.

    Science.gov (United States)

    Cetorelli, Valeria

    2015-03-01

    The public health consequences of the Iraq War (2003-2011) have remained difficult to quantify, mainly due to a scarcity of adequate data. This paper is the first to assess whether and to what extent the war affected neonatal polio immunisation coverage. The study relies on retrospective neonatal polio vaccination histories from the 2000, 2006 and 2011 Iraq Multiple Indicator Cluster Surveys (N=64,141). Pooling these surveys makes it possible to reconstruct yearly trends in immunisation coverage from 1996 to 2010. The impact of the war is identified with a difference-in-difference approach contrasting immunisation trends in the autonomous Kurdish provinces, which remained relatively safe during the war, with trends in the central and southern provinces, where violence and disruption were pervasive. After controlling for individual and household characteristics, year of birth and province of residence, children exposed to the war were found to be 21.5 percentage points (95% CI -0.341 to -0.089) less likely to have received neonatal polio immunisation compared with non-exposed children. The decline in neonatal polio immunisation coverage is part of a broader war-induced deterioration of routine maternal and newborn health services. Postwar strategies to promote institutional deliveries and ensure adequate vaccine availability in primary health facilities could increase dramatically the percentage of newborns immunised. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Preventing Vaccine-Derived Poliovirus Emergence during the Polio Endgame.

    Directory of Open Access Journals (Sweden)

    Margarita Pons-Salort

    2016-07-01

    Full Text Available Reversion and spread of vaccine-derived poliovirus (VDPV to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs. Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2 in April 2016. Supplementary immunisation activities (SIAs with trivalent OPV (tOPV in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2. Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently "missed" groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004-2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55-0.82]. We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population

  15. Preventing Vaccine-Derived Poliovirus Emergence during the Polio Endgame.

    Science.gov (United States)

    Pons-Salort, Margarita; Burns, Cara C; Lyons, Hil; Blake, Isobel M; Jafari, Hamid; Oberste, M Steven; Kew, Olen M; Grassly, Nicholas C

    2016-07-01

    Reversion and spread of vaccine-derived poliovirus (VDPV) to cause outbreaks of poliomyelitis is a rare outcome resulting from immunisation with the live-attenuated oral poliovirus vaccines (OPVs). Global withdrawal of all three OPV serotypes is therefore a key objective of the polio endgame strategic plan, starting with serotype 2 (OPV2) in April 2016. Supplementary immunisation activities (SIAs) with trivalent OPV (tOPV) in advance of this date could mitigate the risks of OPV2 withdrawal by increasing serotype-2 immunity, but may also create new serotype-2 VDPV (VDPV2). Here, we examine the risk factors for VDPV2 emergence and implications for the strategy of tOPV SIAs prior to OPV2 withdrawal. We first developed mathematical models of VDPV2 emergence and spread. We found that in settings with low routine immunisation coverage, the implementation of a single SIA increases the risk of VDPV2 emergence. If routine coverage is 20%, at least 3 SIAs are needed to bring that risk close to zero, and if SIA coverage is low or there are persistently "missed" groups, the risk remains high despite the implementation of multiple SIAs. We then analysed data from Nigeria on the 29 VDPV2 emergences that occurred during 2004-2014. Districts reporting the first case of poliomyelitis associated with a VDPV2 emergence were compared to districts with no VDPV2 emergence in the same 6-month period using conditional logistic regression. In agreement with the model results, the odds of VDPV2 emergence decreased with higher routine immunisation coverage (odds ratio 0.67 for a 10% absolute increase in coverage [95% confidence interval 0.55-0.82]). We also found that the probability of a VDPV2 emergence resulting in poliomyelitis in >1 child was significantly higher in districts with low serotype-2 population immunity. Our results support a strategy of focused tOPV SIAs before OPV2 withdrawal in areas at risk of VDPV2 emergence and in sufficient number to raise population immunity above the

  16. Reflux esophagitis triggered after Helicobacter pylori eradication: a noteworthy demerit of eradication therapy among the Japanese?

    Directory of Open Access Journals (Sweden)

    Katsunori eIijima

    2015-06-01

    Full Text Available In the February 2013 Revision of Insured Medical Treatment, bacterial eradication for all Helicobacter pylori-positive individuals in Japan was covered under the insurance scheme. However, reflux esophagitis is believed to occur in approximately 10% of Japanese patients who undergo eradication therapy. Hence, the risk of reflux esophagitis among such cases should be carefully considered, particularly in the treatment for H. pylori-positive patients who are otherwise healthy. The eradication of Helicobacter pylori in cases of H. pylori-positive gastritis markedly suppresses gastric inflammation, and inhibits gastric mucosal atrophy and its progression to intestinal metaplasia. In a long-term follow-up study (10-20 years, eradication treatment was found to reduce the risk of subsequent gastric cancer. However, the fact that eradication-induced reflux esophagitis could increase the long-term risk of Barrett’s esophagus and esophageal adenocarcinoma should also be considered in the Japanese population. Appropriate treatment with proton pump inhibitors should be taken into consideration for patients undergoing eradication therapy in clinical practice.

  17. Clinical Outcome of Eradication Therapy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma according to H. pylori Infection Status.

    Science.gov (United States)

    Kim, Ju Seok; Kang, Sun Hyung; Moon, Hee Seok; Sung, Jae Kyu; Jeong, Hyun Yong

    2016-01-01

    Background. To evaluate the long-term outcome of H. pylori eradication therapy for gastric MALT lymphoma according to the presence of H. pylori infection. Methods. We retrospectively reviewed the medical records of patients between January 2001 and June 2014. The clinicopathologic characteristics and clinical outcomes were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphoma groups. Results. Fifty-four patients were enrolled: 12 H. pylori-negative and 42 H. pylori-positive patients. The tumor was located more frequently in both the proximal and distal parts of the stomach (P = 0.001), and the percentage of multiple lesions was significantly greater in the H. pylori-negative group (P = 0.046). Forty-seven patients received initial eradication therapy, and 85% (35/41) of H. pylori-positive patients and 50% (3/6) of H. pylori-negative patients achieved complete remission after eradication therapy. The presence of multiple lesions was a predictive factor for unresponsiveness to H. pylori eradication (P = 0.024). The efficacy of eradication therapy (P = 0.133), complete remission (CR) maintenance period, and relapse after eradication therapy were not significantly different between the two groups. Conclusions. H. pylori eradication therapy could be an effective first-line treatment for localized H. pylori-negative gastric MALT lymphoma, especially for single lesions.

  18. Clinical Outcome of Eradication Therapy for Gastric Mucosa-Associated Lymphoid Tissue Lymphoma according to H. pylori Infection Status

    Directory of Open Access Journals (Sweden)

    Ju Seok Kim

    2016-01-01

    Full Text Available Background. To evaluate the long-term outcome of H. pylori eradication therapy for gastric MALT lymphoma according to the presence of H. pylori infection. Methods. We retrospectively reviewed the medical records of patients between January 2001 and June 2014. The clinicopathologic characteristics and clinical outcomes were compared between H. pylori-positive and H. pylori-negative gastric MALT lymphoma groups. Results. Fifty-four patients were enrolled: 12 H. pylori-negative and 42 H. pylori-positive patients. The tumor was located more frequently in both the proximal and distal parts of the stomach (P=0.001, and the percentage of multiple lesions was significantly greater in the H. pylori-negative group (P=0.046. Forty-seven patients received initial eradication therapy, and 85% (35/41 of H. pylori-positive patients and 50% (3/6 of H. pylori-negative patients achieved complete remission after eradication therapy. The presence of multiple lesions was a predictive factor for unresponsiveness to H. pylori eradication (P=0.024. The efficacy of eradication therapy (P=0.133, complete remission (CR maintenance period, and relapse after eradication therapy were not significantly different between the two groups. Conclusions. H. pylori eradication therapy could be an effective first-line treatment for localized H. pylori-negative gastric MALT lymphoma, especially for single lesions.

  19. 100 years poliovirus: from discovery to eradication. A meeting report.

    Science.gov (United States)

    Skern, Tim

    2010-09-01

    Just over hundred years ago, Karl Landsteiner and Erwin Popper identified a virus, later termed poliovirus, as the causative agent of poliomyelitis. This groundbreaking discovery simultaneously provided the basis for the measures that today prevent the outbreaks of the terrible epidemics caused by poliovirus. In 1988, the WHO started its eradication program to eliminate the virus from the planet. The symposium celebrated the discovery of poliovirus and discussed our current state of knowledge of poliovirus biology. Prospects for the eradication program were evaluated, with particular emphasis being placed on why certain countries still have not succeeding in interrupting wild-type transmission of poliovirus. Discussion also centred on the role of inactivated poliovirus vaccines in the eradication program and the maintenance of a poliovirus-free world, whenever this goal should be achieved.

  20. Poverty Relief or Poverty Eradication? | Kritzinger | Acta Theologica

    African Journals Online (AJOL)

    The author challenges the reader to make two mindshifts: from a focus on poverty relief to an emphasis on poverty eradication; and from viewing the poor as the objects of poverty alleviation to accepting them as the subjects of poverty eradication. The case is argued and a practical approach towards poverty eradication is ...

  1. Some lessons for the future from the Global Malaria Eradication Programme (1955-1969).

    Science.gov (United States)

    Nájera, José A; González-Silva, Matiana; Alonso, Pedro L

    2011-01-25

    Encouraged by the early success of using dichloro-diphenyl-trichloroethane (DDT) against malaria, the World Health Organization (WHO) embarked on the Global Malaria Eradication Program (GMEP) in 1955. Fourteen years later, the campaign was discontinued when it was recognised that eradication was not achievable with the available means in many areas, although the long-term goal remained unchanged. During the GMEP, malaria was permanently eliminated from many regions. In other areas, however, substantial gains were lost in resurgences, sometimes of epidemic proportions. During the 1970s and 1980s, because of economic and financial crises, international support for malaria control declined rapidly, but in the past decade, following increasing demands from endemic countries and promising results from scaling up of control activities, interest in malaria elimination and the long-term goal of eradication has received international political and financial support. In 2007, there was a renewed call for malaria eradication and a consultative process to define a research and development agenda for malaria eradication (malERA) was established. Lessons learned from the GMEP (1955-1969) highlight the fact that no single strategy can be applicable everywhere and that a long-term commitment with a flexible strategy that includes community involvement, integration with health systems, and the development of agile surveillance systems is needed.

  2. Some Lessons for the Future from the Global Malaria Eradication Programme (1955–1969)

    Science.gov (United States)

    Nájera, José A.; González-Silva, Matiana; Alonso, Pedro L.

    2011-01-01

    Encouraged by the early success of using dichloro-diphenyl-trichloroethane (DDT) against malaria, the World Health Organization (WHO) embarked on the Global Malaria Eradication Program (GMEP) in 1955. Fourteen years later, the campaign was discontinued when it was recognised that eradication was not achievable with the available means in many areas, although the long-term goal remained unchanged. During the GMEP, malaria was permanently eliminated from many regions. In other areas, however, substantial gains were lost in resurgences, sometimes of epidemic proportions. During the 1970s and 1980s, because of economic and financial crises, international support for malaria control declined rapidly, but in the past decade, following increasing demands from endemic countries and promising results from scaling up of control activities, interest in malaria elimination and the long-term goal of eradication has received international political and financial support. In 2007, there was a renewed call for malaria eradication and a consultative process to define a research and development agenda for malaria eradication (malERA) was established. Lessons learned from the GMEP (1955–1969) highlight the fact that no single strategy can be applicable everywhere and that a long-term commitment with a flexible strategy that includes community involvement, integration with health systems, and the development of agile surveillance systems is needed. PMID:21311585

  3. Some lessons for the future from the Global Malaria Eradication Programme (1955-1969.

    Directory of Open Access Journals (Sweden)

    José A Nájera

    2011-01-01

    Full Text Available Encouraged by the early success of using dichloro-diphenyl-trichloroethane (DDT against malaria, the World Health Organization (WHO embarked on the Global Malaria Eradication Program (GMEP in 1955. Fourteen years later, the campaign was discontinued when it was recognised that eradication was not achievable with the available means in many areas, although the long-term goal remained unchanged. During the GMEP, malaria was permanently eliminated from many regions. In other areas, however, substantial gains were lost in resurgences, sometimes of epidemic proportions. During the 1970s and 1980s, because of economic and financial crises, international support for malaria control declined rapidly, but in the past decade, following increasing demands from endemic countries and promising results from scaling up of control activities, interest in malaria elimination and the long-term goal of eradication has received international political and financial support. In 2007, there was a renewed call for malaria eradication and a consultative process to define a research and development agenda for malaria eradication (malERA was established. Lessons learned from the GMEP (1955-1969 highlight the fact that no single strategy can be applicable everywhere and that a long-term commitment with a flexible strategy that includes community involvement, integration with health systems, and the development of agile surveillance systems is needed.

  4. Eradication of Aujeszky's disease from a large-scale pig farm.

    Science.gov (United States)

    Komáromi, M; Szabó, I

    2005-01-01

    Eradication of Aujeszky's disease from a large-scale pig farm by the 'test-and-cull' eradication procedure based on the use of gene-deleted vaccines and serological monitoring using gE ELISA is described. Aujeszky's disease free status was successfully achieved on a farrow-to-finish type farm characterised by three difficulties interfering with the success of eradication: (i) weaned (30-day-old) piglets remained in the farrowing house until 65 days of age; (ii) the farm did not use nursery rearing; (iii) fatteners were kept together with the breeding gilts. Thus, the immunisation programme had to be adjusted to the management technology used on the farm, and by regular serological monitoring it had to be periodically modified to make it suitable for attaining the goals. This meant that breeding animal candidates of a wide age range and kept in the same air space had to be provided with a continuously high-level immunity by regular vaccination sufficient even for rectifying potential human errors. The immunisation programme was designed by taking into consideration the disappearance of maternal immunity, and a strict vaccination programme was applied during the rearing of breeding gilts kept together with the fattening pigs. Frequent immunisation applied during the rearing of the own breeding animal replacements proved to be of decisive importance for the eradication of Aujeszky's disease from the entire herd. In addition to the accurate implementation of the vaccination programme, regular serological monitoring also made a major contribution to the success of eradication.

  5. The long journey: a brief review of the eradication of rinderpest.

    Science.gov (United States)

    Njeumi, F; Taylor, W; Diallo, A; Miyagishima, K; Pastoret, P-P; Vallat, B; Traore, M

    2012-12-01

    In 2011, the 79th General Session of the World Assembly of the World Organisation for Animal Health (OIE) and the 37th Food and Agriculture Organization of the United Nations (FAD) Conference adopted a resolution declaring the world free from rinderpest and recommending follow-up measures to preserve the benefits of this new and hard-won situation. Eradication is an achievable objective for any livestock disease, provided that the epidemiology is uncomplicated and the necessary tools, resources and policies are available. Eradication at a national level inevitably reflects national priorities, whereas global eradication requires a level of international initiative and leadership to integrate these tools into a global framework, aimed first at suppressing transmission across all infected areas and concluding with a demonstration thatthis has been achieved. With a simple transmission chain and the environmental fragility of the virus, rinderpest has always been open to control and even eradication within a zoosanitary approach. However, in the post-1945 drive for more productive agriculture, national and global vaccination programmes became increasingly relevant and important. As rinderpest frequently spread from one region to another through trade-related livestock movements, the key to global eradication was to ensure that such vaccination programmes were carried out in a synchronised manner across all regions where the disease was endemic - an objective to which the European Union, the United States Agency for International Development, the International Atomic Energy Agency, the African Union-Interafrican Bureau of Animal Resources, FA0 and OIE fully subscribed. This article provides a review of rinderpest eradication, from the seminal work carried out by Giovanni Lancisi in the early 18th Century to the global declaration in 2011.

  6. Periodontal therapy improves gastric Helicobacter pylori eradication.

    Science.gov (United States)

    Zaric, S; Bojic, B; Jankovic, Lj; Dapcevic, B; Popovic, B; Cakic, S; Milasin, J

    2009-10-01

    The oral cavity has been proposed as a reservoir for H. pylori that could be responsible for the refractoriness of gastric infection to triple therapy (antibiotics, antimicrobials, and proton pump inhibitors). The aim of this study was to evaluate the efficiency of combined periodontal and triple therapy vs. triple therapy alone, in gastric H. pylori eradication in persons with H. pylori in the subgingival biofilm. Individuals positive for H. pylori in their gastric and oral samples, as determined by nested PCR, were treated either with periodontal and triple therapy or with triple therapy alone. Our results indicate that 77.3% of those treated with the combined therapy exhibited successful eradication of gastric H. pylori, compared with 47.6% who underwent only triple therapy. Analysis of these data suggests that periodontal treatment in combination with systemic therapy could be a promising approach to increasing the therapy's efficacy and decreasing the risk of infection recurrence.

  7. RESEARCH Helicobacter pylori eradication: A randomised ...

    African Journals Online (AJOL)

    [http://dx.doi.org/10.1136/gut.2006.102269]. 13. Laine L, Estrada R, Trujillo M, Fukanaga K, Neil G. Randomized comparison of differing periods of twice-a-day triple therapy for the eradication of Helicobacter pylori. Aliment Pharmacol Ther. 1996;10(6):1029-33. [http://dx.doi.org/10.1046/j.1365-2036.1996.111282000.x]. 14.

  8. Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning

    OpenAIRE

    Garip, Yesim; Eser, Filiz; Bodur, Hatice; Baskan, Bedriye; Sivas, Filiz; Yilmaz, Ozlem

    2017-01-01

    ABSTRACT Objective: To determine the impact of postpolio-syndrome on quality of life in polio survivors. Methods: Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Sc...

  9. A research agenda for malaria eradication: drugs.

    Science.gov (United States)

    2011-01-25

    Antimalarial drugs will be essential tools at all stages of malaria elimination along the path towards eradication, including the early control or "attack" phase to drive down transmission and the later stages of maintaining interruption of transmission, preventing reintroduction of malaria, and eliminating the last residual foci of infection. Drugs will continue to be used to treat acute malaria illness and prevent complications in vulnerable groups, but better drugs are needed for elimination-specific indications such as mass treatment, curing asymptomatic infections, curing relapsing liver stages, and preventing transmission. The ideal malaria eradication drug is a coformulated drug combination suitable for mass administration that can be administered in a single encounter at infrequent intervals and that results in radical cure of all life cycle stages of all five malaria species infecting humans. Short of this optimal goal, highly desirable drugs might have limitations such as targeting only one or two parasite species, the priorities being Plasmodium falciparum and Plasmodium vivax. The malaria research agenda for eradication should include research aimed at developing such drugs and research to develop situation-specific strategies for using both current and future drugs to interrupt malaria transmission.

  10. Use of Mobile Information Technology during Planning, Implementation and Evaluation of a Polio Campaign in South Sudan.

    Directory of Open Access Journals (Sweden)

    John Haskew

    Full Text Available Use of mobile information technology may aid collection of real-time, standardised data to inform and improve decision-making for polio programming and response. We utilised Android-based smartphones to collect data electronically from more than 8,000 households during a national round of polio immunisation in South Sudan. The results of the household surveys are presented here, together with discussion of the application of mobile information technology for polio campaign planning, implementation and evaluation in a real-time setting.Electronic questionnaires were programmed onto Android-based smartphones for mapping, supervision and survey activities during a national round of polio immunisation. National census data were used to determine the sampling frame for each activity and select the payam (district. Individual supervisors, in consultation with the local district health team, selected villages and households within each payam. Data visualisation tools were utilised for analysis and reporting.Implementation of mobile information technology and local management was feasible during a national round of polio immunisation in South Sudan. Red Cross visits during the polio campaign were equitable according to household wealth index and households who received a Red Cross visit had significantly higher odds of being aware of the polio campaign than those who did not. Nearly 95% of children under five were reported to have received polio immunisation (according to maternal recall during the immunisation round, which varied by state, county and payam. A total of 11 payams surveyed were identified with less than 90% reported immunisation coverage and the least poor households had significantly higher odds of being vaccinated than the most poor. More than 95% of households were aware of the immunisation round and households had significantly higher odds of being vaccinated if they had prior awareness of the campaign taking place

  11. Use of Mobile Information Technology during Planning, Implementation and Evaluation of a Polio Campaign in South Sudan.

    Science.gov (United States)

    Haskew, John; Kenyi, Veronica; William, Juma; Alum, Rebecca; Puri, Anu; Mostafa, Yehia; Davis, Robert

    2015-01-01

    Use of mobile information technology may aid collection of real-time, standardised data to inform and improve decision-making for polio programming and response. We utilised Android-based smartphones to collect data electronically from more than 8,000 households during a national round of polio immunisation in South Sudan. The results of the household surveys are presented here, together with discussion of the application of mobile information technology for polio campaign planning, implementation and evaluation in a real-time setting. Electronic questionnaires were programmed onto Android-based smartphones for mapping, supervision and survey activities during a national round of polio immunisation. National census data were used to determine the sampling frame for each activity and select the payam (district). Individual supervisors, in consultation with the local district health team, selected villages and households within each payam. Data visualisation tools were utilised for analysis and reporting. Implementation of mobile information technology and local management was feasible during a national round of polio immunisation in South Sudan. Red Cross visits during the polio campaign were equitable according to household wealth index and households who received a Red Cross visit had significantly higher odds of being aware of the polio campaign than those who did not. Nearly 95% of children under five were reported to have received polio immunisation (according to maternal recall) during the immunisation round, which varied by state, county and payam. A total of 11 payams surveyed were identified with less than 90% reported immunisation coverage and the least poor households had significantly higher odds of being vaccinated than the most poor. More than 95% of households were aware of the immunisation round and households had significantly higher odds of being vaccinated if they had prior awareness of the campaign taking place. Pre-campaign community education

  12. Maternal education, empowerment, economic status and child polio vaccination uptake in Pakistan: a population based cross sectional study.

    Science.gov (United States)

    Khan, Muhammad Tahir; Zaheer, Sidra; Shafique, Kashif

    2017-03-10

    To explore the association of maternal education and empowerment with childhood polio vaccination using nationally representative data of Pakistani mothers in a reproductive age group. Cross-sectional. Secondary analysis of Pakistan Demographic and Health Survey (PDHS), 2012-2013 data was performed. Of the 13 558 mothers included in the survey sample, 6982 mothers were able to provide information regarding polio vaccinations. Polio vaccination coverage among children aged up to 5 years was categorised as complete vaccination (all four oral polio vaccine (OPV) doses), incomplete vaccination, and no vaccination (zero OPV dose received). Mothers' empowerment status was assessed using standard 'Measure DHS' questions regarding their involvement in decision-making related to health, household possessions and visits among family and friends. Education was categorised as no education, primary, secondary and higher education. Results of multinomial regression analyses were reported as adjusted OR with 95% CI. We adjusted for age, wealth index, urban/rural residence, place of delivery, and antenatal and postnatal visits. Only 56.4% (n=3936) of the children received complete polio vaccination. Women with no education had significantly higher odds of their child receiving no polio vaccination (OR 2.34, 95% CI 1.05 to 5.18; pwomen also had significantly higher odds of not taking their child for any polio vaccination (OR 1.58, 95% CI 1.17 to 2.12; pempowerment of women remained significant factors linked to poorer uptake of routine polio vaccination. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  13. Managing and eradicating wildlife tuberculosis in New Zealand

    Science.gov (United States)

    Warburton, B; Livingstone, P

    2015-01-01

    Abstract Tuberculosis (TB) due to Mycobacterium bovis infection was first identified in brushtail possums (Trichosurus vulpecula) in New Zealand in the late 1960s. Since the early 1970s, possums in New Zealand have been controlled as part of an ongoing strategy to manage the disease in livestock. The TB management authority (TBfree New Zealand) currently implements three strategic choices for disease-related possum control: firstly TB eradication in areas selected for eradication of the disease from livestock and wildlife, secondly Free Area Protection in areas in which possums are maintained at low densities, normally along a Vector Risk Area (VRA) boundary, and thirdly Infected Herd Suppression, which includes the remaining parts of VRA where possums are targeted to minimise the infection risk to livestock. Management is primarily through a range of lethal control options. The frequency and intensity of control is driven by a requirement to reduce populations to very low levels (usually to a trap-catch index below 2%), then to hold them at or below this level for 5–10 years to ensure disease eradication.Lethal possum control is implemented using aerial- and ground-based applications, under various regulatory and operational constraints. Extensive research has been undertaken aimed at improving the efficacy and efficiency of control. Aerial applications use sodium fluoroacetate (1080) bait for controlling possums over extensive and rugged areas of forest that are difficult to access by foot. Ground-based control uses a range of toxins (primarily, a potassium cyanide-based product) and traps. In the last 5 years there has been a shift from simple possum population control to the collection of spatial data on possum presence/absence and relative density, using simple possum detection devices using global positioning system-supported data collection tools, with recovery of possum carcasses for diagnostic necropsy. Such data provide information subsequently used in

  14. malERA: An updated research agenda for malaria elimination and eradication.

    Science.gov (United States)

    Rabinovich, Regina N; Drakeley, Chris; Djimde, Abdoulaye A; Hall, B Fenton; Hay, Simon I; Hemingway, Janet; Kaslow, David C; Noor, Abdisalan; Okumu, Fredros; Steketee, Richard; Tanner, Marcel; Wells, Timothy N C; Whittaker, Maxine A; Winzeler, Elizabeth A; Wirth, Dyann F; Whitfield, Kate; Alonso, Pedro L

    2017-11-01

    Achieving a malaria-free world presents exciting scientific challenges as well as overwhelming health, equity, and economic benefits. WHO and countries are setting ambitious goals for reducing the burden and eliminating malaria through the "Global Technical Strategy" and 21 countries are aiming to eliminate malaria by 2020. The commitment to achieve these targets should be celebrated. However, the need for innovation to achieve these goals, sustain elimination, and free the world of malaria is greater than ever. Over 180 experts across multiple disciplines are engaged in the Malaria Eradication Research Agenda (malERA) Refresh process to address problems that need to be solved. The result is a research and development agenda to accelerate malaria elimination and, in the longer term, transform the malaria community's ability to eradicate it globally.

  15. Denial, Oblivion and New Fears: Poliomyelitis and the Post-Polio Syndrome in the Spanish and Portuguese Press (1995-2009

    Directory of Open Access Journals (Sweden)

    Juan Antonio Rodriguez-Sanchez

    2015-06-01

    Full Text Available Polio disappeared in the Iberian Peninsula at the end of the eighties. That promoted the disappearance in the medias agenda and the oblivion of people living with polios sequaleae. The consequence was that polio was forgotten in the public agenda. We explore the change in the social perception of polio in the Iberian Peninsula through content analysis (agenda setting and framing of four newspapers with a large circulation (the Spanish El Pais and El Mundo, and the Portuguese Jornal de Noticias and Publico, between 1995 and 2009. Polio was linked to poverty and ignorance in distant countries, susceptible to cooperation activities. It was only considered an issue when it was perceived as a threat to the West, linked to health crises or giving it a metaphorical sense. Thus, post-polio syndrome was invisible in the Portuguese case and weakly represented in Spain by the patient associations.

  16. Dodging silver bullets: good CRISPR gene-drive design is critical for eradicating exotic vertebrates.

    Science.gov (United States)

    Prowse, Thomas A A; Cassey, Phillip; Ross, Joshua V; Pfitzner, Chandran; Wittmann, Talia A; Thomas, Paul

    2017-08-16

    Self-replicating gene drives that can spread deleterious alleles through animal populations have been promoted as a much needed but controversial 'silver bullet' for controlling invasive alien species. Homing-based drives comprise an endonuclease and a guide RNA (gRNA) that are replicated during meiosis via homologous recombination. However, their efficacy for controlling wild populations is threatened by inherent polymorphic resistance and the creation of resistance alleles via non-homologous end-joining (NHEJ)-mediated DNA repair. We used stochastic individual-based models to identify realistic gene-drive strategies capable of eradicating vertebrate pest populations (mice, rats and rabbits) on islands. One popular strategy, a sex-reversing drive that converts heterozygous females into sterile males, failed to spread and required the ongoing deployment of gene-drive carriers to achieve eradication. Under alternative strategies, multiplexed gRNAs could overcome inherent polymorphic resistance and were required for eradication success even when the probability of NHEJ was low. Strategies causing homozygotic embryonic non-viability or homozygotic female sterility produced high probabilities of eradication and were robust to NHEJ-mediated deletion of the DNA sequence between multiplexed endonuclease recognition sites. The latter two strategies also purged the gene drive when eradication failed, therefore posing lower long-term risk should animals escape beyond target islands. Multiplexing gRNAs will be necessary if this technology is to be useful for insular extirpation attempts; however, precise knowledge of homing rates will be required to design low-risk gene drives with high probabilities of eradication success. © 2017 The Author(s).

  17. Endoscopic gastric atrophy is strongly associated with gastric cancer development after Helicobacter pylori eradication.

    Science.gov (United States)

    Toyoshima, Osamu; Yamaji, Yutaka; Yoshida, Shuntaro; Matsumoto, Shuhei; Yamashita, Hiroharu; Kanazawa, Takamitsu; Hata, Keisuke

    2017-05-01

    Risk factors for gastric cancer during continuous infection with Helicobacter pylori have been well documented; however, little has been reported on the risk factors for primary gastric cancer after H. pylori eradication. We conducted a retrospective, endoscopy-based, long-term, large-cohort study to clarify the risk factors for gastric cancer following H. pylori eradication. Patients who achieved successful H. pylori eradication and periodically underwent esophagogastroduodenoscopy surveillance thereafter at Toyoshima Endoscopy Clinic were enrolled. The primary endpoint was the development of gastric cancer. Statistical analysis was performed using the Kaplan-Meier method and Cox's proportional hazards models. Gastric cancer developed in 15 of 1232 patients. The cumulative incidence rates were 1.0 % at 2 years, 2.6 % at 5 years, and 6.8 % at 10 years. Histology showed that all gastric cancers (17 lesions) in the 15 patients were of the intestinal type, within the mucosal layer, and gastric atrophy were significantly associated with gastric cancer development after eradication of H. pylori, and gastric ulcers were marginally associated. Multivariate analysis identified higher grade of gastric atrophy (hazard ratio 1.77; 95 % confidence interval 1.12-2.78; P = 0.01) as the only independently associated parameter. Endoscopic gastric atrophy is a major risk factor for gastric cancer development after H. pylori eradication. Further long-term studies are required to determine whether H. pylori eradication leads to regression of H. pylori-related gastritis and reduces the risk of gastric cancer.

  18. Impact of an Intervention to Use a Measles, Rubella, and Polio Mass Vaccination Campaign to Strengthen Routine Immunization Services in Nepal.

    Science.gov (United States)

    Wallace, Aaron S; Bohara, Rajendra; Stewart, Steven; Subedi, Giri; Anand, Abhijeet; Burnett, Eleanor; Giri, Jagat; Shrestha, Jagat; Gurau, Suraj; Dixit, Sameer; Rajbhandari, Rajesh; Schluter, W William

    2017-07-01

    The potential to strengthen routine immunization (RI) services through supplementary immunization activities (SIAs) is an important benefit of global measles and rubella elimination and polio eradication strategies. However, little evidence exists on how best to use SIAs to strengthen RI. As part the 2012 Nepal measles-rubella and polio SIA, we developed an intervention package designed to improve RI processes and evaluated its effect on specific RI process measures. The intervention package was incorporated into existing SIA activities and materials to improve healthcare providers' RI knowledge and practices throughout Nepal. In 1 region (Central Region) we surveyed the same 100 randomly selected health facilities before and after the SIA and evaluated the following RI process measures: vaccine safety, RI planning, RI service delivery, vaccine supply chain, and RI data recording practices. Data collection included observations of vaccination sessions, interviews with the primary healthcare provider who administered vaccines at each facility, and administrative record reviews. Pair-matched analytical methods were used to determine whether statistically significant changes in the selected RI process measures occurred over time. After the SIA, significant positive changes were measured in healthcare provider knowledge of adverse events following immunization (11% increase), availability of RI microplans (+17%) and maps (+12%), and awareness of how long a reconstituted measles vial can be used before it must be discarded (+14%). For the SIA, 42% of providers created an SIA high-risk villages list, and >50% incorporated this information into RI outreach session site planning. Significant negative changes occurred in correct knowledge of measles vaccination contraindications (-11%), correct definition for a measles outbreak (-21%), and how to treat a child with a severe adverse event following immunization (-10%). Twenty percent of providers reported cancelling ≥1 RI

  19. Disability and functional assessment in former polio patients with and without postpolio syndrome.

    Science.gov (United States)

    Nollet, F; Beelen, A; Prins, M H; de Visser, M; Sargeant, A J; Lankhorst, G J; de Jong, B A

    1999-02-01

    To compare perceived health problems and disability in former polio subjects with postpolio syndrome (PPS) and those without postpolio syndrome (non-PPS), and to evaluate perceived health problems, disability, physical performance, and muscle strength. Cross-sectional survey; partially blinded data collection. One hundred three former polio subjects, aged 32 to 60yrs. This volunteer sample came from referrals and patient contacts. Criterion for PPS: new muscle weakness among symptoms. Nottingham Health Profile (NHP), adapted D-code of the International Classification of Impairments, Disabilities and Handicaps, performance test, and muscle strength assessment. PPS subjects (n = 76) showed higher scores (p < .001) than non-PPS subjects (n = 27) within the NHP categories of physical mobility, energy, and pain. On a 16-item Polio Problems List, 78% of PPS subjects selected fatigue as their major problem, followed by walking outdoors (46%) and climbing stairs (41%). The disabilities of PPS subjects were mainly seen in physical and social functioning. No differences in manually tested strength were found between patient groups. PPS subjects needed significantly more time for the performance test than non-PPS subjects and their perceived exertion was higher. Perceived health problems (NHP-PhysMobility) correlated significantly with physical disability (r = .66), performance-time (r = .54), and muscle strength (r = .38). With linear regression analysis, 54% of the NHP-PhysMobility score could be explained by the performance test (time and exertion), presence of PPS, and muscle strength, whereas strength itself explained only 14% of the NHP-PhysMobility score. PPS subjects are more prone to fatigue and have more physical mobility problems than non-PPS subjects. In former polio patients, measurements of perceived health problems and performance tests are the most appropriate instruments for functional evaluation.

  20. Effect of Multiple Simultaneous Vaccines on Polio Seroresponse and Associated Health Outcomes

    Science.gov (United States)

    2015-01-01

    Haemophilus influenzae type b vaccine given concurrently with meningococcal group C conjugate vaccine at 2, 3 and 4 months of age. Arch Dis Child 2007;92:11–6...responses to biological warfare vaccines in human vaccinees . Clin Infect Dis 2006;43:1–7. 20] Butler D. Admission on Gulf War vaccines spurs debate on...Naval Health Research Center Effect of Multiple, Simultaneous Vaccines on Polio Seroresponse and Associated Health Outcomes Michael P

  1. Effect of pretreatment with Lactobacillus gasseri OLL2716 on first-line Helicobacter pylori eradication therapy.

    Science.gov (United States)

    Deguchi, Ryuzo; Nakaminami, Hidemasa; Rimbara, Emiko; Noguchi, Norihisa; Sasatsu, Masanori; Suzuki, Takayoshi; Matsushima, Masashi; Koike, Jun; Igarashi, Muneki; Ozawa, Hideki; Fukuda, Ryuki; Takagi, Atsushi

    2012-05-01

    Helicobacter pylori eradication clearly decreases peptic ulcer recurrence rates. H. pylori eradication is achieved in 70-90% of cases, but treatment failures due to poor patient compliance and resistant organisms do occur. Lactobacillus gasseri can suppress both clarithromycin-susceptible and -resistant strains of H. pylori in vitro. The aim of this study was to determine the effect of pretreatment with L. gasseri- containing yogurt on H. pylori eradication. We conducted a randomized, controlled clinical trial in patients with H. pylori infection. A total of 229 patients were randomized into either a 1-week triple therapy of rabeprazole (10 mg bid), amoxicillin (750 mg bid), and clarithromycin (200 mg bid) or triple therapy plus L. gasseri-containing yogurt. In the yogurt-plus-triple therapy groups, yogurt containing L. gasseri OLL2716 (112 g) was given twice daily for 4 weeks (3 weeks pretreatment and also 1 week during eradication therapy). Clarithromycin resistance was determined by the detection of a mutation in 23S rRNA using nested polymerase chain reaction and the direct sequencing of DNA from pretreatment feces. H. pylori eradication was diagnosed based on the urea breath test and a stool antigen test after 8 weeks of eradication. The status of H. pylori susceptibility to clarithromycin was successively determined in 188 out of 229 samples. The rate of infection with clarithromycin-resistant strains of H. pylori was 27.1%. Overall eradication (intention to treat/per protocol) was 69.3/74.5% for the triple-only group, and 82.6/85.6% for the yogurt-plus-triple group (P = 0.018/P = 0.041). Eradication of primary clarithromycin-resistant strains tended to be higher for yogurt-plus-triple therapy than triple-only therapy (38.5 vs 28.0%, respectively, P = 0.458). This study confirmed that the major cause of treatment failure is resistance to clarithromycin. A 4-week treatment with L. gasseri-containing yogurt improves the efficacy of triple therapy in patients

  2. Ankle-foot orthoses that restrict dorsiflexion improve walking in polio survivors with calf muscle weakness.

    Science.gov (United States)

    Ploeger, Hilde E; Bus, Sicco A; Brehm, Merel-Anne; Nollet, Frans

    2014-07-01

    In polio survivors with calf muscle weakness, dorsiflexion-restricting ankle-foot orthoses (DR-AFOs) aim to improve gait in order to reduce walking-related problems such as instability or increased energy cost. However, evidence on the efficacy of DR-AFOs in polio survivors is lacking. We investigated the effect of DR-AFOs on gait biomechanics, walking energy cost, speed, and perceived waking ability in this patient group. Sixteen polio survivors with calf muscle weakness underwent 3D-gait analyses to assess gait biomechanics when walking with a DR-AFOs and with shoes only. Ambulant registration of gas-exchange during a 6 min walk test determined walking energy cost, and comfortable gait speed was calculated from the walked distance during this test. Perceived walking ability was assessed using purposely-designed questionnaires. Compared with shoes-only, walking with the DR-AFOs significantly increased forward progression of the center of pressure (CoP) in mid-stance and it reduced ankle dorsiflexion and knee flexion in mid- and terminal stance (p muscle weakness, DR-AFOs improved gait biomechanics, speed, and perceived walking ability, compared to shoes-only. Effects may depend on the shoes-only gait pattern, therefore further study is needed to determine which patients benefit most from the DR-AFO. Copyright © 2014 Elsevier B.V. All rights reserved.

  3. ROLE OF MEDICAL REHABILITATION TREATMENT IN POST-POLIO SYNDROME – A CASE REPORT

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    DOGARU Gabriela

    2015-05-01

    Full Text Available The term post-polio syndrome (PPS was introduced in 1985 by Halstead. It is characterized by sudden or progressive muscle weakness, new muscular atrophy, muscle pain, fatigue, functional impotence, cold intolerance, after a period of at least 15 years from acute polio virus infection, a period of neurological and functional stability, in the absence of other medical explanation [1]. The reported prevalence of PPS is between 15% and 80% of all patients with previous polio virus infections [2, 3]. Poliomyelitis continues to be a public health problem, because the consequences of the disease last throughout life. In Europe, there are about 700,000 persons who survived the infection and are still alive. Non-randomized studies with kinesitherapy programs with a duration between 6 weeks and 7 months, involving isokinetic and isometric endurance muscle training, have demonstrated an increase of muscle strength in the case of patients with mild or moderate muscle weakness, and a reduction of muscle fatigue [7, 8, 9]. The differential diagnosis of PPS can be difficult because of the need to exclude both neurological and non-neurological conditions that aggravate the pre-existing motor deficit. Rehabilitation programs using therapeutic means: kinesitherapy, thermotherapy, hydrothermotherapy, occupational therapy represent the only way to limit functional deficit and to improve pain, playing an important role in the long-term management and care of patients.

  4. Comparison of two 6-minute walk tests to assess walking capacity in polio survivors.

    Science.gov (United States)

    Brehm, Merel-Anne; Verduijn, Suzan; Bon, Jurgen; Bredt, Nicoline; Nollet, Frans

    2017-11-21

    To compare walking dynamics and test-retest reliability for 2 frequently applied walk tests in polio survivors: the 6-minute walk test (6MWT) to walk as far as possible; and the 6-minute walking energy cost test (WECT) at comfortable speed. Observational study. Thirty-three polio survivors, able to walk ≥ 150 m. On the same day participants performed a 6MWT and a WECT, which were repeated 1-3 weeks later. For each test, distance walked, heart rate and reduction in speed were assessed. The mean distance walked and mean heart rate were significantly higher in the 6MWT (441 m (standard deviation) (SD 79.7); 118 bpm (SD 19.2)) compared with the WECT (366 m (SD 67.3); 103 bpm (SD 14.3)); pwalked distance was 42 m (9.7% change from the mean) and 50 m (13.7%) on the 6MWT and WECT, respectively. Both the 6MWT and the WECT are reliable to assess walking capacity in polio survivors, with slightly superior sensitivity to detect change for the 6MWT. Differences in walking dynamics confirm that the tests cannot be used interchangeably. The 6MWT is recommended for measuring maximal walking capacity and the WECT for measuring submaximal walking capacity.

  5. Improving polio vaccination coverage in Nigeria through the use of geographic information system technology.

    Science.gov (United States)

    Barau, Inuwa; Zubairu, Mahmud; Mwanza, Michael N; Seaman, Vincent Y

    2014-11-01

    Historically, microplanning for polio vaccination campaigns in Nigeria relied on inaccurate and incomplete hand-drawn maps, resulting in the exclusion of entire settlements and missed children. The goal of this work was to create accurate, coordinate-based maps for 8 polio-endemic states in northern Nigeria to improve microplanning and support tracking of vaccination teams, thereby enhancing coverage, supervision, and accountability. Settlement features were identified in the target states, using high-resolution satellite imagery. Field teams collected names and geocoordinates for each settlement feature, with the help of local guides. Global position system (GPS) tracking of vaccination teams was conducted in selected areas and daily feedback provided to supervisors. Geographic information system (GIS)-based maps were created for 2238 wards in the 8 target states. The resulting microplans included all settlements and more-efficient team assignments, owing to the improved spatial reference. GPS tracking was conducted in 111 high-risk local government areas, resulting in improved team performance and the identification of missed/poorly covered settlements. Accurate and complete maps are a necessary part of an effective polio microplan, and tracking vaccinators gives supervisors a tool to ensure that all settlements are visited. © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  6. [History of development of the live poliomyelitis vaccine from Sabin attenuated strains in 1959 and idea of poliomyelitis eradication].

    Science.gov (United States)

    Lashkevich, V A

    2013-01-01

    against poliomyelitis. In some developing countries the vaccination data are falsified, thereby threatening the polio epidemics reappearance and the virus spreading to other countries. Methods must be developed for detection and dealing with extremely rare persistent virus carriers. Because of all these constraints the outcome of poliomyelitis eradication at present is uncertain and vaccination must be continued. The world has become poliovaccine dependent.

  7. Simulated effects of YY-male stocking and manual suppression for eradicating nonnative Brook Trout populations

    Science.gov (United States)

    Schill, Daniel J.; Meyer, Kevin A.; Hansen, Michael J.

    2017-01-01

    Eradication of nonnative Brook Trout Salvelinus fontinalis populations is difficult to achieve with standard techniques, such as electrofishing removal or piscicides; new approaches are needed. A novel concept is to stock “supermale” hatchery fish with wild conspecifics. Supermales (MYY) have two Y-chromosomes, resulting in offspring that are all males; over time, successful supermale reproduction could eradicate the wild population. We constructed an age-structured stochastic model to investigate the effects of manually suppressing wild fish and stocking MYY fingerlings on the long-term viability of hypothetical nonnative Brook Trout populations. In streams, an annual stocking rate of supermales equivalent to 50% of wild age-0 Brook Trout density combined with an annual selective suppression rate equivalent to 50% of wild Brook Trout density resulted in a time to extirpation of only 2–4 years if supermale fitness was equivalent to wild male fitness. However, time to extirpation in streams was 5–15 years if supermale fitness was 80% lower than wild male fitness. In alpine lakes, higher supermale stocking rates and nonselective gillnetting were required to eradicate Brook Trout populations. If supermales were assumed to be as fit as wild males, however, any supermale stocking rate greater than 49% in alpine lakes or 60% in streams achieved eradication in 10 years or less, regardless of the suppression rate. Because manual suppression and the stocking of MYY fingerlings can readily be conducted at the levels assumed in our simulations, use of such an integrated pest management (IPM) approach could extirpate undesirable Brook Trout populations within reasonably short periods of time. Given the recent successful development of an MYY Brook Trout broodstock capable of producing large numbers of MYY fingerlings and given the positive results of the present simulations for both streams and alpine lakes, field testing of MYY stocking is warranted within an

  8. A significant increase in the pepsinogen I/II ratio is a reliable biomarker for successful Helicobacter pylori eradication.

    Directory of Open Access Journals (Sweden)

    Hiroki Osumi

    Full Text Available Helicobacter pylori (H. pylori eradication is usually assessed using the 13C-urea breath test (UBT, anti-H. pylori antibody and the H. pylori stool antigen test. However, a few reports have used pepsinogen (PG, in particular, the percentage change in the PG I/II ratio. Here, we evaluated the usefulness of the percentage changes in serum PG I/II ratios for determining the success of eradication therapy for H. pylori.In total, 650 patients received eradication therapy from October 2008 to March 2013 in our Cancer Institute Hospital. We evaluated the relationship between H. pylori eradication and percentage changes in serum PG I/II ratios before and 3 months after treatment with CLEIA® (FUJIREBIO Inc, Tokyo, Japan. The gold standard of H. pylori eradication was defined as negative by the UBT performed 3 months after completion of eradication treatment. Cut-off values for percentage changes in serum PG I/II ratios were set as +40, +25 and +10% when the serum PG I/II ratio before treatment was below 3.0, above 3.0 but below 5.0 and 5.0 or above, respectively.Serum PG I and PG II levels were measured in 562 patients with H. pylori infection before and after eradication therapy. Eradication of H. pylori was achieved in 433 patients studied (77.0%. The ratios of first, second, third-line and penicillin allergy eradication treatment were 73.8% (317/429, 88.3% (99/112, 75% (12/16 and 100% (5/5, respectively. An increasing percentage in the serum levels of the PG I/II ratios after treatment compared with the values before treatment clearly distinguished success from failure of eradication (108.2±57.2 vs. 6.8±30.7, p<0.05. Using the above cut-off values, the sensitivity, specificity and validity for determination of H. pylori were 93.1, 93.8 and 93.2%, respectively.In conclusion, the percentage changes in serum PG I/II ratios are useful as evaluation criteria for assessing the success of eradication therapy for H. pylori.

  9. Corruption Eradication In The Perspective Of Criminology

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    La Niasa

    2015-08-01

    Full Text Available This research aimed to find out the substance of corruption as an extraordinary crime and the efforts that can be taken in eradicate corruption. This research is in the field of criminal law. This study is a normative-empirical research a legal research that its study is statutory provisions in abstracto is linked with the field application in concreto. The results of research showed that 1 the substance of corruption is an evil act or reprehensible by law qualified or labeled as a form of corruption. Acts of corruption assessed as an extraordinary crime because of its systematic and wide-ranging impact and contrary to the interests of the country in general. 2 the arrangement of corruption involves two major aspects of prevention and prosecution aspects. Establishment of legislation was based by desire to bring state enforcement are clean and free from corruption as a policy basis. 3 Efforts to eradicate corruption can be divided into two i.e prevention and curative. Prevention undertaken by government and law enforcement agencies is still low so it needs to be further improved. Criminal sanctions imposed on the corruptor also tend to just apply the minimum criminal sanctions. Types of corruption are most prevalent in Southeast Sulawesi Indonesia is corruption related to acts of abuse of authority or position.

  10. Effect of bacterial and host factors on Helicobacter pylori eradication therapy.

    Science.gov (United States)

    Uotani, Takahiro; Miftahussurur, Muhammad; Yamaoka, Yoshio

    2015-01-01

    A clearer understanding of the factors affecting the cure rate of Helicobacter pylori infection might lead to the development of novel prevention strategies and therapeutic targets. This review covers two important issues that affect the eradication of H. pylori: bacterial and host factors. Several virulence factors have been shown to be predictors for gastroduodenal diseases. Successful treatment of H. pylori infection also depends on host genetic factors such as CYP2C19 and IL-1B. The latest evidence on host genetic factors is discussed. The authors identify three main targets for achieving effective eradication therapy. The first therapeutic target is to identify counter measures for antibiotic-resistant H. pylori strains. Thus, antibiotic susceptibility should be checked in all patients, ideally, before the start of eradication treatment. The second therapeutic target is the inhibition of acid suppression. Maintaining a high intragastric pH for 24 h increases the effectiveness of some antibiotics and the eradication effects for H. pylori. The third therapeutic target is to identify high-risk groups; the CYP2C19 and IL-1B polymorphisms are candidates for significant risk factors. A personalized medical approach will likely increase the cure rate of H. pylori infection.

  11. Challenges to health workers and their opinions about parents' refusal of oral polio vaccination in the Khyber Pakhtoon Khawa (KPK) province, Pakistan.

    Science.gov (United States)

    Khan, Tahir Mehmood; Sahibzada, Muhammad Umar Khayam

    2016-04-19

    A qualitative study design was adapted to explore the challenges faced by health workers (HWs) during the polio health campaign. In addition, HWs' opinions about the factors causing parents to refuse oral polio vaccination (OPV) were also explored. Four focus group discussions (FGDs) were held (from 1st January 2015-31st March 2015) with the HWs who participated in the OPV campaigns in the polio red zones of Khyber Pakhtoon Khawa (KPK) province of Pakistan, namely Kohat (FG 1), Domel and Bannu (FG 2), Hangoo (FG 3), and Peshawar (FG 4). A total of N=42 HWs (10-11 in each FG) agreed to participate in this study. Overall, HWs disclosed that public attitude and harsh behaviour towards the HWs and security threats are the two main challenges they face. Common issues hindering parents' willingness to vaccinate their children against OPV are: OPV is seen as haram and not permitted in Islam, it is said to contain the blood of pigs (Khinzir) and monkeys, and parents are afraid that it is done to induce sterility among their children. HWs also shared that parents have a strong belief in the conspiracies that are associated with OPV, i.e. the USA and CIA, are spying on us and our government is helping them to achieve their agenda. Furthermore, HWs revealed that frequent visits may further strengthen parents' perceptions and make them more resistant to OPV. The common side effects of OPV reported by parents were mainly gastro-intestinal problems and in some cases mild to moderate fever with some respiratory symptoms. There is a great need to improve the logistics and facilities for HWs assisting in vaccination programmes. Furthermore, it is necessary to improve education, so people understand the basic concept of revaccination and booster doses, thereby assisting in creating a basic understanding of vaccinations, which may trigger changes in attitudes and make people believe in the benefits of OPV rather than following the conspiracies that lead them to refuse it. Copyright

  12. Cognitive behavioural therapy for reducing fatigue in post-polio syndrome and in facioscapulohumeral dystrophy: A comparison

    Directory of Open Access Journals (Sweden)

    Fieke S. Koopman

    2017-06-01

    Full Text Available Background: Cognitive behavioural therapy does not reduce fatigue in post-polio syndrome, but is effective in facioscapulohumeral dystrophy. This difference in efficacy might be explained by a different role of cognitions in these conditions. Objective: To compare fatigue-related cognitions between patients with post-polio syndrome and facio-scapulohumeral dystrophy. Subjects: Patients with post-polio syndrome (n = 21 and facioscapulohumeral dystrophy (n = 24 allocated to a cognitive behavioural therapy intervention in 2 identical trials. Methods: Assessed cognitions included: sense of control over fatigue; catastrophizing; acceptance; focusing on fatigue; and perceived social support. Group differences in cognitions (independent t-tests or Mann–Whitney U tests and group differences in the association of cognitions with fatigue (linear regression models were studied. Results: No differences in cognitions were found between the 2 groups (p > 0.18. Furthermore, there were no cognition-by-group interaction effects, except for “perceived social support”, for which a different association with fatigue was found between the 2 groups (p = 0.01. However, univariate models revealed no associations per group. Conclusion: Fatigue-related cognitions in severely fatigued patients with post-polio syndrome are not clearly different from that in facioscapulohumeral dystrophy. Thus, the lack of efficacy of cognitive behavioural therapy in post-polio syndrome cannot be attributed to unique cognitive characteristics of this population.

  13. Towards the eradication of hepatitis B in Taiwan

    Directory of Open Access Journals (Sweden)

    Suzanne Wait

    2012-01-01

    in the vaccinees was also found to decrease in parallel. This is the first time that a human cancer was prevented by vaccination. Despite the success, there are still some who were born after implementation of the program but were not prevented from developing chronic hepatitis B infection and hepatocellular carcinoma. Non-compliance to the vaccination schedule, breakthrough infection and intrauterine infection are the causes of the failure. At present, we have effective measures for immunizing susceptible individuals, interrupting the routes of transmission and treating the chronically infected. The time for considering the elimination or even the eradication of HBV infection has come. This is especially true for countries where hepatitis B infection is not endemic. Nevertheless, with the admirable results achieved in the past, Taiwan should also think about elimination/eradication of hepatitis B, even though it will certainly be much more difficult than in the non-endemic countries. In exploring the possibility of eliminating/eradicating hepatitis B in Taiwan, we reviewed the epidemiology of hepatitis B, and analyzed the problems that remain to be tackled in Taiwan. We hope that Taiwan can take further steps towards the elimination or eradication of hepatitis B.

  14. Oestrid flies: eradication and extinction versus biodiversity.

    Science.gov (United States)

    Colwell, Douglas D; Otranto, Domenico; Stevens, Jamie R

    2009-11-01

    Larvae of oestrid flies are obligate parasites of mammals. This article focuses on two potential drivers that could be forcing these flies into extinction: (i) the highly effective and widespread use of anti-parasitic drugs for domestic livestock; and (ii) the co-extinction of oestrids associated with non-domestic hosts that are endangered. Other oestrid species could be the victims of benign neglect in that they are so poorly studied that their disappearance might go unnoticed. In addition, we explore current knowledge in each of these categories of vulnerability for oestrids, and address the potential impacts of their disappearance. Finally, we examine the potential consequences of eradicating a group of livestock parasites, and ask what possibilities for improvement of the health of humans and animals might also be lost.

  15. Efficacy of fermented milk and whey proteins in Helicobacter pylori eradication: A review

    Science.gov (United States)

    Sachdeva, Aarti; Rawat, Swapnil; Nagpal, Jitender

    2014-01-01

    Helicobacter pylori (H. pylori) eradication is considered a necessary step in the management of peptic ulcer disease, chronic gastritis, gastric adenocarcinoma and mucosa associated lymphoid tissue lymphoma. Standard triple therapy eradication regimens are inconvenient and achieve unpredictable and often poor results. Eradication rates are decreasing over time with increase in antibiotic resistance. Fermented milk and several of its component whey proteins have emerged as candidates for complementary therapy. In this context the current review seeks to summarize the current evidence available on their role in H. pylori eradication. Pertinent narrative/systematic reviews, clinical trials and laboratory studies on individual components including fermented milk, yogurt, whey proteins, lactoferrin, α-lactalbumin (α-LA), glycomacropeptide and immunoglobulin were comprehensively searched and retrieved from Medline, Embase, Scopus, Cochrane Controlled Trials Register and abstracts/proceedings of conferences up to May 2013. A preponderance of the evidence available on fermented milk-based probiotic preparations and bovine lactoferrin suggests a beneficial effect in Helicobacter eradication. Evidence for α-LA and immunoglobulins is promising while that for glycomacropeptide is preliminary and requires substantiation. The magnitude of the potential benefit documented so far is small and the precise clinical settings are ill defined. This restricts the potential use of this group as a complementary therapy in a nutraceutical setting hinging on better patient acceptability/compliance. Further work is necessary to identify the optimal substrate, fermentation process, dose and the ideal clinical setting (prevention/treatment, first line therapy/recurrence, symptomatic/asymptomatic, gastritis/ulcer diseases etc.). The potential of this group in high antibiotic resistance or treatment failure settings presents interesting possibilities and deserves further exploration. PMID

  16. Quadruple, sequential, and concomitant first-line therapies for H. pylori eradication: a prospective, randomized study.

    Science.gov (United States)

    De Francesco, Vincenzo; Pontone, Stefano; Bellesia, Annamaria; Serviddio, Gaetano; Panetta, Cristina; Palma, Rossella; Zullo, Angelo

    2017-10-18

    Current Italian guidelines recommend 10-day bismuth-based or bismuth-free (sequential and concomitant) regimens for first-line H. pylori eradication. However, comparison among these regimens is lacking in our country. To perform a 'head-to-head' comparison among these three therapies as first-line treatment for H. pylori eradication in clinical practice. This was a prospective, open-label randomized study enrolling consecutive patients diagnosed with H. pylori infection never previously treated. Patients were randomized to receive one of the following 10-day therapies: (a) Bismuth-based therapy: esomeprazole 20mg b.i.d and Pylera 3 tablets q.i.d; (b) Concomitant therapy: esomeprazole 20mg plus amoxicyllin 1,000mg, clarithromycin 500mg and tinidazole 500mg (all b.i.d.), and (c) Sequential therapy: esomeprazole 20mg plus amoxicyllin 1,000mg for 5days followed by esomeprazole 20mg plus clarithromycin 500mg and tinidazole 500mg for 5days (all b.i.d). H. pylori eradication was assessed by using UBT 4-6 weeks after the end of therapy. Overall, 187 patients were enrolled. The eradication rates achieved with Pylera, concomitant and sequential were 85.2%, 95.2%, and 93.6%, respectively, at intention to treat, and 94.5%, 96.7%, and 95.1% at per protocol analyses, without a statistically significant difference. The incidence of severe side-effects was higher with the bismuth-based therapy than with the two bismuth-free regimens (9.8% vs 1.6%; p=0.046). Bismuth-based and bismuth-free therapies are equally effective for first-line H. pylori eradication. However, bismuth therapy was more frequently interrupted for side-effects than bismuth-free therapies. Copyright © 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  17. Onset of Ulcerative Colitis after Helicobacter pylori Eradication Therapy: A Case Report.

    Science.gov (United States)

    Chiba, Mitsuro; Tsuji, Tsuyotoshi; Takahashi, Kenichi; Komatsu, Masafumi; Sugawara, Takeshi; Ono, Iwao

    2016-01-01

    In Japan, Helicobacter pylori eradication has been approved since 2013 for treatment of H pylori-induced chronic gastritis, in an attempt to reduce the prevalence of gastric cancer, a leading cancer in Japan. H pylori infection affects more than 50% of the world's population. H pylori eradication therapy is generally safe. To our knowledge, no case of newly diagnosed ulcerative colitis occurring immediately after H pylori eradication therapy has previously been reported.A 63-year-old man received a diagnosis of chronic gastritis and H pylori infection. In early March 2014, primary H pylori eradication therapy was initiated; lansoprazole, amoxicillin, and clarithromycin were administered for 1 week. Beginning on the fourth day, he had watery diarrhea twice a day. From the 11th day, bloody stools and watery diarrhea increased to 6 times a day. Colonoscopy, performed on the 40th day after termination of drug therapy, revealed diffuse inflammation in the distal aspect of the colon, with histologic findings consistent with ulcerative colitis. He was admitted to the hospital and was provided with a semivegetarian diet and metronidazole. He noticed a gradual decrease in the amount of blood in his feces then a disappearance of the blood. A fecal occult blood test on the 11th hospital day recorded 337 ng/mL. Fecal occult blood test is not indicated during macroscopic bloody stool but is indicated after disappearance of bloody stool. Therefore, he achieved clinical remission by the 11th hospital day. He was in remission on discharge.New onset of ulcerative colitis should be added to a list of adverse events of H pylori eradication therapy.

  18. Helicobacter pylori eradication therapy: A review of current trends ...

    African Journals Online (AJOL)

    There has been a substantial decline in the H. pylori eradication rates over the years, despite the use of proton pump inhibitor and bismuth salts for triple and quadruple therapies respectively. The reasons for eradication failure are diverse, among them, antibiotic resistance is an important factor in the treatment failure.

  19. Eradicating Poverty and Promoting Dignity in Botswana through ...

    African Journals Online (AJOL)

    Poverty in post-Independence Botswana remains a significant problem for many people today as it inhibits human dignity. Eradicating it is equally a serious challenge. The difficulty with fighting poverty is that oppressive issues such as landlessness, gender/ethnic disparity and HIV and AIDS continue to make its eradication ...

  20. extent of involvement of participants in the poverty eradication ...

    African Journals Online (AJOL)

    ERADICATION PROGRAMME IN CROSS RIVER STATE, NIGERIA '. C.L. ABOH AND MARIA BISONG ONABE. ABSTRACT. The paper focuses on the extent of involvement of participants in the National Poverty. Eradication Programme in Cross River State, Nigeria. Data for the study were collected from 75 randomly ...

  1. AN ECONOMIC ANALYSIS OF COCA ERADICATION POLICY IN COLOMBIA

    OpenAIRE

    Moreno-Sanchez, Rocio del Pilar; Kraybill, David S.; Thompson, Stanley R.

    2002-01-01

    We estimate an econometric model of coca production in Colombia. Our results indicate that coca eradication is an ineffective means of supply control as farmers compensate by cultivating the crop more extensively. The evidence further suggests that incentives to produce legal substitute crops may have greater supply-reducing potential than eradication.

  2. 76 FR 53165 - Certification Related to Aerial Eradication in Colombia

    Science.gov (United States)

    2011-08-25

    ... for aerial eradication of illicit crops in Colombia is being used in accordance with EPA label... Certification Related to Aerial Eradication in Colombia Pursuant to the authority vested in the Secretary of... environment including endemic species; and (3) complaints of harm to health or licit crops caused by such...

  3. Poverty Eradication and Sustainability of Healthful Living in Nigeria ...

    African Journals Online (AJOL)

    This paper discussed poverty eradication as a tool to sustainablehealthful living in developing countries with special reference to Nigeriaunder the following:- poverty on human environment, Nigeria experiencesand poverty eradication program. In Nigeria it was evident that despite allsocio-economic, educational measures ...

  4. Printing education and poverty eradication in Nigeria | Afolabi ...

    African Journals Online (AJOL)

    One of the key goals of the Millennium Development Goals (MDGs) is the eradication of extreme poverty and hunger. In the Nigerian context, unemployment is a major cause of poverty which can be eradicated through empowerment and wealth creation. Printing technology, a technical based course offers benefits in this ...

  5. Exploring the practice and attitude of circumcisers in the eradication ...

    African Journals Online (AJOL)

    Background: Female Genital Mutilation/Cutting (FGM/C) remains a form of violence against women despite efforts aimed at its eradication. Objectives: To explore the practice and attitude of circumcisers towards eradication of FGM/C. Methods: A descriptive (pilot) study involving local circumcisers in Kwara State, Nigeria ...

  6. The effective eradication and control strategies for tsetse and ...

    African Journals Online (AJOL)

    I conducted an extensive literature review on the effective tsetse and trypanosomiasis eradication method strategies in Africa in 2010 as i embarked on my research that coincided with the formulation of the Tsetse and Trypanosomiasis Eradication Strategy for Kenya spearheaded by Pan African Tsetse and Trypanosomiasis ...

  7. Sex-differential effect on infant mortality of oral polio vaccine administered with BCG at birth in Guinea-Bissau. A natural experiment.

    Directory of Open Access Journals (Sweden)

    Christine Stabell Benn

    Full Text Available The policy to provide oral polio vaccine (OPV at birth was introduced in low-income countries to increase coverage. The effect of OPV at birth on overall child mortality was never studied. During a trial of vitamin A supplementation (VAS at birth in Guinea-Bissau, OPV was not available during several periods. We took advantage of this "natural experiment" to test the effect on mortality of receiving OPV at birth.Between 2002 and 2004, the VAS trial randomised normal-birth-weight infants to 50,000 IU VAS or placebo administered with BCG. Provision of OPV at birth was not part of the trial, but we noted whether the infants received OPV or not. OPV was missing during several periods in 2004. We used Cox proportional hazards models to compute mortality rate ratios (MRR of children who had received or not received OPV at birth.A total of 962 (22.1% of the 4345 enrolled children did not receive OPV at birth; 179 children died within the first year of life. Missing OPV at birth was associated with a tendency for decreased mortality (adjusted MRR = 0.69 (95% CI = 0.46-1.03, the effect being similar among recipients of VAS and placebo. There was a highly significant interaction between OPV at birth and sex (p = 0.006. Not receiving OPV at birth was associated with a weak tendency for increased mortality in girls (1.14 (0.70-1.89 but significantly decreased mortality in boys (0.35 (0.18-0.71.In our study OPV at birth had a sex-differential effect on mortality. Poliovirus is almost eradicated and OPV at birth contributes little to herd immunity. A randomised study of the effect of OPV at birth on overall mortality in both sexes is warranted.

  8. Introduction of inactivated polio vaccine (IPV) into the routine immunization schedule of South Africa.

    Science.gov (United States)

    Schoub, Barry D

    2012-09-07

    South Africa is currently the only country on the African continent using inactivated polio vaccine (IPV) for routine immunization in a sequential schedule in combination with oral polio vaccine (OPV). IPV is a component of an injectable pentavalent vaccine introduced nationwide in April 2009 and administered according to EPI schedule at 6, 10 and 14 weeks with a booster dose at 18 months. OPV is administered at birth and together with the first IPV dose at 6 weeks, which stimulates gut immune system producing a memory IgA response (OPV), followed by IPV to minimize the risk of vaccine associated paralytic polio (VAPP). OPV is also given to all children under 5 years of age as part of regular mass immunizations campaigns. The decision to incorporate IPV into the routine schedule was not based on cost-effectiveness, which it is not. Other factors were taken into account: Firstly, the sequence benefits from the initial mucosal contact with live(vaccine) virus which promotes the IgA response from subsequent IPV, as well as herd immunity from OPV, together with the safety of IPV. Secondly, given the widespread and increasing use of IPV in the developed world, public acceptance of vaccination in general is enhanced in South Africa which is classified as an upper middle income developing country. Thirdly, to address equity concerns because of the growing use of IPV in the private sector. Fourthly, the advent of combination vaccines facilitated the incorporation of IPV into the EPI schedule. Copyright © 2012 Elsevier Ltd. All rights reserved.

  9. Update on current and emerging treatment options for post-polio syndrome

    Directory of Open Access Journals (Sweden)

    Elisabeth Farbu

    2010-07-01

    Full Text Available Elisabeth Farbu Neurocenter and National Competence Center for Movement Disorders, Stavanger University Hospital, Stavanger, NorwayAbstract: Post-polio syndrome (PPS refers to the clinical deterioration experienced by many polio survivors several decades after their acute illness. The symptoms are new muscle weakness, decreased muscle endurance, fatigue, muscle pain, joint pain, cold intolerance, and this typical clinical entity is reported from different parts of the world. The pathophysiology behind PPS is not fully understood, but a combination of distal degeneration of enlarged motor units caused by increased metabolic demands and the normal aging process, in addition to inflammatory mechanisms, are thought to be involved. There is no diagnostic test for PPS, and the diagnosis is based on a proper clinical workup where all other possible explanations for the new symptoms are ruled out. The basic principle of management of PPS lies in physical activity, individually tailored training programs, and lifestyle modification. Muscle weakness and muscle pain may be helped with specific training programs, in which training in warm water seems to be particularly helpful. Properly fitted orthoses can improve the biomechanical movement pattern and be energy-saving. Fatigue can be relieved with lifestyle changes, assistive devices, and training programs. Respiratory insufficiency can be controlled with noninvasive respiratory aids including biphasic positive pressure ventilators. Pharmacologic agents like prednisone, amantadine, pyridostigmine, and coenzyme Q10 are of no benefit in PPS. Intravenous immunoglobulin (IVIG has been tried in three studies, all having positive results. IVIG could probably be a therapeutic alternative, but the potential benefit is modest, and some important questions are still unanswered, in particular to which patients this treatment is useful, the dose, and the therapeutic interval.Keywords: polio, survivors, fatigue, aging

  10. Eradication of Pseudomonas aeruginosa cells by cathodic electrochemical currents delivered with graphite electrodes.

    Science.gov (United States)

    Niepa, Tagbo H R; Wang, Hao; Gilbert, Jeremy L; Ren, Dacheng

    2017-03-01

    Antibiotic resistance is a major challenge to the treatment of bacterial infections associated with medical devices and biomaterials. One important intrinsic mechanism of such resistance is the formation of persister cells that are phenotypic variants of microorganisms and highly tolerant to antibiotics. Recently, we reported a new approach to eradicating persister cells of Pseudomonas aeruginosa using low-level direct electrochemical current (DC) and synergy with the antibiotic tobramycin. To further understand the underlying mechanism and develop this technology toward possible medical applications, we investigated the electricidal activities of non-metallic biomaterial on persister and biofilm cells of P. aeruginosa using graphite-based TGON™ 805 electrodes. We employed both single and dual chamber systems to compare electrochemical factors of TGON and stainless steel 304 electrodes. The results revealed that TGON-based treatments were highly effective against P. aeruginosa persister cells. In the single chamber system, complete eradication of planktonic persister cells (corresponding to a 7-log killing) was achieved with 70μA/cm2 DC using TGON electrodes within 40min of treatment, while the cell viability in biofilms was reduced by 2 logs within 1h. The killing effects were dose and time dependent with higher current densities requiring less time. Moreover, reduction reactions were found more effective than oxidation reactions, confirming that metal cations are not indispensable, although they may facilitate cell killing. The findings of this study can help develop electrochemical technologies to eradicate persister and biofilm cells for more effective treatment of medical device and biomaterial associated infections. Infections associated with medical devices and biomaterials present a major challenge due to high-level tolerance of microbes to conventional antibiotics. It is well established that such tolerance is due to the formation of dormant persister

  11. The immunological effects of oral polio vaccine provided with BCG vaccine at birth

    DEFF Research Database (Denmark)

    Jensen, Kristoffer Jarlov; Karkov, Hanne Sophie; Lund, Najaaraq

    2014-01-01

    BACKGROUND: Vaccines may have non-specific effects. An observational study from Guinea-Bissau suggested that oral polio vaccine at birth (OPV0) provided with Bacillus Calmette-Guérin (BCG) vaccine was associated with down-regulation of the immune response to BCG vaccine 6 weeks later. Based...... BCG alone at birth, and subsequently randomised to have a blood sample taken at 2, 4 or 6 weeks post-randomisation. Excreted levels of cytokines (IL-2, IL-5, IL-10, TNF-α and IFN-γ) were measured from whole blood in vitro stimulations with a panel of recall vaccine antigens (BCG, PPD, OPV), mitogen...

  12. And they shall walk: ideal versus reality in polio rehabilitation in the United States

    Directory of Open Access Journals (Sweden)

    Wilson, Daniel J.

    2009-06-01

    Full Text Available This essay explores the significance that rehabilitation physicians and polio patients in the United States put on recovering the ability to walk. Polio often paralyzed or severely weakened the legs of those who contracted the disease. Regaining the ability to walk was thus a significant measure of recovery from the disease. However, walking meant more than the physical act itself. Regaining the ability to walk meant, in a symbolic sense, that one was no longer disabled, that one had again become normal. This attitude was shared by rehabilitation specialists and patients alike. This essay examines this attitude and the cultural values it embodied through a study of the efforts of selected polio survivors to learn to walk again and of the rehabilitation literature that held walking as an ideal. It also explores what happened when polio patients were unable to walk again because of the severity of their paralysis.

    En este artículo se analiza la importancia que tiene la recuperación de la capacidad de andar para los especialistas en rehabilitación y los pacientes de polio en los Estados Unidos. La polio iba a menudo acompañada de parálisis o de una grave debilitación de las piernas en aquellas personas que contraían la enfermedad. El recuperar la capacidad de andar era por lo tanto un importante factor indicativo de la recuperación de la enfermedad. Sin embargo, el andar significaba algo más que la simple acción física. El recuperar la movilidad significaba simbólicamente que uno dejaba de ser un minusválido y que volvía a ser una persona normal. Esta postura la compartían tanto los especialistas en rehabilitación como los pacientes. Este artículo analiza esta actitud y los valores culturales derivados de la misma, a través de un estudio sobre los esfuerzos llevados a cabo por un grupo seleccionado de supervivientes de polio para aprender a andar de nuevo así como de un análisis de la literatura sobre la rehabilitaci

  13. Non-technical constraints to eradication: the Italian experience.

    Science.gov (United States)

    Moda, Giuliana

    2006-02-25

    Although technical constraints to eradication of bovine tuberculosis are well-recognised, non-technical constraints can also delay progress towards eradication, leading to inefficiency and increased programme costs. This paper seeks to analyse the main non-technical constraints that can interfere with the successful implementation of tuberculosis eradication plans, based on experiences from an area of high tuberculosis prevalence in Regione Piemonte, Italy. The main social and economic constraints faced in the past 20 years are reviewed, including a social reluctance to recognise the importance of seeking eradication as the goal of disease control, effective communication of technical issues, the training and the organization of veterinary services, the relationship between the regional authority and farmers and their representatives, and data management and epidemiological reporting. The paper analyses and discusses the solutions that were applied in Regione Piemonte and the benefits that were obtained. Tuberculosis eradication plans are one of the most difficult tasks of the Veterinary Animal Health Services, and non-technical constraints must be considered when progress towards eradication is less than expected. Organizational and managerial resources can help to overcome social or economic obstacles, provided the veterinary profession is willing to address technical, but also non-technical, constraints to eradication.

  14. Treatment of low-grade gastric malt lymphoma using Helicobacter pylori eradication

    Directory of Open Access Journals (Sweden)

    Grgov Saša

    2015-01-01

    Full Text Available Background/Aim. Lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma of the stomach usually occurs as a consequence of Helicobacter pylori (H. pylori infection. The aim of this study was to investigate the long-term effect of treatment of low-grade gastric MALT lymphoma with the H. pylori eradication method. Methods. In the period 2002-2012 in 20 patients with dyspepsia, mean age 55.1 years, the endoscopic and histologic diagnosis of gastric MALT lymphoma in the early stages were made. Histological preparations of endoscopic biopsy specimens were stained with hematoxyllineosin (HE, histochemical and immunohistochemical methods. Results. Endoscopic findings of gastritis were documented in 25% of the patients, and 75% of the patients had hypertrophic folds, severe mucosal hyperemia, fragility, nodularity, exulcerations and rigidity. Histopathologically, pathognomonic diagnostic criterion were infiltration and destruction of glandular epithelium with neoplastic lymphoid cells, the so-called lymphoepithelial lesions. In all 20 patients H. pylori was verified by rapid urease test and Giemsa stain. After the triple eradication therapy complete remission of MALT lymphoma was achieved in 85% of the patients, with no recurrence of lymphoma and H. pylori infection in the average follow-up period of 48 months. In 3 (15% of the patients, there was no remission of MALT lymphoma 12 months after the eradication therapy. Of these 3 patients 2 had progression of MALT lymphoma to diffuse large-cell lymphoma. Conclusion. Durable complete re-mission of low-grade gastric MALT lymphoma is achieved in a high percentage after eradication of H. pylori infection, thus preventing the formation of diffuse large-cell lymphoma and gastric adenocarcinoma.

  15. Factors influencing the eradication of Helicobacter pylori with triple therapy.

    Science.gov (United States)

    Graham, D Y; Lew, G M; Malaty, H M; Evans, D G; Evans, D J; Klein, P D; Alpert, L C; Genta, R M

    1992-02-01

    Helicobacter pylori infection has been associated with gastritis, duodenal ulcer, gastric ulcer, and the epidemic form of gastric carcinoma. Eradication of H. pylori infection has proven to be difficult. Recently, combinations of antimicrobial drugs have been shown to eradicate greater than 50% of infections; however, the results have proven variable, and the factors influencing effectiveness of therapy are unclear. In the present study, the effectiveness of a triple therapy for eradication of H. pylori infection was evaluated. Triple therapy consisted of 2 g tetracycline, 750 mg metronidazole, and five or eight tablets of bismuth subsalicylate daily in 93 patients (70 with duodenal ulcer, 17 with gastric ulcer, and 6 with simple H. pylori gastritis). Combinations of a sensitive urea breath test, serology, culture, and histology were used to confirm the presence of infection, eradication, or relapse. Eradication was defined as inability to show H. pylori greater than or equal to 1 month after ending therapy. The overall eradication rate was 87%. The factors evaluated for their effect on predicting eradication included age, gender, type of disease, duration of therapy, amount of bismuth subsalicylate [five or eight Pepto-Bismol tablets daily (Procter & Gamble, Cincinnati, OH)], and compliance with the prescribed medications. Stepwise regression showed that compliance was the most important factor predicting success; the success rate was 96% for patients who took greater than 60% of the prescribed medications and 69% for patients who took less. For those taking greater than 60% of the prescribed therapy, the eradication rates were similar (a) for patients receiving therapy for 14 days or when tetracycline and bismuth subsalicylate were taken for an additional 14 days; (b) for patients with duodenal ulcer, gastric ulcer, and simple H. pylori gastritis; and (c) whether five or eight bismuth subsalicylate tablets were taken. It is concluded that triple therapy is

  16. Six challenges in the eradication of infectious diseases

    Directory of Open Access Journals (Sweden)

    Petra Klepac

    2015-03-01

    Full Text Available Eradication and elimination are increasingly a part of the global health agenda. Once control measures have driven infection to low levels, the ecology of disease may change posing challenges for eradication efforts. These challenges vary from identifying pockets of susceptibles, improving monitoring during and after the endgame, to quantifying the economics of disease eradication versus sustained control, all of which are shaped and influenced by processes of loss of immunity, susceptible build-up, emergence of resistance, population heterogeneities and non-compliance with control measures. Here we discuss how modelling can be used to address these challenges.

  17. Sequential therapy for Helicobacter pylori eradication: a critical review.

    Science.gov (United States)

    Gisbert, Javier P; Calvet, Xavier; O'Connor, Anthony; Mégraud, Francis; O'Morain, Colm A

    2010-01-01

    Alternative treatment regimens for standard triple therapy are urgently needed. To critically review the evidence on the role of "sequential" regimen for the treatment of Helicobacter pylori infection. Bibliographical searches were performed in MEDLINE and international congresses. Several pooled-data analyses and meta-analyses have demonstrated that sequential regimen is more effective than standard triple therapy. Sequential therapy is not affected by bacterial (CagA status, infection density) and host factors (underlying disease, smoking). Clarithromycin resistance seems to be the only factor reducing their efficacy. However, even in these patients, an acceptable >75% eradication rate can be achieved. Unfortunately, almost all the studies have been performed in Italy. Whether it is necessary to provide the drugs sequentially or if the 4 components of sequential therapy can be given concurrently is unclear. Nonbismuth quadruple therapy seems to be an effective and safe alternative to triple therapy and is less complex than sequential therapy. Sequential therapy is a novel promising treatment approach that deserves consideration as a treatment strategy for H. pylori infection. However, further robust assessment across a much broader range of patients is required before sequential therapy could supplant existing treatment regimens and be generally recommended in clinical practice.

  18. [Eradication of Staphylococcus aureus in carrier patients undergoing joint arthroplasty].

    Science.gov (United States)

    Barbero Allende, José M; Romanyk Cabrera, Juan; Montero Ruiz, Eduardo; Vallés Purroy, Alfonso; Melgar Molero, Virginia; Agudo López, Rosa; Gete García, Luis; López Álvarez, Joaquín

    2015-02-01

    Prosthetic joint infection (PJI) is a complication with serious repercussions and its main cause is Staphylococcus aureus. The purpose of this study is to determine whether decolonization of S.aureus carriers helps to reduce the incidence of PJI by S.aureus. An S.aureus screening test was performed on nasal carriers in patients undergoing knee or hip arthroplasty between January and December 2011. Patients with a positive test were treated with intranasal mupirocin and chlorhexidine soap 5 days. The incidence of PJI was compared with patients undergoing the same surgery between January and December 2010. A total of 393 joint replacements were performed in 391 patients from the control group, with 416 joint replacements being performed in the intervention group. Colonization study was performed in 382 patients (91.8%), of which 102 were positive (26.7%) and treated. There was 2 PJI due S.aureus compared with 9 in the control group (0.5% vs 2.3%, odds ratio [OR]: 0.2, 95% confidence interval [CI]: 0.4 to 2.3, P=.04). In our study, the detection of colonization and eradication of S.aureus carriers achieved a significant decrease in PJI due to S.aureus compared to a historical group. Copyright © 2013 Elsevier España, S.L.U. y Sociedad Española de Enfermedades Infecciosas y Microbiología Clínica. All rights reserved.

  19. Cold-Chain Adaptability During Introduction of Inactivated Polio Vaccine in Bangladesh, 2015.

    Science.gov (United States)

    Billah, Mallick M; Zaman, K; Estivariz, Concepcion F; Snider, Cynthia J; Anand, Abhijeet; Hampton, Lee M; Bari, Tajul I A; Russell, Kevin L; Chai, Shua J

    2017-07-01

    Introduction of inactivated polio vaccine creates challenges in maintaining the cold chain for vaccine storage and distribution. We evaluated the cold chain in 23 health facilities and 36 outreach vaccination sessions in 8 districts and cities of Bangladesh, using purposive sampling during August-October 2015. We interviewed immunization and cold-chain staff, assessed equipment, and recorded temperatures during vaccine storage and transportation. All health facilities had functioning refrigerators, and 96% had freezers. Temperature monitors were observed in all refrigerators and freezers but in only 14 of 66 vaccine transporters (21%). Recorders detected temperatures >8°C for >60 minutes in 5 of 23 refrigerators (22%), 3 of 6 cold boxes (50%) transporting vaccines from national to subnational depots, and 8 of 48 vaccine carriers (17%) used in outreach vaccination sites. Temperatures chain storage and transportation capacity after inactivated polio vaccine introduction, but temperature fluctuations during vaccine transport could cause vaccine potency loss that could go undetected. Bangladesh and other countries should strive to ensure consistent and sufficient cold-chain storage and monitor the cold chain during vaccine transportation at all levels.

  20. Eradication of multidrug-resistant pseudomonas biofilm with pulsed electric fields.

    Science.gov (United States)

    Khan, Saiqa I; Blumrosen, Gaddi; Vecchio, Daniela; Golberg, Alexander; McCormack, Michael C; Yarmush, Martin L; Hamblin, Michael R; Austen, William G

    2016-03-01

    Biofilm formation is a significant problem, accounting for over eighty percent of microbial infections in the body. Biofilm eradication is problematic due to increased resistance to antibiotics and antimicrobials as compared to planktonic cells. The purpose of this study was to investigate the effect of Pulsed Electric Fields (PEF) on biofilm-infected mesh. Prolene mesh was infected with bioluminescent Pseudomonas aeruginosa and treated with PEF using a concentric electrode system to derive, in a single experiment, the critical electric field strength needed to kill bacteria. The effect of the electric field strength and the number of pulses (with a fixed pulse length duration and frequency) on bacterial eradication was investigated. For all experiments, biofilm formation and disruption were confirmed with bioluminescent imaging and Scanning Electron Microscopy (SEM). Computation and statistical methods were used to analyze treatment efficiency and to compare it to existing theoretical models. In all experiments 1500 V are applied through a central electrode, with pulse duration of 50 μs, and pulse delivery frequency of 2 Hz. We found that the critical electric field strength (Ecr) needed to eradicate 100-80% of bacteria in the treated area was 121 ± 14 V/mm when 300 pulses were applied, and 235 ± 6.1 V/mm when 150 pulses were applied. The area at which 100-80% of bacteria were eradicated was 50.5 ± 9.9 mm(2) for 300 pulses, and 13.4 ± 0.65 mm(2) for 150 pulses. 80% threshold eradication was not achieved with 100 pulses. The results indicate that increased efficacy of treatment is due to increased number of pulses delivered. In addition, we that showed the bacterial death rate as a function of the electrical field follows the statistical Weibull model for 150 and 300 pulses. We hypothesize that in the clinical setting, combining systemic antibacterial therapy with PEF will yield a synergistic effect leading to improved

  1. Attempted eradication of Porphyrio porphyrio Linnaeus in the Florida Everglades

    Directory of Open Access Journals (Sweden)

    Dave EGGEMAN

    2011-01-01

    Full Text Available Porphyrio porphyrio (Fulica porphyrio Linnaeus was reported to the South Florida Water Management District in a Water Conservation Area and in constructed wetlands in the Everglades in 2006. A rapid assessment, including casual observations and surveys of land managers, indicated a limited number of P. porphyrio (~300 birds was present, and an eradication attempt was initiated. From 2006 – 2008, more than 3100 P. porphyrio were killed by shotgun from airboats during 73 hunts, suggesting the initial population assessment was severely underestimated. After removing nearly 1500 P. porphyrio in 2008, we concluded that eradication was not possible. Failure of this eradication attempt is attributed to P. porphyrio’s affinity with dense emergent vegetation, which greatly limited shooting effectiveness. Further, the failed eradication underscores the importance of a reporting network to improve early detection and the chance to eliminate naturalized or feral populations of non‐native species.

  2. Mid-Columbia - Eradication of Yellow-flag Iris 2013

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The project as described was to attempt to eradicate yellow-flag iris from Toppenish, McNary and Columbia National Wildlife Refuges using chemical and, where...

  3. Control and eradication of endemic infectious diseases in cattle

    DEFF Research Database (Denmark)

    Houe, Hans; Nielsen, Liza Rosenbaum; Nielsen, Søren Saxmose

    "Control and eradication of endemic infectious diseases in cattle" provides the key elements that should be addressed in the establishment of bovine disease control and eradication programmes. The book aims to reach a broad group of readers, including: students; professionals in veterinary practice......, industry and governmental institutions; researchers; and others involved in control and eradication of endemic diseases in livestock. Key elements range from socioeconomic aspects such as motivation; veterinary science (including assessment of biosecurity and establishment of test...... examples: bovine virus diarrhoea virus, Salmonella Dublin and Mycobacterium avium subsp. paratuberculosis. The three authors have been particularly involved in the research and development of control and eradication efforts in the Danish cattle industry for these three diseases. The basic idea is to enable...

  4. Elevated plasma inflammatory mediators in post-polio syndrome: No association with long-term functional decline

    NARCIS (Netherlands)

    Bickerstaffe, A.; Beelen, A.; Lutter, R.; Nollet, F.

    2015-01-01

    A key feature of post-polio syndrome (PPS) is progressive loss of muscle strength. In other chronic diseases systemic inflammation has been linked to muscle wasting. In this study plasma TNF-α, IL-6, IL-8, and leptin levels were significantly increased in PPS-patients compared to healthy controls.

  5. Modelling Risk to US Military Populations from Stopping Blanket Mandatory Polio Vaccination (Open Access Publisher’s Version)

    Science.gov (United States)

    2017-09-14

    routinely vaccinated with inactivated poliovirus vaccine (IPV), supplemented based upon deployment circumstances. Given residual protection from...are further supplemented , based on occupational and deployment circumstances of the recruits” [14]. However, in countries with insufficient...locals was homogeneous within the simulated geographic region. Local birth and nonpolio death rates varied annually [24], and a polio-specific death

  6. Experiences and perspectives of patients with post-polio syndrome and therapists with exercise and cognitive behavioural therapy

    NARCIS (Netherlands)

    Bakker, Minne; Schipper, Karen; Koopman, Fieke S.; Nollet, Frans; Abma, Tineke A.

    2016-01-01

    Many persons affected with poliomyelitis develop post-polio syndrome (PPS) later in their life. Recently, the effectiveness of Exercise Therapy (ET) and Cognitive Behavioural Therapy (CBT) for PPS has been evaluated in a randomized controlled trial, but did not show a decrease in fatigue or

  7. Estimation after classification using lot quality assurance sampling: corrections for curtailed sampling with application to evaluating polio vaccination campaigns.

    Science.gov (United States)

    Olives, Casey; Valadez, Joseph J; Pagano, Marcello

    2014-03-01

    To assess the bias incurred when curtailment of Lot Quality Assurance Sampling (LQAS) is ignored, to present unbiased estimators, to consider the impact of cluster sampling by simulation and to apply our method to published polio immunization data from Nigeria. We present estimators of coverage when using two kinds of curtailed LQAS strategies: semicurtailed and curtailed. We study the proposed estimators with independent and clustered data using three field-tested LQAS designs for assessing polio vaccination coverage, with samples of size 60 and decision rules of 9, 21 and 33, and compare them to biased maximum likelihood estimators. Lastly, we present estimates of polio vaccination coverage from previously published data in 20 local government authorities (LGAs) from five Nigerian states. Simulations illustrate substantial bias if one ignores the curtailed sampling design. Proposed estimators show no bias. Clustering does not affect the bias of these estimators. Across simulations, standard errors show signs of inflation as clustering increases. Neither sampling strategy nor LQAS design influences estimates of polio vaccination coverage in 20 Nigerian LGAs. When coverage is low, semicurtailed LQAS strategies considerably reduces the sample size required to make a decision. Curtailed LQAS designs further reduce the sample size when coverage is high. Results presented dispel the misconception that curtailed LQAS data are unsuitable for estimation. These findings augment the utility of LQAS as a tool for monitoring vaccination efforts by demonstrating that unbiased estimation using curtailed designs is not only possible but these designs also reduce the sample size. © 2014 John Wiley & Sons Ltd.

  8. Towards the eradication of HPV infection through universal specific vaccination.

    Science.gov (United States)

    Crosignani, Piergiorgio; De Stefani, Antonella; Fara, Gaetano Maria; Isidori, Andrea M; Lenzi, Andrea; Liverani, Carlo Antonio; Lombardi, Alberto; Mennini, Francesco Saverio; Palu', Giorgio; Pecorelli, Sergio; Peracino, Andrea P; Signorelli, Carlo; Zuccotti, Gian Vincenzo

    2013-07-11

    The Human Papillomavirus (HPV) is generally recognized to be the direct cause of cervical cancer. The development of effective anti-HPV vaccines, included in the portfolio of recommended vaccinations for any given community, led to the consolidation in many countries of immunization programs to prevent HPV-related cervical cancers. In recent years, increasing evidence in epidemiology and molecular biology have supported the oncogenic role of HPV in the development of other neoplasm including condylomas and penile, anal, vulvar, vaginal, and oro-pharyngeal cancers. Men play a key role in the paradigm of HPV infection: both as patients and as part of the mechanisms of transmission. Data show they are affected almost as often as women. Moreover, no screening procedures for HPV-related disease prevention are applied in men, who fail to undergo routine medical testing by any medical specialist at all. They also do not benefit from government prevention strategies. A panel of experts convened to focus on scientific, medical, and economic studies, and on the achievements from health organizations' intervention programs on the matter. One of the goals was to discuss on the critical issues emerging from the ongoing global implementation of HPV vaccination. A second goal was to identify contributions which could overcome the barriers that impede or delay effective vaccination programs whose purpose is to eradicate the HPV infection both in women and men. The reviewed studies on the natural history of HPV infection and related diseases in women and men, the increasing experience of HPV vaccination in women, the analysis of clinical effectiveness vs economic efficacy of HPV vaccination, are even more supportive of the economic sustainability of vaccination programs both in women and men. Those achievements address increasing and needed attention to the issue of social equity in healthcare for both genders.

  9. H. pylori eradication lower ulcers in cirrhosis. [Corrected].

    Science.gov (United States)

    Chang, Shen-Shong; Hu, Hsiao-Yun

    2014-08-01

    The study aimed to investigate whether early Helicobacter pylori (H. pylori) eradication therapy in cirrhotic patients caused a dramatic reduction of recurrent peptic ulcers compared with those treated with a late eradication. We identified cirrhotic patients using the International Classifications of Diseases, Revision 9 (ICD-9-CM). Decompensated cirrhotic patients can apply for a catastrophic illness card and were identified via the ICD-9-CM codes 571.2, 571.5 and 571.6. Compensated cirrhotic patients were identified via the ICD-9-CM codes 571.2, 571.5 and 571.6, after excluded decompensated cirrhotic patients. We categorized patients into early (time lag ≤365 days after peptic ulcer diagnosis) and late (time lag >365 days) H. pylori eradication therapy groups. The end-point was the occurrence of recurrent peptic ulcers. Cox proportional hazards model was used to calculate the hazard ratios (HRs). Altogether, 154 cirrhotic patients were included in the early H. pylori eradication group and 103 in the late H. pylori eradication group. Cirrhotic patients had a higher risk of recurrent peptic ulcers in the late H. pylori eradication group (HR 1.58, 95% CI 1.09-2.28, P = 0.015). However, the risk of recurrent peptic ulcers in alcoholic cirrhotic patients in both groups (HR 1.47, 95% CI 0.77-2.83, P = 0.247) was similar. Early H. pylori eradication is associated with a lower risk of recurrent peptic ulcers in cirrhotic patients. H. pylori eradication is the mainstay for treating cirrhotic patients who have contracted peptic ulcers. © 2014 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and Wiley Publishing Asia Pty Ltd.

  10. After Beijing: emphasis on poverty eradication.

    Science.gov (United States)

    1996-01-01

    In March 1996, during its first meeting since the Fourth World Conference on Women, the UN Commission on the Status of Women (CSW), called for a gender perspective to be integrated into policies and programs dealing with poverty, child and dependent care, and the media. Three expert panels examined each of these areas through a format which encouraged dialogue and led to the adoption of 17 resolutions, decisions, and agreed conclusions as well as a recommendation that the UN adopt a multi-year work program for the CSW to allow it to review progress in elimination of the 12 main obstacles to women's advancement identified at Beijing. Among the resolutions adopted by the CSW were calls to 1) take a broad and integrated approach to poverty eradication, 2) enhance women's empowerment and autonomy, 3) promote equity and equality in the public domain, 4) promote women's employment, 5) give women social and economic protection when they are unable to work, 6) counteract negative images of women and sex-stereotyping in the media, 7) reduce the representation of violence against women in the media, 8) strengthen the role of women in global communications, 9) encourage the participation of men in child and dependent care, and 10) recognize women's double burden of work. The CSW also agreed to pursue further discussions about drafting an optional protocol to the 1979 Convention on the Elimination of All Forms of Discrimination Against Women. Among its other actions, the CSW called for mechanisms to protect the rights of women migrant workers, to protect women and children during armed conflicts, to include gender-based human rights violations in UN activities, and to address the root factors which lead to social ills such as trafficking in women and girls. In addition, the CSW submitted a draft resolution demanding that Israel protect the rights of Palestinian women and their families.

  11. Brazil: from reduction of poverty to a commitment to eradicate extreme poverty

    Directory of Open Access Journals (Sweden)

    Lena Lavinas

    2012-04-01

    Full Text Available The aim of this article is to summarise certain positive results achieved by the Lula government in the sphere of social policy and to highlight the new challenges taken on by President Dilma Rousseff in terms of eradicating extreme poverty, after her first year in government. After Lula’s success with social policy, Rousseff has committed herself to eradicating extreme poverty over the short term (the four years of her mandate in a federation that is marked by weak links in cooperation, a distinct heterogeneity within the federated bodies and profound socio-economic inequality among citizens. Under Lula’s government, the factors that most helped to reduce poverty and inequality were the recovery of the minimum salary’s real value in rates higher than that of inflation, as well as an increase in formal employment, with the creation of approximately 12,000,000 jobs in eight years. For Dilma’s term of office, which began with a downturn in economic growth rates, an even bigger challenge lies ahead. In light of this, the article evaluates the prospects for success of Dilma’s government in terms of eradicating extreme poverty in Brazil.

  12. Using immunization delivery strategies to accelerate progress in Africa towards achieving the Millennium Development Goals.

    Science.gov (United States)

    Clements, C John; Nshimirimanda, Deo; Gasasira, Alex

    2008-04-07

    Integration of health services brings together common functions within and between organizations to solve common problems, developing a commitment to a shared vision and goals, and using common technologies and resources to achieve these goals. Integration has been the frustrated rally call of Primary Health Care for 30 years. This paper discusses the process of integrating child survival strategies and other heath services with immunization in Africa. Immunization is arguably the most successful health programme throughout the continent, making it the logical vehicle for add-on services. Strong health systems are the best way of delivering cost-effective child survival interventions in a most sustainable manner. But the reality in many African countries is that health systems have been weak for a number of reasons. Joining additional cost-effective child survival interventions on to immunization services may provide the needed boost. The unacceptably high childhood mortality in parts of Africa makes it the ideal location to undertake this exercise. The urgency to scale-up child survival interventions that have proven cost-effective is especially important if the Millennium Development Goals (MDGs) are to be met by 2015. Africa has more to loose than most in failing to scale up to meet these goals, bearing as it does the highest burden of childhood mortality in the world. But so far, prospects do not look good for achieving MDG-4 for the countries with the highest mortality rates. The timeliness of this initiative towards integration could not be better. In the last five years, countries in Africa have received massive injections of financial resources for polio eradication and measles control as well as additional funding for a range of immunization-strengthening activities and the introduction of new and under-utilized vaccines. While the data to support integration are limited, the information to hand suggests the effectiveness of the strategy. Where

  13. The Florey lecture, 1983. Biological control, as exemplified by smallpox eradication and myxomatosis.

    Science.gov (United States)

    Fenner, F

    1983-06-22

    Biological control is an important method of dealing with plant and insect pests. The control of rabbits by myxomatosis and the eradication of smallpox by vaccination are unusual examples of biological control, in that they involve a vertebrate and a viral pest respectively. Myxomatosis is a benign disease in Sylvilagus rabbits in South America which is transmitted mechanically by mosquitoes. In the European rabbit, Oryctolagus, which is a pest in Australia and England, the virus from Sylvilagus produces a generalized disease that is almost always lethal. Myxomatosis was deliberately introduced into Australia in 1950 and into Europe in 1952. It was at first spectacularly successful in controlling the rabbit pest, but biological adjustments occurred in the virulence of the virus and the genetic resistances of rabbits. After 30 years of interaction, natural selection has resulted in a balance at a fairly high level of viral virulence. Smallpox has been a major scourge of mankind for over 1500 years. It spread from Asia to Europe in the Middle ages and from Europe to Africa and the Americas in the 15th and 16th centuries. Jenner's cowpox vaccine provided a method of control that reduced the severity of the disease during the 19th century but failed to eliminate the disease from many countries before the 1930s. Thereafter it was eradicated from Europe and North America, but remained endemic in South America, Africa and Asia. In 1967 it was still endemic in 33 countries and W.H.O. established a programme for global eradication within 10 years. The goal was achieved in 1977. Problems of the eradication programme and reasons for its success will be described.

  14. Malaria eradication: the economic, financial and institutional challenge

    Directory of Open Access Journals (Sweden)

    Hanson Kara

    2008-12-01

    Full Text Available Abstract Malaria eradication raises many economic, financial and institutional challenges. This paper reviews these challenges, drawing on evidence from previous efforts to eradicate malaria, with a special focus on resource-poor settings; summarizes more recent evidence on the challenges, drawing on the literature on the difficulties of scaling-up malaria control and strengthening health systems more broadly; and explores the implications of these bodies of evidence for the current call for elimination and intensified control. Economic analyses dating from the eradication era, and more recent analyses, suggest that, in general, the benefits of malaria control outweigh the costs, though few studies have looked at the relative returns to eradication versus long-term control. Estimates of financial costs are scanty and difficult to compare. In the 1960s, the consolidation phase appeared to cost less than $1 per capita and, in 1988, was estimated to be $2.31 per capita (both in 2006 prices. More recent estimates for high coverage of control measures suggest a per capita cost of several dollars. Institutional challenges faced by malaria eradication included limits to the rule of law (a major problem where malaria was concentrated in border areas with movement of people associated with illegal activities, the existence and performance of local implementing structures, and political sustainability at national and global levels. Recent analyses of the constraints to scaling-up malaria control, together with the historical evidence, are used to discuss the economic, financial and institutional challenges that face the renewed call for eradication and intensified control. The paper concludes by identifying a research agenda covering: ∘ issues of the allocative efficiency of malaria eradication, especially using macro-economic modelling to estimate the benefits and costs of malaria eradication and intensified control, and studies of the links between

  15. Improving polio vaccination during supplementary campaigns at areas of mass transit in India

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    Bahl Sunil

    2010-05-01

    Full Text Available Abstract Background In India, children who are traveling during mass immunization campaigns for polio represent a substantial component of the total target population. These children are not easily accessible to health workers and may thus not receive vaccine. Vaccination activities at mass transit sites (such as major intersections, bus depots and train stations, can increase the proportion of children vaccinated but the effectiveness of these activities, and factors associated with their success, have not been rigorously evaluated. Methods We assessed data from polio vaccination activities in Jyotiba Phule Nagar district, Uttar Pradesh, India, conducted in June 2006. We used trends in the vaccination results from the June activities to plan the timing, locations, and human resource requirements for transit vaccination activities in two out of the seven blocks in the district for the July 2006 supplementary immunization activity (SIA. In July, similar data was collected and for the first time vaccination teams also recorded the proportion of children encountered each day who were vaccinated (a new monitoring system. Results In June, out of the 360,937 total children vaccinated, 34,643 (9.6% received vaccinations at mass transit sites. In the July SIA, after implementation of a number of changes based on the June monitoring data, 36,475 children were vaccinated at transit sites (a 5.3% increase. Transit site vaccinations in July increased in the two intervention blocks from 18,194 to 21,588 (18.7% and decreased from 16,449 to 14,887 (9.5% in the five other blocks. The new monitoring system showed the proportion of unvaccinated children at street intersection transit sites in the July campaign decreased from 24% (1,784/7,405 at the start of the campaign to 3% (143/5,057 by the end of the SIA, consistent with findings from the more labor-intensive post-vaccination coverage surveys routinely performed by the program. Conclusions Analysis of

  16. Polio and Measles Down the Drain: Environmental Enterovirus Surveillance in the Netherlands, 2005 to 2015.

    Science.gov (United States)

    Benschop, Kimberley S M; van der Avoort, Harrie G; Jusic, Edin; Vennema, Harry; van Binnendijk, Rob; Duizer, Erwin

    2017-07-01

    Polioviruses (PVs) are members of the genus Enterovirus In the Netherlands, the exclusion of PV circulation is based on clinical enterovirus (EV) surveillance (CEVS) of EV-positive cases and routine environmental EV surveillance (EEVS) conducted on sewage samples collected in the region of the Netherlands where vaccination coverage is low due to religious reasons. We compared the EEVS data to those of the CEVS to gain insight into the relevance of EEVS for poliovirus and nonpolio enterovirus surveillance. Following the polio outbreak in Syria, EEVS was performed at the primary refugee center in Ter Apel in the Netherlands, and data were compared to those of CEVS and EEVS. Furthermore, we assessed the feasibility of poliovirus detection by EEVS using measles virus detection in sewage during a measles outbreak as a proxy. Two Sabin-like PVs were found in routine EEVS, 11 Sabin-like PVs were detected in the CEVS, and one Sabin-like PV was found in the Ter Apel sewage. We observed significant differences between the three programs regarding which EVs were found. In 6 sewage samples collected during the measles outbreak in 2013, measles virus RNA was detected in regions where measles cases were identified. In conclusion, we detected PVs, nonpolio EVs, and measles virus in sewage and showed that environmental surveillance is useful for poliovirus detection in the Netherlands, where live oral poliovirus vaccine is not used and communities with lower vaccination coverage exist. EEVS led to the detection of EV types not seen in the CEVS, showing that EEVS is complementary to CEVS.IMPORTANCE We show that environmental enterovirus surveillance complements clinical enterovirus surveillance for poliovirus detection, or exclusion, and for nonpolio enterovirus surveillance. Even in the presence of adequate surveillance, only a very limited number of Sabin-like poliovirus strains were detected in a 10-year period, and no signs of transmission of oral polio vaccine (OPV) strains

  17. Severe gastritis decreases success rate of Helicobacter pylori eradication.

    Science.gov (United States)

    Kalkan, Ismail Hakki; Sapmaz, Ferdane; Güliter, Sefa; Atasoy, Pınar

    2016-05-01

    In several studies, different risk factors other than antibiotic resistance have been documented with Helicobacter pylori eradication failure. We aimed in this study to investigate the relationship of gastric density of H. pylori, the occurrence/degree of gastric atrophy, and intestinal metaplasia (IM) with success rate of H. pylori eradication. Two hundred consecutive treatment naive patients who received bismuth containing standart quadruple treatment due to H. pylori infection documented by histopathological examination of two antral or two corpal biopsies entered this retrospective study. The updated Sydney system was used to grade the activity of gastritis, density of H. pylori colonization, atrophy, and IM. Stages III and IV of operative link for gastritis assessment (OLGA) or the operative link on gastric intestinal metaplasia assessment (OLGIM) stages was considered as severe gastritis. H. pylori eradication was determined via stool H. pylori antigen test performed 4 weeks after the end of therapy. The presence of gastric atrophy and IM was significantly higher in patients with eradication failure (p = 0.001 and 0.01, respectively). Severe gastritis (OLGA III-IV and OLGIM III-IV) rates were higher in eradication failure group. A multiple linear regression analysis showed that OLGA and OLGIM stages were to be independent risk factors for eradication failure (p = 0.03 and 0.01, respectively). Our results suggested that histopathologically severe gastritis may cause H. pylori eradication failure. In addition, we found that H. pylori density was not a risk factor for treatment failure in patients who receive quadruple treatment.

  18. Randomized Clinical Trial: Esomeprazole, Bismuth, Levofloxacin, and Amoxicillin or Cefuroxime as First-Line Eradication Regimens for Helicobacter pylori Infection.

    Science.gov (United States)

    Fu, Wei; Song, Zhiqiang; Zhou, Liya; Xue, Yan; Ding, Yu; Suo, Baojun; Tian, Xueli; Wang, Li

    2017-06-01

    The eradication of Helicobacter pylori infection remains a challenge, especially in the patients unsuitable to take penicillin. Cephalosporin has the potential to replace amoxicillin for H. pylori eradication. To compare the effectiveness, safety, and compliance of amoxicillin- and cefuroxime-containing quadruple regimens in treatment-naïve patients. In this open-label randomized control study, 400 patients with H. pylori infection were divided into amoxicillin-containing (esomeprazole 20 mg twice/day, amoxicillin 1000 mg twice/day, levofloxacin 500 mg once/day, and bismuth 220 mg twice/day for 14 days) or cefuroxime-containing (esomeprazole 20 mg twice/day, cefuroxime 500 mg twice/day, levofloxacin 500 mg once/day, and bismuth 220 mg twice/day for 14 days) quadruple therapy groups. The safety and compliance were assessed 1-3 days after eradication. Urea breath test was performed 8-12 weeks after eradication to determine treatment outcome. The baseline data including antibiotic resistance were well matched between the two groups. The eradication rates between amoxicillin- and cefuroxime-containing quadruple therapy groups were not significantly different [intention-to-treat analysis: 83.5% (95% confidence interval 78.3-88.7%) vs. 81.0% (75.5-86.5%), P = 0.513; modified intention-to-treat analysis: 90.3% (86.0-94.6%) vs. 88.5% (83.9-93.2%), P = 0.586; per-protocol analysis: 91.6% (87.5-95.7%) vs. 89.8% (85.3-94.3%), P = 0.560]. The incidence of adverse effects (18.4 vs. 20.1%, P = 0.678) and compliance (94.7 vs. 94.2%, P = 0.813) were also similar. Variate analyses showed that antibiotic resistance and poor compliance were the independent risk factors for eradication failure. Esomeprazole, bismuth, levofloxacin, and amoxicillin or cefuroxime achieved similar and relatively satisfactory cure rates, safety, and compliance in first-line H. pylori eradication. Cefuroxime may be a good alternative medicine for eradication instead of amoxicillin for

  19. The Clinical and Bacteriological Factors for Optimal Levofloxacin-Containing Triple Therapy in Second-Line Helicobacter pylori Eradication

    Science.gov (United States)

    Tai, Wei-Chen; Lee, Chen-Hsiang; Chiou, Shue-Shian; Kuo, Chung-Mou; Kuo, Chung-Huang; Liang, Chih-Ming; Lu, Lung-Sheng; Chiu, Chien-Hua; Wu, Keng-Liang; Chiu, Yi-Chun; Hu, Tsung-Hui; Chuah, Seng-Kee

    2014-01-01

    Quinolone has the disadvantage of easily acquired drug resistance. It is important to prescribe it wisely for a high eradication rate. The current study aimed to determine the clinical and bacteriological factors for optimal levofloxacin-containing triple therapies in second-line H. pylori eradication. We enrolled a total of 158 H. pylori-infected patients who failed H. pylori eradication using the 7-day standard triple therapy (proton-pump inhibitor [PPI] twice daily, 500 mg clarithromycin twice daily, and 1 g amoxicillin twice daily). They were prescribed with either a 10-day (group A) or 14-day (group B) levofloxacin-containing triple therapy group (levofloxacin 500 mg once daily, amoxicillin 1 g twice daily, and esomeprazole 40 mg twice daily for 10 days) by their clinicians. Follow-up studies to assess treatment responses were carried out 8 weeks later. The eradication rates attained by groups A and B were 73.6% (95% confidence interval [CI] = 63.9–85.3%) and 90.5% (95% CI = 84.5–98.1%), respectively in the per protocol analysis (P = 0.008 in the per protocol analysis) and 67.1% (95% CI = 56.6–78.5%) and 84.8% (95% CI = 76.8–93.4%), respectively, in the intention-to-treat analysis (P = 0.009). The subgroup analysis revealed that H. pylori eradication rates for group A patients with levofloxacin-susceptible strains were 92.9% (13/14) but it dropped to 12.5% (1/8) when levofloxacin-resistant strains existed. H. pylori was eradicated among all the group B patients with levofloxacin-susceptible strains, but only half of patients with levofloxacin-resistant strains were successfully eradicated. In conclusion, this study confirms the effectiveness of 14-day treatment. Importantly, the results imply that 10-day treatment duration should be optimal if a culture can be performed to confirm the existence of susceptible strains. The duration of H. pylori eradication and levofloxacin resistance were the influencing factors for successful

  20. The clinical and bacteriological factors for optimal levofloxacin-containing triple therapy in second-line Helicobacter pylori eradication.

    Directory of Open Access Journals (Sweden)

    Wei-Chen Tai

    Full Text Available Quinolone has the disadvantage of easily acquired drug resistance. It is important to prescribe it wisely for a high eradication rate. The current study aimed to determine the clinical and bacteriological factors for optimal levofloxacin-containing triple therapies in second-line H. pylori eradication. We enrolled a total of 158 H. pylori-infected patients who failed H. pylori eradication using the 7-day standard triple therapy (proton-pump inhibitor [PPI] twice daily, 500 mg clarithromycin twice daily, and 1 g amoxicillin twice daily. They were prescribed with either a 10-day (group A or 14-day (group B levofloxacin-containing triple therapy group (levofloxacin 500 mg once daily, amoxicillin 1 g twice daily, and esomeprazole 40 mg twice daily for 10 days by their clinicians. Follow-up studies to assess treatment responses were carried out 8 weeks later. The eradication rates attained by groups A and B were 73.6% (95% confidence interval [CI]  = 63.9-85.3% and 90.5% (95% CI = 84.5-98.1%, respectively in the per protocol analysis (P = 0.008 in the per protocol analysis and 67.1% (95% CI = 56.6-78.5% and 84.8% (95% CI = 76.8-93.4%, respectively, in the intention-to-treat analysis (P = 0.009. The subgroup analysis revealed that H. pylori eradication rates for group A patients with levofloxacin-susceptible strains were 92.9% (13/14 but it dropped to 12.5% (1/8 when levofloxacin-resistant strains existed. H. pylori was eradicated among all the group B patients with levofloxacin-susceptible strains, but only half of patients with levofloxacin-resistant strains were successfully eradicated. In conclusion, this study confirms the effectiveness of 14-day treatment. Importantly, the results imply that 10-day treatment duration should be optimal if a culture can be performed to confirm the existence of susceptible strains. The duration of H. pylori eradication and levofloxacin resistance were the influencing factors for successful treatment. This study

  1. Fatal outcome of a hyperinfection syndrome despite successful eradication of Strongyloides with subcutaneous ivermectin.

    Science.gov (United States)

    Hauber, H P; Galle, J; Chiodini, P L; Rupp, J; Birke, R; Vollmer, E; Zabel, P; Lange, C

    2005-10-01

    We report the case of a 77-year-old man who developed a Strongyloides hyperinfection syndrome following immunosuppressive therapy more than 60 years after he moved away from an area endemic for Strongyloides stercoralis. Successful eradication of the nematode was achieved with an off label subcutaneous formulation of ivermectin. However, the patient subsequently died from acute respiratory distress syndrome (ARDS). Despite a high wormload in the stool and sputum of the patient and delayed infection control measures in the hospital, testing of the medical staff revealed a very low risk of Strongyloides transmission among healthcare workers.

  2. Polio vaccines, SV40 and human tumours, an update on false positive and false negative results.

    Science.gov (United States)

    Elmishad, A G; Bocchetta, M; Pass, H I; Carbone, M

    2006-01-01

    Simian virus 40 (SV40) has been detected in different human tumours in numerous laboratories. The detection of SV40 in human tumours has been linked to the administration of SV40-contaminated polio vaccines from 1954 until 1963. Many of these reports linked SV40 to human mesothelioma. Some studies have failed to detect SV40 in human tumours and this has caused a controversy. Here we review the current literature. Moreover, we present evidence showing how differences in the sensitivities of methodologies can lead to a very different interpretation of the same study. The same 20 mesothelioma specimens all tested negative, 2/20 tested positive or 7/20 tested positive for SV40 Tag by simply changing the detection method on the same immuno-precipitation/western blot membranes. These results provide a simple explanation for some of the apparent discordant results reported in the literature.

  3. Neutralizing antibodies to non-polio enteroviruses in human immune serum globulin.

    Science.gov (United States)

    Dagan, R; Prather, S L; Powell, K R; Menegus, M A

    1983-01-01

    Neutralizing antibodies to selected non-polio enteroviruses were found in three lots of human immune serum globulin (ISG) prepared from the sera of persons from different geographic regions. Reciprocal titers to coxsackieviruses B3 and B4 ranged from 400 to greater than or equal to 2000, whereas titers to coxsackievirus A9 and ECHO viruses 5 and 9 ranged from 100 to 400 in all three lots of ISG. The presence of neutralizing antibodies to commonly occurring (coxsackieviruses B1 to B5 and A9 and ECHO viruses 3, 4 and 9) and infrequently encountered (ECHO viruses 5 and 13) serotypes, coupled with the increasing evidence that antibodies are an important factor in preventing illness, support recommending the administration of ISG to those at high risk for serious disease.

  4. Efficacy and safety of rifaximin associated with standard triple therapy (omeprazole, clarithromycin and amoxicillin) for H. pylori eradication: A phase IV pilot clinical trial.

    Science.gov (United States)

    Ramas, Mercedes; Donday, Maria G; McNicholl, Adrian G; Gisbert, Javier P

    2017-12-01

    A progressive decrease in Helicobacter pylori eradication rates has been described over the years, driving the need for new antibiotic treatments. To evaluate the efficacy and safety of the addition of rifaximin (Spiraxin ® ) to standard triple therapy (omeprazole, amoxicillin and clarithromycin) for the eradication of H. pylori. Independent prospective clinical trial (EUDRACT no.: 2013-001080-23). Forty consecutive adult patients were included with H. pylori infection, dyspeptic symptoms and naive to eradication treatment. A full blood test was performed in the first five patients enrolled to evaluate the safety of the treatment. H. pylori eradication was confirmed with the 13 C-urea breath test at least four weeks after the end of treatment with rifaximin 400mg/8h, clarithromycin 500mg/12h, amoxicillin 1g/12h and omeprazole 20mg/12h for 10 days. Forty patients were consecutively enrolled, 53% woman, mean age 44 years. Indication for eradication: 60% non-investigated dyspepsia, 38% functional dyspepsia and 2% gastric ulcer. Four patients did not attend the eradication confirmatory breath test. The eradication rate was 61% (95% CI: 45-77%) for the protocol and 55% (40-70%) for intention-to-treat. About 76% of the patients experienced adverse events (35% diarrhea, 14% nausea and 24% metallic taste), none of which was serious. The blood tests did not show significant alterations. Acceptable H. pylori eradication rates are not achieved with rifaximin associated with standard triple therapy for 10 days. Copyright © 2017 Elsevier España, S.L.U., AEEH y AEG. All rights reserved.

  5. Strategies to eradicate rubella in the English-speaking Caribbean.

    Science.gov (United States)

    Irons, B; Lewis, M J; Dahl-Regis, M; Castillo-Solórzano, C; Carrasco, P A; de Quadros, C A

    2000-10-01

    This report presents the strategies used to eradicate rubella in the Caribbean region and the challenges faced by that effort. Using the surveillance system for measles cases that was instituted in all countries in the Caribbean Community (CARICOM), 12 countries confirmed cases of rubella between 1992 and 1996. Rubella infections occurred in epidemic proportions in 6 countries during that period. On the basis of the rubella prevalence data, rubella-congenital rubella syndrome (CRS) cost-benefit analysis, and cost-effectiveness of the mass campaign, the Council for Human and Social Development of CARICOM resolved, on April 21, 1998, that every effort would be made to eradicate rubella, as well as to prevent the occurrence of new cases of CRS by the end of 2000. Using the Pan American Health Organization's template for measles eradication, CARICOM proposed and implemented the main strategies for rubella and CRS eradication, and rubella mass campaigns were conducted in 18 countries. The target population, which included males and females (aged 20-40 years), was approximately 2.2 million. The major challenges for rubella eradication are attaining high vaccine coverage in the adult population and maintaining an effective surveillance system able to detect rubella activity.

  6. Social media as a platform for health-related public debates and discussions: the Polio vaccine on Facebook.

    Science.gov (United States)

    Orr, Daniela; Baram-Tsabari, Ayelet; Landsman, Keren

    2016-01-01

    Social media can act as an important platform for debating, discussing, and disseminating information about vaccines. Our objectives were to map and describe the roles played by web-based mainstream media and social media as platforms for vaccination-related public debates and discussions during the Polio crisis in Israel in 2013: where and how did the public debate and discuss the issue, and how can these debates and discussions be characterized? Polio-related coverage was collected from May 28 to October 31, 2013, from seven online Hebrew media platforms and the Facebook groups discussing the Polio vaccination were mapped and described. In addition, 2,289 items from the Facebook group "Parents talk about Polio vaccination" were analyzed for socio-demographic and thematic characteristics. The traditional media mainly echoed formal voices from the Ministry of Health. The comments on the Facebook vaccination opposition groups could be divided into four groups: comments with individualistic perceptions, comments that expressed concerns about the safety of the OPV, comments that expressed distrust in the Ministry of Health, and comments denying Polio as a disease. In the Facebook group "Parents talk about the Polio vaccination", an active group with various participants, 321 commentators submitted 2289 comments, with 64 % of the comments written by women. Most (92 %) people involved were parents. The comments were both personal (referring to specific situations) and general in nature (referring to symptoms or wide implications). A few (13 %) of the commentators were physicians (n = 44), who were responsible for 909 (40 %) of the items in the sample. Half the doctors and 6 % of the non-doctors wrote over 10 items each. This Facebook group formed a unique platform where unmediated debates and discussions between the public and medical experts took place. The comments on the social media, as well as the socio-demographic profiles of the commentators, suggest

  7. ‘Do not eat those apples; they’ve been on the ground!’: polio epidemics and preventive measures, Sweden 1880s-1940s

    Directory of Open Access Journals (Sweden)

    Axelsson, Per

    2009-06-01

    Full Text Available This article will address how Swedish scientists, physicians and public health officers tried to combat the polio epidemics in the pre-vaccine era. It shows that once polio was considered as an epidemic disease the preventive measures used were based on the hindrance of other infectious diseases. It also illustrates how epidemiological and laboratory studies to some degree affected the thoughts of how polio should be prevented, and that Swedish ideas and experiences differed from those put forward in the USA.

    Este artículo trata sobre cómo los científicos, médicos y funcionarios de la sanidad pública de Suecia intentaron combatir la epidemia de la polio en la era anterior a la vacuna y expone que en cuanto la polio fue considerada como una epidemia, las medidas preventivas que se aplicaron se basaban en las de otras enfermedades contagiosas. También ilustra en qué medida los estudios epidemiológicos y los análisis de laboratorio influyeron en la manera de prevenir la polio y también demuestra que las opiniones y experiencias en Suecia eran diferentes a las de los Estados Unidos.

  8. The value of EUS in predicting the response of gastric mucosa-associated lymphoid tissue lymphoma to Helicobacter pylori eradication.

    Science.gov (United States)

    El-Zahabi, Lara M N; Jamali, Faek R; El-Hajj, Ihab I; Naja, Mohammed; Salem, Ziad; Shamseddine, Ali; El-Saghir, Nagi S; Zaatari, Ghazi; Geara, Fady; Soweid, Assaad M

    2007-01-01

    Gastric mucosa-associated lymphoid tissue (MALT) lymphoma is associated with Helicobacter pylori infection, and regression of the tumor has been described after its eradication. To determine the value of EUS, in addition to other clinical/endoscopic features, in predicting the response of low-grade MALT lymphoma to H pylori eradication. A retrospective, single-center study. Twenty-two patients with primary gastric MALT lymphoma were identified through a retrospective review of charts of patients seen at the American University of Beirut Medical Center. Only 19 patients with histopathologically confirmed gastric MALT lymphoma and H pylori infection who had EUS staging were included in the study. Regression of the gastric MALT lymphoma as determined by follow-up endoscopy and mucosal biopsies. Patients with disease restricted to the gastric mucosa had a significantly higher rate of complete remission after H pylori eradication compared with patients who had disease infiltrating into the gastric submucosa (77.8% vs 12.5%, P value .007). There was no statistical difference in terms of the mean follow-up time to achieve such response (P value .212). Age, sex, location of the tumor within the stomach, and endoscopic appearance did not correlate with the probability of complete remission of the MALT lymphoma. The limitations include a retrospective design and a relatively small sample population. EUS determination of the invasion depth of gastric MALT lymphoma helps predict a complete response to H pylori eradication.

  9. Low efficacy of levofloxacin-doxycycline-based third-line triple therapy for Helicobacter pylori eradication in Italy.

    Science.gov (United States)

    Paoluzi, Omero Alessandro; Del Vecchio Blanco, Giovanna; Visconti, Emanuela; Coppola, Manuela; Fontana, Carla; Favaro, Marco; Pallone, Francesco

    2015-06-07

    To evaluate a levofloxacin-doxycycline-based triple therapy with or without a susceptibility culture test in non-responders to Helicobacter pylori (H. pylori) eradication. A total of 142 (99 women, 43 men; mean 53.0 ± 12.7 years) non-responders to more than two H. pylori eradication therapies underwent susceptibility culture tests or were treated with a seven-day triple therapy consisting of esomeprazole, 20 mg b.i.d., levofloxacin, 500 mg b.i.d., and doxycycline, 100 mg b.i.d., randomly associated with (n = 71) or without (n = 71) Lactobacillus casei DG. H. pylori status was checked in all patients at enrollment and at least 8 wk after the end of therapy. Compliance and tolerability of regimens were also assessed. H. pylori eradication was achieved in levofloxacin was 18% and multiple resistance was 31%. Therapy was well tolerated, and side effects were generally mild, with only one patient experiencing severe effects. Third-line levofloxacin-doxycycline triple therapy had a low H. pylori eradication efficacy, though the success and tolerability of this treatment may be enhanced with probiotics.

  10. Prevention of Gastric Cancer: Eradication of Helicobacter Pylori and Beyond

    Directory of Open Access Journals (Sweden)

    Tetsuya Tsukamoto

    2017-08-01

    Full Text Available Although its prevalence is declining, gastric cancer remains a significant public health issue. The bacterium Helicobacter pylori is known to colonize the human stomach and induce chronic atrophic gastritis, intestinal metaplasia, and gastric cancer. Results using a Mongolian gerbil model revealed that H. pylori infection increased the incidence of carcinogen-induced adenocarcinoma, whereas curative treatment of H. pylori significantly lowered cancer incidence. Furthermore, some epidemiological studies have shown that eradication of H. pylori reduces the development of metachronous cancer in humans. However, other reports have warned that human cases of atrophic metaplastic gastritis are already at risk for gastric cancer development, even after eradication of these bacteria. In this article, we discuss the effectiveness of H. pylori eradication and the morphological changes that occur in gastric dysplasia/cancer lesions. We further assess the control of gastric cancer using various chemopreventive agents.

  11. Helicobacter pylori eradication - an update on the latest therapies.

    Science.gov (United States)

    Yaxley, Julian; Chakravarty, Bhaskar

    2014-05-01

    The eradication of Helicobacter pylori (H. pylori) can be challenging in certain circumstances. There is no current first-line therapy that is curative in all patients. This article summaries the role of emerging novel therapies in the treatment of 
H. pylori. Known as sequential therapy and salvage therapy, these new therapeutic strategies are thought to produce eradication rates superior to currently recommended first-line therapies. This article outlines the growing body of evidence supporting their efficacy. Sequential therapy and salvage therapy have emerged recently as alternative regimens for the eradication of H. pylori. Although current guidelines continue to recommend established therapies for first-line management of H. pylori, general practitioners should be aware of these new strategies such that these options could be applied when traditional therapy fails.

  12. Prevention of Gastric Cancer: Eradication of Helicobacter pylori and Beyond

    Science.gov (United States)

    Tsukamoto, Tetsuya; Nakagawa, Mitsuru; Kiriyama, Yuka; Toyoda, Takeshi; Cao, Xueyuan

    2017-01-01

    Although its prevalence is declining, gastric cancer remains a significant public health issue. The bacterium Helicobacter pylori is known to colonize the human stomach and induce chronic atrophic gastritis, intestinal metaplasia, and gastric cancer. Results using a Mongolian gerbil model revealed that H. pylori infection increased the incidence of carcinogen-induced adenocarcinoma, whereas curative treatment of H. pylori significantly lowered cancer incidence. Furthermore, some epidemiological studies have shown that eradication of H. pylori reduces the development of metachronous cancer in humans. However, other reports have warned that human cases of atrophic metaplastic gastritis are already at risk for gastric cancer development, even after eradication of these bacteria. In this article, we discuss the effectiveness of H. pylori eradication and the morphological changes that occur in gastric dysplasia/cancer lesions. We further assess the control of gastric cancer using various chemopreventive agents. PMID:28771198

  13. Eradication of gastric Helicobacter pylori ameliorates halitosis and tongue coating.

    Science.gov (United States)

    Zaric, Svetislav; Bojic, Bozidar; Popovic, Branka; Milasin, Jelena

    2015-03-01

    The influence of gastric Helicobacter pylori infection on the development of oral pathoses remains unclear. The aim of this study is to examine the influence of gastric H. pylori infection on occurrence of halitosis and coated tongue. Ninety-eight patients with dyspepsia were included in the study and their salivary samples and gastric biopsies were analyzed for the presence of H. pylori by Nested-PCR. Halitosis and coated tongue were assessed at the initial examination and 3 months after systemic eradication therapy against H. pylori. Gastric biopsies of 66 patients were positive for H. pylori. Only one saliva sample was H. pylori positive. At initial examination, halitosis was observed in 20 patients (30.3%) out of 66 who had gastric H. pylori infection and in only 3 patients (9.4%) out of 32 without H. pylori infection (p = 0.0236). Coated tongue was diagnosed in 18 (27.2%) patients with the infection compared to only 2 (6.25%) patients negative for gastric H. pylori (p = 0.0164). Patients with gastric infection were treated with the triple eradication therapy (Amoxicillin, Clarythromycin, Pantoprazol) and their gastric biopsies and oral status were examined 3 months later. Halitosis was significantly more prevalent in the group of patients with persistent H. pylori infection (42.1%) compared to only 6.4% of patients in the group where infection was successfully eradicated (p = 0.0012). Coated tongue was diagnosed in 47.4% of patients where H. pylori was still present after eradication therapy and in only 6.4% where eradication succeeded (p = 0.0003). Our findings suggest that eradication of gastric H. pylori significantly alleviates halitosis and coated tongue, the two oral conditions that may be considered as extragastric manifestations of this common chronic bacterial infection.

  14. Eradication of viral haemorrhagic septicaemia in Danish aquaculture

    DEFF Research Database (Denmark)

    Olsen, N. J.; Skall, Helle Frank; Jensen, B. B.

    2013-01-01

    was significantly reduced while the curve flattened the last 20 years. It was only after a large and costly coordinated action in 2009-2013 including all affected areas that the country managed to free itself totally from VHS. Molecular tracing of the origin of VHSV isolates revealed that despite strict trade...... resources have been used to control and eradicate the disease. The control program included strict biosecurity and preventative measures, trade regulations, zoning and intensive inspections and laboratory testing. During the first decades of control and eradication programs the number of infected farms...

  15. Progress toward global eradication of dracunculiasis, January-June 2003.

    Science.gov (United States)

    2003-09-19

    In 1986, when the World Health Assembly adopted a resolution calling for the eradication of dracunculiasis (Guinea worm disease), an estimated 3.5 million persons in 20 countries had the disease, and approximately 120 million persons were at risk for infection. By the end of 2002, annual incidence of the disease had been reduced >98%; seven countries in which dracunculiasis formerly was endemic (Cameroon, Chad, India, Kenya, Pakistan, Senegal, and Yemen) were free of the disease, and four countries (Central African Republic, Ethiopia, Mauritania, and Uganda) reported war in Sudan are required for the eradication of dracunculiasis.

  16. The Rakiura Titi Islands Restoration Project: community action to eradicate Rattus rattus and Rattus exulans for ecological restoration and cultural wellbeing

    Science.gov (United States)

    McClelland, P.J; Coote,; Trow,; Hutchins,; Nevins, HannahRose M.; Adams, Josh; Newman, J.; Moller, H.; Veitch, C.R.; Clout, Mike N.; Towns, D. R.

    2011-01-01

    In 2003, a non-profit group, Ka Mate Nga Kiore, was set up to oversee the restoration of four Maori-owned islands off the south coast of Stewart Island, New Zealand. The first step in the restoration was to eradicate ship rats (Rattus rattus) from three islands and Pacific rats (R. exulans) from another. The eradication was funded by the Command Oil Spill Trustee Council which managed the mitigation money from an oil spill off the Californian coast in 1998. The funding was coordinated via Oikonos Ecosystem Knowledge, a non-profit USA group primarily involved in seabird research and restoration. The project was primarily to benefit sooty shearwater (Puffinus griseus) and to sustain a culturally important customary harvest of their chicks by Rakiura Maori. However, like all island eradications, a wide range of other species also benefited from the removal of rats. The New Zealand Department of Conservation provided technical advice and assistance for the planning and implementation of the eradication programme. This paper describes how, with appropriate funding, community and technical support, rodent eradications can be achieved on private islands. In this case, a range of institutions and individuals joined to achieve a common goal that highlighted a significant international conservation action. We urge that more international and local-community-led restoration projects be initiated in the future.

  17. Assessing the impact of the Lebanese National Polio Immunization Campaign using a population-based computational model.

    Science.gov (United States)

    Alawieh, Ali; Sabra, Zahraa; Langley, E Farris; Bizri, Abdul Rahman; Hamadeh, Randa; Zaraket, Fadi A

    2017-11-25

    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. 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. 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. 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.

  18. Surveillance and laboratory detection for non-polio enteroviruses in the European Union/European Economic Area, 2016

    Science.gov (United States)

    Harvala, Heli; Jasir, Aftab; Penttinen, Pasi; Pastore Celentano, Lucia; Greco, Donato; Broberg, Eeva

    2017-01-01

    Enteroviruses (EVs) cause severe outbreaks of respiratory and neurological disease as illustrated by EV-D68 and EV-A71 outbreaks, respectively. We have mapped European laboratory capacity for identification and characterisation of non-polio EVs to improve preparedness to respond to (re)-emerging EVs linked to severe disease. An online questionnaire on non-polio EV surveillance and laboratory detection was submitted to all 30 European Union (EU)/European Economic Area (EEA) countries. Twenty-nine countries responded; 26 conducted laboratory-based non-polio EV surveillance, and 24 included neurological infections in their surveillance. Eleven countries have established specific surveillance for EV-D68 via sentinel influenza surveillance (n = 7), typing EV-positive respiratory samples (n = 10) and/or acute flaccid paralysis surveillance (n = 5). Of 26 countries performing non-polio EV characterisation/typing, 10 further characterised culture-positive EV isolates, whereas the remainder typed PCR-positive but culture-negative samples. Although 19 countries have introduced sequence-based EV typing, seven still rely entirely on virus isolation. Based on 2015 data, six countries typed over 300 specimens mostly by sequencing, whereas 11 countries characterised under 50 EV-positive samples. EV surveillance activity varied between EU/EEA countries, and did not always specifically target patients with neurological and/or respiratory infections. Introduction of sequence-based typing methods is needed throughout the EU/EEA to enhance laboratory capacity for the detection of EVs. PMID:29162204

  19. Land Right Registration and Property Development for Poverty Eradication and Slum Clearance in Nigeria

    Directory of Open Access Journals (Sweden)

    Olusegun Olaopin Olanrele

    2014-12-01

    Full Text Available The focus of this paper is to unfold the implication of non-registration of land rights on the achievement of the poverty eradication and slum clearance targets of the United Nation's Millennium development goals in Nigeria. The paper is based on empirical survey of land holding in the outskirts of Ibadan city and the rural areas in Oyo State, of Nigeria. A case study research method was adopted and data were collected with the use of questionnaire survey and secondary data was also extracted from the state land registry office in respect of total cost of documentation of subsequent transaction on titled/registered land. The study found that ignorance and government insensitivity in addition to high cost and delay are among major constraints to land titling. Only a few opportune people can afford the land right formalization process and they do so when it becomes necessary. These unequivocally militate against the achievement of the poverty and slum eradication goals of the UN. The paper suggested simplification of the titling procedure, cost reduction, computerization and public enlightenment on the benefits of registered land right to facilitate efficient land right registration towards adequate housing for the citizenry.

  20. The effect of probiotics supplementation on Helicobacter pylori eradication rates and side effects during eradication therapy: a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Yini Dang

    Full Text Available BACKGROUND: Previous meta-analyses reported that probiotics improve the effectiveness of Helicobacter pylori (H. pylori eradication during antibiotic therapy, while results regarding a possible reduction of side effects remained inconclusive. Moreover, the effectiveness of different strains of probiotics has not been studied so far. It is further conceivable that probiotics will produce additional effects only if antibiotics are relatively ineffective. METHODS: This meta-analysis includes eligible randomized controlled trials examining effects of probiotics supplementation on eradication rates (ER and side effects, published up to May 2014. Sub-group analysis was performed to compare different probiotic strains and antibiotic therapies with different effectiveness in controls (ER 80%. Publication bias was assessed with funnel plots and Harbord's test. The quality of the trials was assessed with the Cochrane risk of bias tool. RESULTS: Thirty-three RCTs involving a total of 4459 patients met the inclusion criteria in case of eradication rates of which 20 assessed total side effects in addition. Overall, the pooled eradication rate in probiotics supplementation groups was significantly higher than in controls (ITT analysis: RR 1.122, 95% CI 1.086-1.159, PP analysis: RR 1.114, 95% CI 1.070-1.159. Sub group-analysis could, however, confirm this finding only for four individual strains (Lactobacillus acidophilus, Lactobacillus casei DN-114001, Lactobacillus gasseri, and Bifidobacterium infantis 2036 and for relatively ineffective antibiotic therapies. There was a significant difference between groups in the overall incidence of side effects (RR 0.735, 95% CI 0.598-0.902. This result was, however, only confirmed for non-blinded trials. CONCLUSIONS: The pooled data suggest that supplementation with specific strains of probiotics compared with eradication therapy may be considered an option for increasing eradication rates, particularly when antibiotic

  1. The "New Public" and the "Good Ol' Press": Evaluating Online News Sources During the 2013 Polio Outbreak in Israel.

    Science.gov (United States)

    Gesser-Edelsburg, Anat; Walter, Nathan; Shir-Raz, Yaffa

    2017-02-01

    The current research focuses on the 2013 polio outbreak in Israel as a case study to analyze the sources of information used in new media platforms, examining whether the new media have changed the ways in which we communicate about health issues. Specifically, we tracked and coded polio-related references on Hebrew news websites, blogs, forums, and Facebook posts. Overall, 24,388 polio-related references constituted our sampling frame. The findings suggest that there is a moderate-level correlation between the platform and the type of sources chosen by users. Beyond the differences between various platforms, we found that online information platforms rely not only on popular or pseudoscientific sources, but also on high-quality information. In fact, the analysis indicates that online news websites, forums, blogs, and Facebook posts create a unique blend of information, including scientific literature, medical professionals, and government representatives, as well as pseudoscientific research. These findings suggest a more optimistic view of the Internet as a source for health-related information in times of crises. Although the fact that members of the public are exposed to scientific sources does not indicate to what degree this affects their actual decision making. Exposure to a wider variety of sources may enhance health literacy, resulting in a better understanding of information needed to make informed decisions.

  2. The global switch from trivalent oral polio vaccine (tOPV) to bivalent oral polio vaccine (bOPV): facts, experiences and lessons learned from the south-south zone; Nigeria, April 2016.

    Science.gov (United States)

    Bassey, Bassey Enya; Braka, Fiona; Vaz, Rui Gama; Komakech, William; Maleghemi, Sylvester Toritseju; Koko, Richard; Igbu, Thompson; Ireye, Faith; Agwai, Sylvester; Akpan, Godwin Ubong; Tegegne, Sisay Gashu; Mohammed, Abdul-Aziz Garba; Okocha-Ejeko, Angela

    2018-01-27

    The globally synchronized switch from trivalent Oral Polio Vaccine (tOPV) to bivalent Oral Polio Vaccine (bOPV) took place in Nigeria on April 18th 2016. The country is divided into six geopolitical zones. This study reports the experiences and lessons learned from the switch process in the six states that make up Nigeria's south-south geopolitical zone. This was a descriptive retrospective review of Nigeria's switch plan and structures used for implementing the tOPV-bOPV switch in the south-south zone. Nigeria's National Polio Emergency Operation Centre (NPEOC) protocols, global guidelines and reports from switch supervisors during the switch were used to provide background information for this study. Quantitative data were derived from reviewing switch monitoring and validation documents as submitted to the NPEOC RESULTS: The switch process took place in all 3078 Health Facilities (HFs) and 123 Local Government Areas (LGAs) that make up the six states in the zone. A total of $139,430 was used for this process. The 'healthcare personnel' component received the highest budgetary allocation (59%) followed by the 'logistics' component (18%). Akwa Ibom state was allocated the highest number of healthcare personnel and hence received the most budgetary allocation compared to the six states (total healthcare personnel = 458, total budgetary allocation = $17,428). Validation of the switch process revealed that eight HFs in Bayelsa, Cross-River, Edo and Rivers states still possessed tOPV in cold-chain while six HFs in Cross-River and Rivers states had tOPV out of cold-chain but without the 'do not use' sticker. Akwa-Ibom was the only state in the zone to have bOPV and Inactivated Polio Vaccine (IPV) available in all its HFs monitored. The Nigerian tOPV-bOPV switch was successful. For future Oral Polio Vaccine (OPV) withdrawals, implementation of the switch plan would be more feasible with an earlier dissemination of funds from global donor organizations, which

  3. Eradication of common pathogens at days 2, 3 and 4 of moxifloxacin therapy in patients with acute bacterial sinusitis

    Directory of Open Access Journals (Sweden)

    Benson Alice

    2006-04-01

    Full Text Available Abstract Background Acute bacterial sinusitis (ABS is a common infection in clinical practice. Data on time to bacteriologic eradication after antimicrobial therapy are lacking for most agents, but are necessary in order to optimize therapy. This was a prospective, single-arm, open-label, multicenter study to determine the time to bacteriologic eradication in ABS patients (maxillary sinusitis treated with moxifloxacin. Methods Adult patients with radiologically and clinically confirmed ABS received once-daily moxifloxacin 400 mg for 10 days. Middle meatus secretion sampling was performed using nasal endoscopy pre-therapy, and repeated on 3 consecutive days during treatment. Target enrollment was 30 bacteriologically evaluable patients (pre-therapy culture positive for Streptococcus pneumoniae, Haemophilus influenzae or Moraxella catarrhalis and evaluable cultures for at least Day 2 and Day 3 during therapy visits, including at least 10 each with S. pneumoniae or H. influenzae. Results Of 192 patients enrolled, 42 were bacteriologically evaluable, with 48 pathogens isolated. Moxifloxacin was started on Day 1. Baseline bacteria were eradicated in 35/42 (83.3% patients by day 2, 42/42 (100% patients by day 3, and 41/42 (97.6% patients by day 4. In terms of individual pathogens, 12/18 S. pneumoniae, 22/23 H. influenzae and 7/7 M. catarrhalis were eradicated by day 2 (total 41/48; 85.4%, and 18/18 S. pneumoniae and 23/23 H. influenzae were eradicated by day 3. On Day 4, S. pneumoniae was isolated from a patient who had negative cultures on Days 2 and 3. Thus, the Day 4 eradication rate was 47/48 (97.9%. Clinical success was achieved in 36/38 (94.7% patients at the test of cure visit. Conclusion In patients with ABS (maxillary sinusitis, moxifloxacin 400 mg once daily for 10 days resulted in eradication of baseline bacteria in 83.3% of patients by Day 2, 100% by Day 3 and 97.6% by Day 4.

  4. Smoking epidemic eradication in a eco-epidemiological dynamical model

    NARCIS (Netherlands)

    Voorn, van G.A.K.; Kooi, B.W.

    2013-01-01

    Smoking is perceived as a major epidemic with regard to mortality. Modelling is a major tool used to obtain insight in the dynamics and possible solutions to decrease or even eradicate this epidemic. Most models on smoking consider the epidemiological context explicitly, in which smoking is regarded

  5. The efficacy of sequential therapy in eradication of Helicobacter ...

    African Journals Online (AJOL)

    And 40 patients received standard triple therapy for 2 weeks, 40 patients received bismuth containing quadruple therapy for 2 weeks, 40 patients received 5 + 5 clarithromycin-based sequential therapy, and 40 patients received 7 + 7 clarithromycin-based sequential therapy. H. pylori eradication was assessed by C 14 urea ...

  6. Short report: evaluation of Helicobacter pylori eradication with bismuth sucralfate

    NARCIS (Netherlands)

    Reijers, M. H.; Noach, L. A.; Tytgat, G. N.

    1994-01-01

    In a pilot study we have evaluated the clinical efficacy of bismuth sucralfate to eradicate H. pylori. Ten consecutive patients with chronic dyspepsia and H. pylori associated gastritis were treated with bismuth sucralfate (220 mg bismuth per tablet, 4 tablets per day for 4 weeks). If a 14C urea

  7. Therapeutic options after failed Helicobacter pylori eradication therapy

    NARCIS (Netherlands)

    van der Hulst, R. W.; Weel, J. F.; van der Ende, A.; ten Kate, F. J.; Dankert, J.; Tytgat, G. N.

    1996-01-01

    OBJECTIVES: Many of the currently used Helicobacter pylori eradication regimens fail to cure 5-20% of the patients. Those patients will remain at risk of developing a potentially fatal complication of peptic ulcer disease. Therefore, a new attempt to cure H. pylori infection after initial failure of

  8. Dracunculiasis In Relation To Eradication Activities In Some Rural ...

    African Journals Online (AJOL)

    An epidemiological assessment of the guinea worm infection in three villages in Oyo State, Nigeria was carried out between November 1993 and December 1996 at the peak of eradication activities in the country. A total of 279 people were interviewed and examined and the overall incidence was 14.0%. There was no ...

  9. Dracunculiasis eradication - Finishing the job before surprises arise

    NARCIS (Netherlands)

    Visser, Benjamin Jelle

    2012-01-01

    Dracunculiasis (Guinea worm disease) is a preventable waterborne parasitic disease that affects the poorest people living in remote mad areas in sub-Saharan African countries, who do not have access to safe drinking water. The Guinea Worm Eradication Program, a 25-year old campaign to rid the world

  10. Eradication of Transfusion-Induced Malaria by In vitro Processing ...

    African Journals Online (AJOL)

    The determined lethal dose of chloroquine was safe to all constituents of the stored blood. CONCLUSION: For eradication of transfusion induced malaria by in vitro processing of donors blood, chloroquine is effective and safe drug. We recommend application of the optimal dose of chloroquine (626.1g/L) to the components ...

  11. Asian longhorned beetle cooperative eradication program: program accomplishments 2001

    Science.gov (United States)

    Christine Markham

    2003-01-01

    APHIS spent approximately $3 million to continue ALB eradication activities in New York and Illinois in FY 2001. In New York 6,615 trees were removed, over 4,500 trees replanted, and approximately 121 square miles were under quarantine.

  12. Eradicating Female Genital Mutilation: Case Series Evaluating the ...

    African Journals Online (AJOL)

    Female genital mutilation (FGM) remains a source of abuse to females despite efforts to eradicate it. We present a cases series of two clitoral cysts and one each of post-mutilation haemorrhage, labial adhesion and excess crural flap. One of the victims intended to circumcise her daughters for cultural reasons but rescinded ...

  13. Visualization of temporal aspects of tsetse fly eradication in ...

    African Journals Online (AJOL)

    Further information on areas where different techniques were applied on different years is interactively visualized. Visualization of infestation changes in time was also provided by animation representation. Visualization of eradication operations were disseminated on the web. From the available data, it was possible to ...

  14. Poverty eradication project on indigenous agro food processing in ...

    African Journals Online (AJOL)

    Poverty eradication project on indigenous agro food processing in Molemole local municipality of Limpopo province, South Africa. ... The participants have high commitment for self enhancement to an extent that they get orders from government, private sector and local community members for their products. The project's ...

  15. Eradication of campus cultism: a giant stride toward restoration of ...

    African Journals Online (AJOL)

    One of the main vices making living on the campuses of tertiary institutions in Nigeria a nightmare is the menace of cultism. Like a hydra-headed problem that it is, attempts to eradicate cultism in institutions of higher learning have often been frustrated as the problem gets compounded by the day. This has prompted worries, ...

  16. Scenarios for eradicating foot-and-mouth disease

    NARCIS (Netherlands)

    Bos, E.J.; Leeuwen, van M.G.A.; Vlieger, de J.J.

    2001-01-01

    Research project commissioned by the Ministery of Agriculture, Nature Management and Fisheries. With the help of desk-research and input-output analysis quantitative information is assembled about the differences in cost for agribusiness and tourism of two eradication scenarios for foot-and-mouth

  17. The role of LP gas in eradicating energy poverty

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, Michael; Behuria, Sarthak

    2010-09-15

    LP Gas is an ideal solution for dealing with energy poverty. Clean burning, low carbon, extremely efficient, requiring minimal infrastructure or R and D investment and with plentiful long term global supply, LP Gas can be quickly introduced to play an important role in eradicating energy poverty and steering both industrialised and developing countries onto more sustainable energy development paths.

  18. 59 Poverty Eradication and Sustainability of Healthful Living in Nigeria

    African Journals Online (AJOL)

    User

    2010-10-17

    Oct 17, 2010 ... health and wide spread of social economic gap between families. Key words: Poverty, Eradication, Sustainability, Healthful Living, Global. Spread .... rich, water and sanitation related diseases are a major cause of ill health ..... health care education, public utilities or transportation are privatized, and the.

  19. Aspect of Commuting Behavior and Its Implication for Eradicating ...

    African Journals Online (AJOL)

    Illiteracy is a global problem, Nigeria is not an exception. There are quite sizeable numbers of Nigerians that can't read and write and compute basic arithmetic. Successive governments have invested heavily in an effort to eradicate this disease. They have established structures responsible for working day in day out to ...

  20. An Assessment of Poverty Eradication Programme (NAPEP in Nigeria

    Directory of Open Access Journals (Sweden)

    Adam Adem ANYEBE

    2015-06-01

    Full Text Available Poverty situation in Nigeria has become so serious that in 2013 there were as many as 112 million or 70.0% of the country’s population was living below poverty line. It has realized that poverty anywhere is a threat to peace, security and prosperity everywhere hence the conscious efforts by successive administrations in Nigeria to eradicate all forms of extreme poverty and hunger in a country. In spite of these efforts to eradicate absolute poverty in the country, poverty incidence has been on the rise. This study, therefore, attempted to assess NAPEP as a programme to eradicate extreme poverty in the country. Personal interviews and documents were employed in data collection. The data were analyzed using tables, simple percentages and spearman rank correlation. The study showed among others, that NAPEP as a programme targeted at eradicating extreme poverty has not been effective leading to a mixed bag of limited success and continuing challenges. It was therefore, recommended that the programme should be re-examined and possibly re-designed for effective performance instead of scrapping it.

  1. Probiotics as an adjuvant treatment in Helicobacter pylori eradication therapy.

    Science.gov (United States)

    Zhu, Xin Yan; Liu, Fei

    2017-04-01

    Over 80% of individuals infected with Helicobacter pylori (H. pylori) are asymptomatic. Increased resistance to antibiotics and decreased compliance to the therapeutic regimens have led to the failure of eradication therapy. Probiotics, with direct and indirect inhibitory effects on H. pylori in both animal models and clinical trials, have recently been used as a supplementary treatment in H. pylori eradication therapy. Probiotics have been considered useful because of the improvements in H. pylori eradication rates and therapy-related side effects although treatment outcomes using probiotics are controversial due to the heterogeneity of species, strains, doses and therapeutic duration of probiotics. Thus, despite the positive role of probiotics, several factors need to be further considered during their applications. Moreover, adverse events of probiotic use need to be noted. Further investigations into the safety of adjuvant probiotics to H. pylori eradication therapy are required. © 2017 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  2. When to declare successful eradication of an invasive predator?

    NARCIS (Netherlands)

    Rout, T.M.; Kirkwood, R.J.; Sutherland, D.R.; Murphy, S.; McCarthy, M.

    2014-01-01

    Imperfect detection methods make it difficult to tell whether an invasive species has been successfully eradicated. However, management cannot continue indefinitely when individuals are no longer detected – at some point, efforts must be reduced or ceased entirely. The risks of mistakenly inferring

  3. Effect of oral N-acetyl cysteine on eradication of Helicobacter pylori in patients with dyspepsia.

    Science.gov (United States)

    Karbasi, A; Hossein Hosseini, S; Shohrati, M; Amini, M; Najafian, B

    2013-03-01

    Using mucolytic agents that decrease viscosity of the gastric mucous and therefore, increase the permeability of antibiotics through gastric membrane has been offered as an additive treatment to achieve a higher rate of eradication of Helicobacter pylori (H. Pylori) infection. The aim of this study was to determine the efficacy of oral N-acetyl cysteine (NAC) on eradication of H. pylori infections in patients suffering from dyspepsia. In this randomized double-blinded clinical trial, 60 H. pylori positive patients who were suffering from dyspepsia were included. They were divided into two groups. Both groups received three-drug regimen including pantoprazole 40 mg BD, ciprofloxacin 500 mg BD and bismuth subcitrate 120 mg two tablets BD. Experimental group (30 cases) received 600 mg of NAC besides three-drug regimen. Control group received placebo. The results of therapy were tested by 14C-UBT and were compared with each other two months after the first visit. H. pylori infection was eradicated in 21 (70%) and 17 (60.7%) patients in experimental and control groups, respectively (P=0.526). Regarding clinical and endoscopic variables, no significant difference was observed between the two groups except for erosive gastritis (0.041) and erosive esophagitis (0.031). Our findings offer that NAC has an additive effect on H. pylori triple therapy with pantoprazole, ciprofloxacin and bismuth subcitrate. Although NAC does not have any known activity against H. pylori, it can reduce the thickness of the mucus layer and increase the permeability of antibiotics at the site of infection. To evaluate this effect, more studies with larger sample size should be performed.

  4. [Omeprazole/amoxicillin: improved eradication of Helicobacter pylori in smokers because of N-acetylcysteine].

    Science.gov (United States)

    Zala, G; Flury, R; Wüst, J; Meyenberger, C; Ammann, R; Wirth, H P

    1994-08-09

    Colonization of Helicobacter pylori (HP) beneath the protective film of gastric mucus enables the organism to survive in the hostile environment of the gastric mucosa. N-acetylcysteine (NAC), a sulfhydryl compound with potent mucolytic activity, induces a reduction of gastric barrier mucus thickness of about 75% and reduces mucus viscoelasticity. We therefore tested the hypothesis whether better eradication results could be achieved by addition of NAC to omeprazole/amoxicillin (OME/AMOX). 34 HP positive outpatients with endoscopically documented recurrent duodenal ulcer were included in an ongoing, prospective, randomized trial. Exclusion criteria were: alcoholism, previous gastric surgery, or intake of antibiotics, OME, bismuth salts, corticosteroids or NSAIDs within 4 weeks before study entry. Patients currently smoking > 10 cigarettes/day were classified as smokers. HP infection was confirmed by histology (3 biopsy specimens from gastric antrum and 2 from gastric body; H&E, Giemsa) and at least positive rapid urease test or culture. All 34 patients underwent ulcer therapy with OME (20 mg per day) for 20 days (d 1-20). Group A: in 17 patients (5 females, 12 males, mean age 46 [29-74] years; 8 smokers, 9 nonsmokers) the subsequent eradication therapy, consisting of oral OME (40 mg bid) and AMOX solute (750 mg tid) for 10 days, was combined with NAC solute (2 x 600 mg bid (d 21-30). Group B: 17 patients (2 females, 15 males, mean age 39 [19-70] years; 11 smokers, 6 nonsmokers) underwent eradication therapy without NAC (d 21-30). Control endoscopy was done after a minimal interval of 30 days from the end of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

  5. HIV eradication: virological chances and clinical perspectives

    Directory of Open Access Journals (Sweden)

    Perno C

    2012-11-01

    infected, but viral replicative cycles are absent, and progression of the disease is interrupted. This latter clinical approach may be suitable, and this is where clinical research is directing its efforts. If achievable, infected persons should cope with the virus and keep it under control for decades, without support of chronic antiviral therapy. In conclusion, the proper knowledge of the biological characteristics of HIV helps in selecting the best strategies aimed at obtaining the maximum achievable clinical result.

  6. Reliability of contractile properties of the knee extensor muscles in individuals with post-polio syndrome.

    Directory of Open Access Journals (Sweden)

    Eric L Voorn

    Full Text Available To assess the reliability of contractile properties of the knee extensor muscles in 23 individuals with post-polio syndrome (PPS and 18 age-matched healthy individuals.Contractile properties of the knee extensors were assessed from repeated electrically evoked contractions on 2 separate days, with the use of a fixed dynamometer. Reliability was determined for fatigue resistance, rate of torque development (MRTD, and early and late relaxation time (RT50 and RT25, using the intraclass correlation coefficient (ICC and standard error of measurement (SEM, expressed as % of the mean.In both groups, reliability for fatigue resistance was good, with high ICCs (>0.90 and small SEM values (PPS: 7.1%, healthy individuals: 7.0%. Reliability for contractile speed indices varied, with the best values found for RT50 (ICCs>0.82, SEM values <2.8%. We found no systematic differences between test and retest occasions, except for RT50 in healthy subjects (p = 0.016.In PPS and healthy individuals, the reliability of fatigue resistance, as obtained from electrically evoked contractions is high. The reliability of contractile speed is only moderate, except for RT50 in PPS, demonstrating high reliability.This was the first study to examine the reliability of electrically evoked contractile properties in individuals with PPS. Our results demonstrate its potential to study mechanisms underlying muscle fatigue in PPS and to evaluate changes in contractile properties over time in response to interventions or from natural course.

  7. Non-polio enteroviruses from acute flaccid paralysis surveillance in Shandong Province, China, 1988-2013.

    Science.gov (United States)

    Tao, Zexin; Wang, Haiyan; Liu, Yao; Li, Yan; Jiang, Ping; Liu, Guifang; Lin, Xiaojuan; Li, Manshi; Wang, Suting; Ji, Feng; Feng, Lei; Xiong, Ping; Zhang, Yan; Feng, Yi; Fan, Qingying; Yang, He; Yang, Jing; Chen, Peng; Li, Wenfeng; Xu, Aiqiang; Song, Lizhi

    2014-08-22

    Enteroviruses (EVs) are important human pathogens associated with various clinical syndromes. This study represents an overview of non-polio enteroviruses (NPEVs) isolated from acute flaccid paralysis (AFP) surveillance in Shandong Province, China from 1988 to 2013. Altogether 792 and 170 NPEV isolates were isolated from stool specimens of 9263 AFP cases and 1059 contacts, respectively. Complete VP1 sequencing and typing on all 962 isolates revealed 53 NPEV types in which echovirus (E) 6 (7.6%), E14 (7.6%), E11 (7.4%), coxsackievirus (CV) B3 (7.4%), E25 (5.6%), CVB5 (4.9%), E7 (4.5%) and EV-A71 (4.4%) were the eight most commonly reported serotypes. Distinct summer-fall seasonality was observed, with June-October accounting for 79.3% of isolation from AFP cases with known month of specimen collection. Increase of isolation of EV-A71 and CVA--the predominant pathogens for the hand, foot, and mouth disease--was observed in recent years. Sequence analysis on VP1 coding region of EV-A71 and E6 suggested Shandong strains had great genetic divergence with isolates from other countries. The results described in this study provide valuable information on the circulation and emergence of different EV types in the context of limited EV surveillance in China.

  8. Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Shandong Province, China, 1988–2013

    Science.gov (United States)

    Tao, Zexin; Wang, Haiyan; Liu, Yao; Li, Yan; Jiang, Ping; Liu, Guifang; Lin, Xiaojuan; Li, Manshi; Wang, Suting; Ji, Feng; Feng, Lei; Xiong, Ping; Zhang, Yan; Feng, Yi; Fan, Qingying; Yang, He; Yang, Jing; Chen, Peng; Li, Wenfeng; Xu, Aiqiang; Song, Lizhi

    2014-01-01

    Enteroviruses (EVs) are important human pathogens associated with various clinical syndromes. This study represents an overview of non-polio enteroviruses (NPEVs) isolated from acute flaccid paralysis (AFP) surveillance in Shandong Province, China from 1988 to 2013. Altogether 792 and 170 NPEV isolates were isolated from stool specimens of 9263 AFP cases and 1059 contacts, respectively. Complete VP1 sequencing and typing on all 962 isolates revealed 53 NPEV types in which echovirus (E) 6 (7.6%), E14 (7.6%), E11 (7.4%), coxsackievirus (CV) B3 (7.4%), E25 (5.6%), CVB5 (4.9%), E7 (4.5%) and EV-A71 (4.4%) were the eight most commonly reported serotypes. Distinct summer–fall seasonality was observed, with June–October accounting for 79.3% of isolation from AFP cases with known month of specimen collection. Increase of isolation of EV-A71 and CVA—the predominant pathogens for the hand, foot, and mouth disease—was observed in recent years. Sequence analysis on VP1 coding region of EV-A71 and E6 suggested Shandong strains had great genetic divergence with isolates from other countries. The results described in this study provide valuable information on the circulation and emergence of different EV types in the context of limited EV surveillance in China. PMID:25145609

  9. Aerobic Exercise Training in Post-Polio Syndrome: Process Evaluation of a Randomized Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Eric L Voorn

    Full Text Available To explore reasons for the lack of efficacy of a high intensity aerobic exercise program in post-polio syndrome (PPS on cardiorespiratory fitness by evaluating adherence to the training program and effects on muscle function.A process evaluation using data from an RCT.Forty-four severely fatigued individuals with PPS were randomized to exercise therapy (n = 22 or usual care (n = 22.Participants in the exercise group were instructed to exercise 3 times weekly for 4 months on a bicycle ergometer (60-70% heart rate reserve.The attendance rate was high (median 89%. None of the participants trained within the target heart rate range during >75% of the designated time. Instead, participants exercised at lower intensities, though still around the anaerobic threshold (AT most of the time. Muscle function did not improve in the exercise group.Our results suggest that severely fatigued individuals with PPS cannot adhere to a high intensity aerobic exercise program on a cycle ergometer. Despite exercise intensities around the AT, lower extremity muscle function nor cardiorespiratory fitness improved. Improving the aerobic capacity in PPS is difficult through exercise primarily focusing on the lower extremities, and may require a more individualized approach, including the use of other large muscle groups instead.Netherlands National Trial Register NTR1371.

  10. Circadian variation of fatigue in both patients with paralytic poliomyelitis and post-polio syndrome

    Directory of Open Access Journals (Sweden)

    Celiana Figueiredo Viana

    2013-07-01

    Full Text Available Objective It was to evaluate the degree of fatigue in patients with paralytic poliomyelitis (PP and with post-polio syndrome (PPS, and correlate it with parameters of sleep and the circadian cycle. Methods Thirty patients, 17 female (56.7%, participated in the study: they answered the Revised Piper Fatigue Scale and performed a nocturnal polysomnographic study. Eleven had PP (mean age±standard deviation of 47.9±6.4 years, and 19 had PPS (mean age±standard deviation of 46.4±5.6 years. Results Our study showed that fatigue was worse in the afternoon in the PP Group and had a progressive increase throughout the day in the PPS Group. We also observed compromised quality of sleep in both groups, but no statically significant difference was found in the sleep parameters measured by polysomnography. Conclusion Fatigue has a well-defined circadian variation, especially in PPS Group. Poor sleep quality is associated with fatigue and, therefore, sleep disturbances should be evaluated and treated in this group of PPS.

  11. Oral polio vaccine response in breast fed infants with malnutrition and diarrhea

    Science.gov (United States)

    Haque, Rashidul; Snider, Cynthia; Liu, Yue; Ma, Jennie Z.; Liu, Lei; Nayak, Uma; Mychaleckyj, Josyf C.; Korpe, Poonum; Mondal, Dinesh; Kabir, Mamun; Alam, Masud; Pallansch, Mark; Oberste, M. Steven; Weldon, William; Kirkpatrick, Beth D.; Petri, William A.

    2016-01-01

    Oral vaccines for polio (OPV) and rotavirus are less effective in children in the developing world. The reasons for this are not well understood. We tested for risk factors for poor response to OPV in infants from an urban slum of Dhaka, Bangladesh. Diminished serum neutralizing response to OPV, but not failure of intramuscularly administered vaccines, was associated with malnutrition, diarrhea, and shorter breastfeeding duration. Children with malnutrition (WAZ <−2) had significantly lower OPV 3 titers (p = 0.029). Children who had 2 or more diarrhea episodes during the 1st months of life were more than twice as likely to experience OPV failure as those who had 1 diarrhea episode or no diarrhea (p = 0.0245). In contrast, each additional month in exclusive breastfeeding was associated with an increase in OPV 3 titer by 0.41 (p = 0.0072) and 0.16 (p = 0.0065) at the 25th and 50th percentiles of OPV 3 titers respectively. These data are consistent with a defect in induction of immunity in the gut for OPV but not parenteral vaccines, a defect that may be amenable to intervention in part via promotion of exclusive breastfeeding. PMID:24300591

  12. Assessing Inactivated Polio Vaccine Introduction and Utilization in Kano State, Nigeria, April-November 2015.

    Science.gov (United States)

    Osadebe, Lynda U; MacNeil, Adam; Elmousaad, Hashim; Davis, Lora; Idris, Jibrin M; Haladu, Suleiman A; Adeoye, Olorunsogo B; Nguku, Patrick; Aliu-Mamudu, Uneratu; Hassan, Elizabeth; Vertefeuille, John; Bloland, Peter

    2017-07-01

    Kano State, Nigeria, introduced inactivated polio vaccine (IPV) into its routine immunization (RI) schedule in March 2015 and was the pilot site for an RI data module for the National Health Management Information System (NHMIS). We determined factors impacting IPV introduction and the value of the RI module on monitoring new vaccine introduction. Two assessment approaches were used: (1) analysis of IPV vaccinations reported in NHMIS, and (2) survey of 20 local government areas (LGAs) and 60 associated health facilities (HF). By April 2015, 66% of LGAs had at least 20% of HFs administering IPV, by June all LGAs had HFs administering IPV and by July, 91% of the HFs in Kano reported administering IPV. Among surveyed staff, most rated training and implementation as successful. Among HFs, 97% had updated RI reporting tools, although only 50% had updated microplans. Challenges among HFs included: IPV shortages (20%), hesitancy to administer 2 injectable vaccines (28%), lack of knowledge on multi-dose vial policy (30%) and age of IPV administration (8%). The introduction of IPV was largely successful in Kano and the RI module was effective in monitoring progress, although certain gaps were noted, which should be used to inform plans for future vaccine introductions.

  13. Oral Polio Vaccine Influences the Immune Response to BCG Vaccination. A Natural Experiment

    DEFF Research Database (Denmark)

    Sartono, E.; Lisse, I.M.; Terveer, E.M.

    2010-01-01

    Background: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did...... not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. Methods and Findings: We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who received BCG...... scar (0.95 (0.91-1.00), p = 0.057)). Among children with a scar, OPV was associated with reduced scar size, the regression coefficient being -0.24 (-0.43-0.05), p = 0.012. Conclusions: This study is the first to address the consequences for the immune response to BCG of simultaneous administration...

  14. Oral polio vaccine influences the immune response to BCG vaccination. A natural experiment

    DEFF Research Database (Denmark)

    Sartono, Erliyani; Lisse, Ida M; Terveer, Elisabeth M

    2010-01-01

    BACKGROUND: Oral polio vaccine (OPV) is recommended to be given at birth together with BCG vaccine. While we were conducting two trials including low-birth-weight (LBW) and normal-birth-weight (NBW) infants in Guinea-Bissau, OPV was not available during some periods and therefore some infants did...... not receive OPV at birth, but only BCG. We investigated the effect of OPV given simultaneously with BCG at birth on the immune response to BCG vaccine. METHODS AND FINDINGS: We compared the in vitro and the in vivo response to PPD in the infants who received OPV and BCG with that of infants who received BCG...... scar (0.95 (0.91-1.00), p = 0.057)). Among children with a scar, OPV was associated with reduced scar size, the regression coefficient being -0.24 (-0.43-0.05), p = 0.012. CONCLUSIONS: This study is the first to address the consequences for the immune response to BCG of simultaneous administration...

  15. Wearable Monitoring Devices for Assistive Technology: Case Studies in Post-Polio Syndrome

    Directory of Open Access Journals (Sweden)

    Giuseppe Andreoni

    2014-01-01

    Full Text Available The correct choice and customization of an orthosis are crucial to obtain the best comfort and efficiency. This study explored the feasibility of a multivariate quantitative assessment of the functional efficiency of lower limb orthosis through a novel wearable system. Gait basographic parameters and energetic indexes were analysed during a Six-Minute Walking Test (6-MWT through a cost-effective, non-invasive polygraph device, with a multichannel wireless transmission, that carried out electro-cardiograph (ECG; impedance-cardiograph (ICG; and lower-limb accelerations detection. Four subjects affected by Post-Polio Syndrome (PPS were recruited. The wearable device and the semi-automatic post-processing software provided a novel set of objective data to assess the overall efficiency of the patient-orthosis system. Despite the small number of examined subjects, the results obtained with this new approach encourage the application of the method thus enlarging the dataset to validate this promising protocol and measuring system in supporting clinical decisions and out of a laboratory environment.

  16. Wearable Monitoring Devices for Assistive Technology: Case Studies in Post-Polio Syndrome

    Science.gov (United States)

    Andreoni, Giuseppe; Mazzola, Marco; Perego, Paolo; Standoli, Carlo Emilio; Manzoni, Simone; Piccini, Luca; Molteni, Franco

    2014-01-01

    The correct choice and customization of an orthosis are crucial to obtain the best comfort and efficiency. This study explored the feasibility of a multivariate quantitative assessment of the functional efficiency of lower limb orthosis through a novel wearable system. Gait basographic parameters and energetic indexes were analysed during a Six-Minute Walking Test (6-MWT) through a cost-effective, non-invasive polygraph device, with a multichannel wireless transmission, that carried out electro-cardiograph (ECG); impedance-cardiograph (ICG); and lower-limb accelerations detection. Four subjects affected by Post-Polio Syndrome (PPS) were recruited. The wearable device and the semi-automatic post-processing software provided a novel set of objective data to assess the overall efficiency of the patient-orthosis system. Despite the small number of examined subjects, the results obtained with this new approach encourage the application of the method thus enlarging the dataset to validate this promising protocol and measuring system in supporting clinical decisions and out of a laboratory environment. PMID:24469354

  17. 75 FR 55626 - Certification Related to Aerial Eradication in Colombia Under the International Narcotics Control...

    Science.gov (United States)

    2010-09-13

    ... determine and certify that: (1) The herbicide used for aerial eradication of illicit crops in Colombia is... Certification Related to Aerial Eradication in Colombia Under the International Narcotics Control and Law... harm to health or licit crops caused by such aerial eradication are thoroughly evaluated and fair...

  18. Lessons for Implementation from the World's Most Successful Programme: The Global Eradication of Smallpox.

    Science.gov (United States)

    Pratt, David

    1999-01-01

    Focuses on lessons educators might learn from the Intensified Campaign for the Global Eradication of Smallpox. Outlines the history of smallpox eradication. Discusses the eradication effort's obstacles, campaign, and costs and benefits. Considers five factors relevant to the successful implementation of educational programs. (CMK)

  19. Efficacy of levofloxacin-doxycycline-based rescue therapy for Helicobacter pylori eradication: A prospective open-label trial in Saudi Arabia

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    Fahad I Alsohaibani

    2017-01-01

    Full Text Available Background: Helicobacter pylori eradication is achieved in 60%–80% with first-line therapy. Different second-line therapeutic options are available. However, the success of second-line therapy has not been addressed or reported from Saudi Arabia. Objectives: The primary objective was to evaluate the efficacy of the 10-day course of levofloxacin, doxycycline and esomeprazole in non-responders to first-line therapies for H. pylori eradication in Saudi Arabia. Secondary objectives included were symptoms' response to treatment, factors associated with eradication of H. pylori and adverse events associated with the treatment. Patients and Methods: A prospective, open-label, single-arm study was conducted. Patients were recruited from a tertiary care hospital in Saudi Arabia from June 2013 to April 2014. A total of 55 patients had previously received standard triple therapy and/or sequential therapy from 2011 to 2014 and failed to eradicate the infection. The rescue treatment was given for 10 days consisting of levofloxacin 500 mg once daily, doxycycline 100 mg twice daily and esomeprazole 20 mg twice daily. Urea breath test (UBT was done at a minimum of 6 weeks after completion of the treatment to confirm the H. pylori eradication. Results: From 55 patients recruited, 32 had failed to respond to previous standard triple therapy, 15 patients failed to respond to sequential therapy and 8 patients failed to both regimens. Persistent H. pylori infection was confirmed by rapid urease test, histology or UBT. H. pylori eradication was achieved in 20 out of 51 patients (39.22%, per protocol analysis, 36.36% by intention to treat analysis. Therapy was well tolerated and side effects were generally mild. Conclusion: Rescue treatment with levofloxacin and doxycycline-based therapy for 10 days was well tolerated but effective only in 39.22% of patients infected with H. pylori in Saudi Arabia. More trials to determine the most efficacious rescue therapy in

  20. Eradication of Helicobacter pylori: Past, present and future.

    Science.gov (United States)

    Lopes, Daniela; Nunes, Cláudia; Martins, M Cristina L; Sarmento, Bruno; Reis, Salette

    2014-09-10

    Helicobacter pylori is the major cause of chronic gastritis and peptic ulcers. Since the classification as a group 1 carcinogenic by International Agency for Research on Cancer, the importance of the complete H. pylori eradication has obtained a novel meaning. Hence, several studies have been made in order to deepen the knowledge in therapy strategies. However, the current therapy presents unsatisfactory eradication rates due to the lack of therapeutic compliance, antibiotic resistance, the degradation of antibiotics at gastric pH and their insufficient residence time in the stomach. Novel approaches have been made in order to overcome these limitations. The purpose of this review is to provide an overview about the current therapy and its limitations, while highlighting the possibility of using micro- and nanotechnology to develop gastric drug delivery systems, overcoming these difficulties in the future. Copyright © 2014 Elsevier B.V. All rights reserved.

  1. Control and eradication of animal diseases in New Zealand.

    Science.gov (United States)

    Davidson, R M

    2002-01-01

    New Zealand is free from all the major epidemic (Office International des Epizooties List A) diseases of animals and other important diseases, such as rabies and the transmissible spongiform encephalopathies. The once endemic conditions of sheep scab (Psoroptes ovis), bovine brucellosis (Brucella abortus), hydatids (Echinococcus granulosus) and Aujeszky's disease have been eradicated. Anthrax (Bacillus anthracis) is no longer considered endemic and Pullorum disease (Salmonella Pullorum) has effectively been eradicated from commercial poultry flocks. There are current control programmes for bovine tuberculosis (Mycobacterium bovis), enzootic bovine leucosis in dairy cattle, infectious bursal disease, ovine epididymitis (Brucella ovis), and caprine arthritis encephalitis. Historically, incursions by three important non-endemic diseases, contagious bovine pleuropneumonia, classical swine fever and scrapie, have been successfully eliminated. Any new occurrence of a serious exotic disease would be dealt with swiftly using powerful legislative authorities available for the purpose.

  2. Guinea worm (Dracunculiasis) eradication: update on progress and endgame challenges.

    Science.gov (United States)

    Al-Awadi, Abdul R; Al-Kuhlani, Abdulhakim; Breman, Joel G; Doumbo, Ogobara; Eberhard, Mark L; Guiguemde, Robert T; Magnussen, Pascal; Molyneux, David H; Nadim, Abolhassan

    2014-05-01

    The International Commission for the Certification of Dracunculiasis Eradication (ICCDE) met in December to review progress towards eradication. The status of the programme was presented by WHO and The Carter Center, Atlanta. The Commission received reports from international certification teams that Cote d'Ivoire, Niger and Nigeria were free of transmission and should be certified, while four countries, namely Chad, Ethiopia, Mali and South Sudan, remained endemic. The Commission certified that Somalia and South Africa were free of transmission. During 2013, there was a decline of about 78% in the numbers of cases reported in South Sudan. A report of the perplexing dracunculiasis epidemiology in Chad was also discussed, where dogs have been found to be infected with Dracunculus medinensis.

  3. Macroeconomics, (Adult) Education, and Poverty Eradication in Southern Africa

    Science.gov (United States)

    Nhamo, Senia; Nhamo, Godwell

    2006-05-01

    The Millennium Summit held in New York in September 2000 outlined the Millennium Development Goals (MDGs). The first of these involves the eradication of extreme poverty and hunger, setting two targets: halving by 2015 the percentage of the world's populace in 1990 with income less than US-1 a day (i.e., cutting this percentage from 27.9 to 14%); and halving the share of people who suffer from hunger. As for education, the MDGs seek to ensure that all children can complete primary schooling by 2015. Drawing on examples from selected southern African countries, the present study examines the need to strengthen economic support for (adult) education as an instrument of poverty eradication. It argues that human capital is one of the fundamental determinants of economic growth, and that this economic resource is essentially determined in both qualitative and quantitative regards by education.

  4. Protective, curative and eradicative activities of fungicides against grapevine rust

    Directory of Open Access Journals (Sweden)

    Francislene Angelotti

    2014-01-01

    Full Text Available The protective, eradicative and curative activities of the fungicides azoxystrobin, tebuconazole, pyraclostrobin+metiram, and ciproconazole against grapevine rust, were determined in greenhouse. To evaluate the protective activity, leaves of potted ´Niagara´ (Vitis labrusca vines were artificially inoculated with an urediniospore suspension of Phakopsora euvitis four, eight or forteen days after fungicidal spray; and to evaluate the curative and eradicative activities, leaves were sprayed with fungicides two, four or eight days after inoculation. Disease severity was assessed 14 days after each inoculation. All tested fungicides present excellent preventive activity against grapevine rust; however, tebuconazole and ciproconazole provide better curative activity than azoxystrobin and pyraclostrobin+metiram. It was observed also that all tested fungicides significantly reduced the germination of urediniospore produced on sprayed leaves.

  5. Development of the New Zealand strategy for local eradication of tuberculosis from wildlife and livestock.

    Science.gov (United States)

    Livingstone, P G; Hancox, N; Nugent, G; Mackereth, G; Hutchings, S A

    2015-06-01

    We describe the progressive development of New Zealand's national strategy for control of tuberculosis (TB) in its agricultural sector over the last four decades. The strategy is globally unique, reflecting the need for effective and co-ordinated management of TB in a wildlife maintenance host, the brushtail possum (Trichosurus vulpecula), in addition to controlling infection in cattle and farmed deer herds. Since the early 1990s, the strategy has been developed by the Animal Health Board (AHB), formed to empower the farming industry to take the leadership role in funding of TB control, policy development and administration. The AHB became the first non-government organisation to develop and gain acceptance by the funders (farming industry and government) of a National Pest Management Strategy (NPMS) under the Biosecurity Act 1993. A key outcome of the NPMS for TB control was the development and inclusion of very challenging objectives that provided direction for management, research and possum control. This paper describes the process whereby the NPMS was revised twice, following achievement of each successive set of strategy objectives within budget. Success was based on firstly, reorganisation of the AHB and its operational systems to achieve increased efficiency; secondly, improved efficiency through contracting possum and disease control, and thirdly research delivering effective and practical applications, while also providing a scientific basis for setting directions for future control strategies. The last revision of the NPMS was implemented in 2011, and included objectives to eradicate Mycobacterium bovis-infected wildlife populations over 2.5 million hectares by 2026. This ambitious objective was adopted only after extensive forecast modelling enabled stakeholders to identify and select the most cost-effective long-term solution for the management of M. bovis-infected possum populations. The accomplishment of New Zealand's TB control programme, in meeting

  6. A brief history of smallpox eradication in Iran.

    Science.gov (United States)

    Azizi, Mohammad Hossein

    2010-01-01

    Smallpox, which currently is only of historical interest, was once one of the most terrible illnesses with high mortality and morbidity. In the late 18th century, the English physician and naturalist, Edward Jenner (1749 - 1823), discovered an efficient preventive technique against smallpox which he termed "vaccination". Afterwards, the practice of vaccination gradually became widespread when finally in 1979, the World Health Organization formally declared the global eradication of this fatal disease.Presented here is a brief account of smallpox eradication in Iran which started on a limited scale in the 19th century by the order of Abbas Mirza (1789 - 1833), the Crown Prince of Fath Ali Shah Qajar (reign from 1797 - 1834), and reinforced in 1848 by Mirza Taghi Khan Amir Kabir (1807 - 1852) the Prime Minster of Naser ad-Din Shah, and became more popular after the establishment of the Pasteur Institute in Tehran in 1921, where considerable doses of smallpox vaccine were produced. In addition, in subsequent years, a law that mandated public smallpox vaccination was passed by the Iranian parliament (Majles) in 1953 and eventually, the mass vaccination program led to the complete eradication of smallpox in Iran in 1978.

  7. Eradication of Helicobacter pylori infection: which regimen first?

    Science.gov (United States)

    Federico, Alessandro; Gravina, Antonietta Gerarda; Miranda, Agnese; Loguercio, Carmela; Romano, Marco

    2014-01-21

    Helicobacter pylori (H. pylori) is a well-known human pathogen that plays an essential role in the pathogenesis of chronic gastritis, peptic ulcer disease, and gastric malignancies. Although H. pylori is susceptible to several antimicrobials, this infection has proven challenging to cure because of the increasing prevalence of bacterial strains that are resistant to the most commonly used antimicrobials, particularly clarithromycin. An effective (i.e., > 90%) first-line therapy is mandatory for avoiding supplementary treatments and testing, and more importantly for preventing the development of secondary resistance. This study reviews the recent literature on first-line therapies for H. pylori. The eradication rates following standard triple therapy (a proton pump inhibitor plus amoxicillin and clarithromycin) for H. pylori infection are declining worldwide. Several first-line strategies have been proposed to increase the eradication rate, including extending the treatment duration to 14 d, the use of a four-drug regimen (bismuth-containing quadruple, sequential, and concomitant treatments), and the use of novel antibiotics, such as fluoroquinolones. However, the efficacy of these regimens is controversial. A first-line eradication regimen should be based on what works best in a defined geographical area and must take into account the prevalence of antimicrobial resistance in that region.

  8. Enterovirus no polio de casos con parálisis residual. Colombia, 1992-1995

    Directory of Open Access Journals (Sweden)

    Dioselina Peláez

    1999-06-01

    Full Text Available Las parálisis fláccidas agudas (PFA tienen una amplia variedad de orígenes y de agentes causales: físicos, fisiopatológicos, tóxicos e infecciosos. Entre estos últimos, el virus salvaje (silvestre de la poliomielitis y el enterovirus 71 (EV71, parecen ser los agentes virales más frecuentes. Habiendo eliminado el poliovirus salvaje autóctono como agente causal de enfermedad paralítica en Colombia desde junio de 1991 y teniendo aislamientos de virus no polio en el 20,8% del total de casos de PFA notificados anualmente, quisimos conocer el papel que juegan los enterovirus en la incidencia de parálisis fláccida aguda y la dinámica de circulación y distribución de los mismos en Colombia. Se revisó la base de datos de los casos notificados al Programa de Erradicación de la Poliomielitis en Colombia entre el 1"" de enero de 1992 y el 31 de diciembre de 1995, al cual se notificaron 856 casos sospechosos de niños menores de 15 años, y se escogieron 69 casos para el estudio pero se recuperaron 57 aislamientos virales por reinoculación en células RD y Hep-2C. Estos se identificaron mediante neutralización con mezclas de antisueros de Lim & Benyesh-Melnick (LBM.Todos ellos fueron sometidos a caracterización molecular mediante reacción en cadena de la polimerasa -PCR-, utilizando iniciadores complementarios a la regiónVP1 del genoma viral, seguida del análisis de secuencia de nucleótidos de los fragmentos amplificados por PCR. La identificación final del serotipo se realizó por comparación de nucleótidos en auto assemblery el análisis descriptivo de los datos. No se estableció circulación mayor de ningún serotipo específico en región geográfica alguna del país. Tampoco hubo asociación causal a ninguna patología característica con ninguno de los enterovirus aislados. Se describe el hallazgo de EV71 en un caso de PFA con diagnóstico clínico de síndrome de Guillain-Barré. La descripción de 22 serotipos diferentes

  9. Welfare effects of a disease eradication programme for dairy goats.

    Science.gov (United States)

    Muri, K; Leine, N; Valle, P S

    2016-02-01

    The Norwegian dairy goat industry has largely succeeded in controlling caprine arthritis encephalitis (CAE), caseous lymphadenitis (CLA) and paratuberculosis through a voluntary disease eradication programme called Healthier Goats (HG). The aim of this study was to apply an on-farm welfare assessment protocol to assess the effects of HG on goat welfare. A total of 30 dairy goat farms were visited, of which 15 had completed disease eradication and 15 had not yet started. Three trained observers assessed the welfare on 10 farms each. The welfare assessment protocol comprised both resource-based and animal-based welfare measures, including a preliminary version of qualitative behavioural assessments with five prefixed terms. A total of 20 goats in each herd were randomly selected for observations of human-animal interactions and physical health. The latter included registering abnormalities of eyes, nostrils, ears, skin, lymph nodes, joints, udder, claws and body condition score. For individual-level data, robust clustered logistic regression analyses with farm as cluster variable were conducted to assess the association with disease eradication. Wilcoxon rank-sum tests were used for comparisons of herd-level data between the two groups. Goats with swollen joints (indicative of CAE) and enlarged lymph nodes (indicative of CLA) were registered on 53% and 93% of the non-HG farms, respectively, but on none of the HG farms. The only other health variables with significantly lower levels in HG herds were skin lesions (P=0.008) and damaged ears due to torn out ear tags (P<0.001). Goats on HG farms showed less fear of unknown humans (P=0.013), and the qualitative behavioural assessments indicated that the animals in these herds were calmer than in non-HG herds. Significantly more space and lower gas concentrations reflected the upgrading of buildings usually done on HG farms. In conclusion, HG has resulted in some welfare improvements beyond the elimination of infectious

  10. Expresión en escherichia coli de un peptido perteneciente a la proteina vp1 del virus del polio

    Directory of Open Access Journals (Sweden)

    Myriam Sánchez de Gómez

    2010-07-01

    Full Text Available Una secuencia sintética de 49 pb codificante para un péptido de la cubierta del virus del Polio se clonó en el vector de fusión pEZZ8, basado en el gen de la proteína A del Staphylococcus aureus. La expresión se hizo en Escherichia coli y la proteína de fusión se recuperó en el sobrenadante. Se purificó mediante cromatografía de afinidad con IgG Sepharosa y se identificó por medio de electroforesis en presencia de SDS.

  11. Water isotope effect on the thermostability of a polio viral RNA hairpin: A metadynamics study

    Science.gov (United States)

    Pathak, Arup K.; Bandyopadhyay, Tusar

    2017-04-01

    Oral polio vaccine is considered to be the most thermolabile of all the common childhood vaccines. Despite heavy water (D2O) having been known for a long time to stabilise attenuated viral RNA against thermodegradation, the molecular underpinnings of its mechanism of action are still lacking. Whereas, understanding the basis of D2O action is an important step that might reform the way other thermolabile drugs are stored and could possibly minimize the cold chain problem. Here using a combination of parallel tempering and well-tempered metadynamics simulation in light water (H2O) and in D2O, we have fully described the free energy surface associated with the folding/unfolding of a RNA hairpin containing a non-canonical basepair motif, which is conserved within the 3'-untranslated region of poliovirus-like enteroviruses. Simulations reveal that in heavy water (D2O) there is a considerable increase of the stability of the folded basin as monitored through an intramolecular hydrogen bond (HB), size, shape, and flexibility of RNA structures. This translates into a higher melting temperature in D2O by 41 K when compared with light water (H2O). We have explored the hydration dynamics of the RNA, hydration shell around the RNA surface, and spatial dependence of RNA-solvent collective HB dynamics in the two water systems. Simulation in heavy water clearly showed that D2O strengthens the HB network in the solvent, lengthens inter-residue water-bridge lifetime, and weakens dynamical coupling of the hairpin to its solvation environment, which enhances the rigidity of solvent exposed sites of the native configurations. The results might suggest that like other added osmoprotectants, D2O can act as a thermostabilizer when used as a solvent.

  12. Knowledge and work performance of multi-purpose workers under national leprosy eradication programme in Satara district, Maharashtra.

    Science.gov (United States)

    Mohite, R V; Mohite, V R

    2012-01-01

    After integration of leprosy services into general health care services, peripheral health care workers played important role in leprosy elimination. The objectives of present study are to assess the knowledge and work performance of multi-purpose workers and it's correlation towards eradication of leprosy under national leprosy eradication programme in Satara district. The cross sectional study was conducted over a period of 6 months includes 71 Primary health centres (PHCs) and 6 Urban leprosy centres (ULCs) providing leprosy services to whole Satara district, Maharashtra. Random sampling technique was used to select study subjects (Multi-purpose workers, MPWs) and data was collected by using pre-tested semi structured proforma by personal interview method. Percentage distribution and statistical association between knowledge and work performance was analysed. More than 88.31% MPWs had good knowledge about leprosy and National leprosy eradication programme (NLEP), similarly more than 88.42% showed good work performance under NLEP in Satara district. Significant statistical association was existed between age and work experience of MPWs with their work performance under NLEP (chi2=11.2, p=0.023* and chi2=10.1, p=0.038*). Significant correlation was also observed between knowledge of MPWs about leprosy and NLEP with their work performance under NLEP (r=0.66, p=0.001*). Satara district achieved leprosy elimination which was mainly due to very good knowledge and quality work performance by multi-purpose workers.

  13. Active epidemiological surveillance in the program of poliomyelitis eradication in Serbia

    Directory of Open Access Journals (Sweden)

    Jevremović Ivana

    2002-01-01

    Full Text Available The main strategy of the worldwide Program of Poliomyelitis Eradication is based on immunization with oral poliovirus vaccine and active epidemiological surveillance aimed to demonstrate the absence of wild poliovirus circulation. The specification of the surveillance in the program, reporting and investigation of certain syndrome – the acute flaccid paralysis - as a specific feature of surveillance of poliomyelitis, is a new experience both for clinicians and epidemiologists. Along with the achieved results, problems in conducting the active epidemiological surveillance in Serbia, applied measures, and suggestions for improving its quality were presented. This experience might help in implementing the active surveillance for some other diseases that could be prevented by vaccine immunization.

  14. Global economic crisis and social sector transformation: achieving ...

    African Journals Online (AJOL)

    Global economic crisis and social sector transformation: achieving MDGs in Nigeria. ... nation closer to these goals and it would include reflationary prorammes, sound fiscal discipline, sustained economic reforms and eradication of widespread corruption to enhance fiscal interventions in the social sector of the economy.

  15. [Commemorative lecture of receiving Imamura Memorial Prize. III. Estimating the year of eradication of tuberculosis in Japan].

    Science.gov (United States)

    Ohmori, M

    1994-09-01

    The year by which tuberculosis could be eradicated, has been discussed for several foreign countries, and based on those results, new strategic plans and goals have been elaborated. Therefore, in Japan too, it was desired to estimate the point at which eradication of tuberculosis would be achieved. The author estimated the year of eradication of tuberculosis, according to the criterion proposed by Dr. Styblo that "tuberculosis is eradicated when the prevalence of tuberculosis infection in the general population has fallen below 1% and continues to decrease". If the risk of infection is changing at a regular rate, it is possible to estimate the risk of infection at any particular time. Once the risk of infection is determined, it is also possible to calculate the age-specific prevalence of infection and the proportion of the population infected with tubercle bacilli at any given time. In Japan, the risk of infection before World War II was assumed to be around 4%; since then, it has declined on average, by 10 to 11% annually. The incidence rate in Japan also has declined, on average, by 10 to 11% annually. However, since late 1970s, the annual speed of decline of the incidence rate has slowed down. Therefore, I assumed that the recent trend of the infection risk is the same as the trend of the recent incidence rate among the 0-29 year age-group. The size of the effect of age on the risk of infection has been discussed. The author also considered age-effects in the model.(ABSTRACT TRUNCATED AT 250 WORDS)

  16. HCV eradication does not impact gut dysbiosis or systemic inflammation in cirrhotic patients.

    Science.gov (United States)

    Bajaj, J S; Sterling, R K; Betrapally, N S; Nixon, D E; Fuchs, M; Daita, K; Heuman, D M; Sikaroodi, M; Hylemon, P B; White, M B; Ganapathy, D; Gillevet, P M

    2016-09-01

    Eradication of hepatitis C virus (HCV) is increasing but its residual impact on the pro-inflammatory milieu in cirrhosis, which is associated with gut dysbiosis, is unclear. To define the impact of sustained virological response (SVR) on gut dysbiosis and systemic inflammation in HCV cirrhosis patients. Cirrhotic out-patients with HCV with/without SVR (achieved >1 year prior) and age-matched healthy controls underwent serum and stool collection. Serum was analysed for IL-6, TNF-α and endotoxin while stool microbiota analysis was performed using multitagged pyrosequencing. Microbial comparisons were made using UNIFRAC and cirrhosis dysbiosis ratio (lower score indicates dysbiosis). Comparisons were performed between cirrhotics with/without SVR and controls vs. cirrhotic patients. A total of 105 HCV cirrhotics and 45 age-matched healthy controls were enrolled. Twenty-one patients had achieved SVR using pegylated interferon + ribavrin a median of 15 months prior. No significant differences on demographics, cirrhosis severity, concomitant medications or diabetes were seen between cirrhotics with/without SVR. There was no significant difference in overall microbiota composition (UNIFRAC P = 0.3) overall or within specific microbial families (cirrhosis dysbiosis ratio median 1.3 vs. 1.0, P = 0.45) between groups with/without SVR. This also extended towards IL-6, TNF-α and endotoxin levels. Both cirrhosis groups, however, had significant dysbiosis compared to healthy controls [UNIFRAC P = 0.01, cirrhosis dysbiosis ratio (1.1 vs. 2.9, P dysbiosis and a pro-inflammatory systemic milieu, are found in HCV cirrhosis regardless of SVR. This persistent dysbiosis could contribute towards varying rates of improvement after HCV eradication in cirrhosis. © 2016 John Wiley & Sons Ltd.

  17. Rabeprazole, Minocycline, Amoxicillin, and Bismuth as First-Line and Second-Line Regimens for Helicobacter pylori Eradication.

    Science.gov (United States)

    Song, Zhiqiang; Suo, Baojun; Zhang, Lingyun; Zhou, Liya

    2016-12-01

    Because of general unavailability of tetracycline, common adverse effects, and complicated administration, the clinical application of bismuth quadruple therapy often faces difficulties. Whether the combination of minocycline and amoxicillin can replace tetracycline and metronidazole for Helicobacter pylori eradication remains unclear. This study was to determine the efficacy, compliance, and safety of rabeprazole, minocycline, amoxicillin, and bismuth (RMAB) therapy as first-line and second-line regimens. Between July 2013 and December 2015, a total of 160 patients in first-line and 70 patients in second-line therapies received rabeprazole 10 mg, minocycline 100 mg, amoxicillin 1000 mg, and bismuth potassium citrate 220 mg twice daily for 14 days. Eradication status was assessed 6-12 weeks after treatment. RMAB therapy achieved the eradication rates of 87.5% (95% confidence interval, 81.9-92.5%, intention-to-treat analysis), 90.9% (85.7-95.5%, modified intention-to-treat analysis), and 92.6% (88.5-96.6%, per-protocol analysis) in first-line therapy in a setting with high antibiotic resistance rates (amoxicillin 3.4%, clarithromycin 39.7%, metronidazole 60.3%, levofloxacin 36.2%, tetracycline 3.4%, and minocycline 6.9%). As for second-line therapy, the eradication rates were 82.9% (74.3-91.4%, intention-to-treat analysis), 86.6% (77.6-94.0%, modified intention-to-treat analysis), and 89.1% (81.3-95.3%, per-protocol analysis). Totally, 24.0% patients had adverse effects, 2.2% discontinued medications, and good compliance was achieved in 94.7%. Poor compliance and minocycline resistance were identified as the risk factors for treatment failure. Significant differences in efficacy existed among the groups of both sensitive (48/51 and 18/20), isolated amoxicillin resistance (1/1 and 0/0), isolated minocycline resistance (2/3 and 1/1), and dual resistance (0/1 and 0/1) in both first-line (p = .004) and second-line (p = .035) therapies. The eradication efficacies of RMAB

  18. Vacunología en conflictos armados: una intervención puntual frente a poliomielitis en Afganistán Vaccinology in armed conflicts: a punctual intervention in poliomyelitis eradication in Afghanistan

    Directory of Open Access Journals (Sweden)

    Juan M. López-González

    2006-06-01

    Full Text Available Las situaciones de conflicto armado suponen un hándicap para la erradicación de la poliomielitis por las dificultades de acceso a la población susceptible. En Afganistán, tras la operación militar que supuso la caída del régimen talibán, se llevó a cabo por sanitarios militares españoles una intervención dirigida a mejorar el nivel de protección frente a poliomielitis en la población infantil de la zona donde realizaban su misión. Solventados los obstáculos logísticos y de planificación, se efectuaron 2 rondas de vacunación con vacuna de polio inactivada (VPI. Un cuestionario mediado por un intérprete permitió una aproximación al escenario vacunal, proporcionando información sobre las características sociodemográficas de los niños que acudieron, su estado vacunal, sus conocimientos sobre las vacunas y el alcance de los medios empleados para difundir la intervención. Fueron inmunizados 293 y 321 niños en dos rondas. Se observó que muy pocos estaban vacunados con anterioridad (10% y mostraban un bajo conocimiento sobre las vacunas. Los padres no se implicaron en la campaña, que obtuvo mejor resultado de difusión por carteles (70% que por cuñas radiofónicas (10%. La vacunación es una iniciativa de salud que allana el camino hacia la paz.The situations of armed conflict suppose a handicap for the eradication of the poliomyelitis due to the difficulties to access the susceptible population. In Afghanistan, after the military operation which put an end to the Taliban regime, Spanish military sanitarians made an intervention in order to immunize the children of the zone where they were conducting their mission, against poliomyelitis. After having solved planning and logistic problems, two rounds of vaccination with IPV were made. A local translator helped to fill out a questionnaire about the state of immunization in that zone, providing information regarding the socio-demographic data of the children that showed up

  19. Eradication of viral haemorrhagic septicaemia in Danish aquaculture

    DEFF Research Database (Denmark)

    Olesen, Niels Jørgen; Skall, Helle Frank; Jensen, Britt Bang

    Eradication of viral haemorrhagic septicaemia in Danish aquaculture Olesen N.J.1, Skall H.F.1, Jensen B.B.2, Henriksen N.H.3, Mellergård S.4, H. Korsholm H.5 1National Veterinary Institute, Technical University of Denmark, Aarhus, Denmark 2Norwegian Veterinary Institute, Oslo, Norway 3Danish...... Aquaculture Association, Silkeborg, Denmark 4Danish Veterinary and Food Administration, Glostrup, Denmark 5Danish Veterinary and Food Administration, Vejle, Denmark Viral haemorrhagic septicaemia (VHS) virus was first isolated in Denmark in 1962, when more than half of the approximately 800 Danish fish farms...

  20. Sustainable implementation of microhydro to eradicate poverty in Africa

    Energy Technology Data Exchange (ETDEWEB)

    Jonker Klunne, Wim

    2010-09-15

    Local, micro scale, village level hydropower plants can play an important role towards eradication of poverty in rural areas. However, despite a good understanding of the technology involved and the enormous potential that exists in Africa, relative small numbers of micro hydro projects are currently in operation in Africa. This paper does look into the current situation on the continent with respect to installed systems and projects that are being implemented. It compares different implementation models and will conclude on ingredients for implementation models that will support the sustainable operation of micro hydroplants once built.

  1. Investing in Justice: Ethics, Evidence, and the Eradication Investment Cases for Lymphatic Filariasis and Onchocerciasis

    Science.gov (United States)

    Merritt, Maria W.; Tediosi, Fabrizio

    2015-01-01

    It has been suggested that initiatives to eradicate specific communicable diseases need to be informed by eradication investment cases to assess the feasibility, costs, and consequences of eradication compared with elimination or control. A methodological challenge of eradication investment cases is how to account for the ethical importance of the benefits, burdens, and distributions thereof that are salient in people’s experiences of the diseases and related interventions but are not assessed in traditional approaches to health and economic evaluation. We have offered a method of ethical analysis grounded in theories of social justice. We have described the method and its philosophical rationale and illustrated its use in application to eradication investment cases for lymphatic filariasis and onchocerciasis, 2 neglected tropical diseases that are candidates for eradication. PMID:25713967

  2. Assessment of subjective and motor fatigue in Polio survivors, attending a Postpolio clinic, comparison with healthy controls and an exploration of clinical correlates.

    Science.gov (United States)

    Murray, Deirdre; Hardiman, Orla; Meldrum, Dara

    2014-05-01

    Polio survivors experience declining mobility, pain and fatigue. The extent of motor fatigue and its impact on mobility and quality of life, in addition to other commonly reported impairments requires evaluation. An observational, case-control, cross-sectional design was used to assess 30 Polio survivors and 30 age- and sex-matched controls. Muscle strength and motor fatigue were assessed using fixed dynamometry. Fatigue, pain and quality of life were assessed using the Piper Fatigue Scale, the Fatigue Severity Scale, visual analogue scales and the RAND Short Form-36, respectively. An 8-min walking test, including physiological cost index (PCI), evaluated mobility. A significant difference in motor fatigue was identified only in hand grip (p = 0.03). Polio survivors were significantly weaker (p < 0.001) and more fatigued (p < 0.001) than controls. Motor fatigue was not related to subjective fatigue, mobility or quality of life. Muscle strength predicted mobility. Pain and fatigue were associated with lower mental quality of life, while PCI was associated with physical quality of life. Motor fatigue has been identified in Polio survivors but was only significantly different in hand grip, using this approach. Pain, fatigue and elevated energy cost of walking negatively influenced quality of life. Motor fatigue was unrelated to subjective fatigue, mobility or quality of life.

  3. Strategies for Improving Polio Surveillance Performance in the Security-Challenged Nigerian States of Adamawa, Borno, and Yobe During 2009–2014

    Science.gov (United States)

    Hamisu, Abdullahi Walla; Johnson, Ticha Muluh; Craig, Kehinde; Mkanda, Pascal; Banda, Richard; Tegegne, Sisay G.; Oyetunji, Ajiboye; Ningi, Nuhu; Mohammed, Said M.; Adamu, Mohammed Isa; Abdulrahim, Khalid; Nsubuga, Peter; Vaz, Rui G.; Muhammed, Ado J. G.

    2016-01-01

    Background. The security-challenged states of Adamawa, Borno, and Yobe bear most of the brunt of the Boko Haram insurgency in Nigeria. The security challenge has led to the killing of health workers, destruction of health facilities, and displacement of huge populations. To identify areas of polio transmission and promptly detect possible cases of importation in these states, polio surveillance must be very sensitive. Methods. We conducted a retrospective review of acute flaccid paralysis surveillance in the security-compromised states between 2009 and 2014, using the acute flaccid paralysis database at the World Health Organization Nigeria Country Office. We also reviewed the reports of surveillance activities conducted in these security-challenged states, to identify strategies that were implemented to improve polio surveillance. Results. Environmental surveillance was implemented in Borno in 2013 and in Yobe in 2014. All disease surveillance and notification officers in the 3 security-challenged states now receive annual training, and the number of community informants in these states has dramatically increased. Media-based messaging (via radio and television) is now used to sensitize the public to the importance of surveillance, and contact samples have been regularly collected in both states since 2014. Conclusions. The strategies implemented in the security-challenged states improved the quality of polio surveillance during the review period. PMID:26655842

  4. Strategies for Improving Polio Surveillance Performance in the Security-Challenged Nigerian States of Adamawa, Borno, and Yobe During 2009-2014.

    Science.gov (United States)

    Hamisu, Abdullahi Walla; Johnson, Ticha Muluh; Craig, Kehinde; Mkanda, Pascal; Banda, Richard; Tegegne, Sisay G; Oyetunji, Ajiboye; Ningi, Nuhu; Mohammed, Said M; Adamu, Mohammed Isa; Abdulrahim, Khalid; Nsubuga, Peter; Vaz, Rui G; Muhammed, Ado J G

    2016-05-01

    The security-challenged states of Adamawa, Borno, and Yobe bear most of the brunt of the Boko Haram insurgency in Nigeria. The security challenge has led to the killing of health workers, destruction of health facilities, and displacement of huge populations. To identify areas of polio transmission and promptly detect possible cases of importation in these states, polio surveillance must be very sensitive. We conducted a retrospective review of acute flaccid paralysis surveillance in the security-compromised states between 2009 and 2014, using the acute flaccid paralysis database at the World Health Organization Nigeria Country Office. We also reviewed the reports of surveillance activities conducted in these security-challenged states, to identify strategies that were implemented to improve polio surveillance. Environmental surveillance was implemented in Borno in 2013 and in Yobe in 2014. All disease surveillance and notification officers in the 3 security-challenged states now receive annual training, and the number of community informants in these states has dramatically increased. Media-based messaging (via radio and television) is now used to sensitize the public to the importance of surveillance, and contact samples have been regularly collected in both states since 2014. The strategies implemented in the security-challenged states improved the quality of polio surveillance during the review period. © 2016 World Health Organization; licensee Oxford Journals.

  5. Sex-differential effect on infant mortality of oral polio vaccine administered with BCG at birth in Guinea-Bissau. A natural experiment

    DEFF Research Database (Denmark)

    Benn, Christine Stabell; Fisker, Ane Baerent; Rodrigues, Amabelia

    2008-01-01

    BACKGROUND: The policy to provide oral polio vaccine (OPV) at birth was introduced in low-income countries to increase coverage. The effect of OPV at birth on overall child mortality was never studied. During a trial of vitamin A supplementation (VAS) at birth in Guinea-Bissau, OPV...

  6. Immunity to polio, measles and rubella in women of child-bearing age and estimated congenital rubella syndrome incidence, Cambodia, 2012.

    Science.gov (United States)

    Mao, B; Chheng, K; Wannemuehler, K; Vynnycky, E; Buth, S; Soeung, S C; Reef, S; Weldon, W; Quick, L; Gregory, C J

    2015-07-01

    Significant gaps in immunity to polio, measles, and rubella may exist in adults in Cambodia and threaten vaccine-preventable disease (VPD) elimination and control goals, despite high childhood vaccination coverage. We conducted a nationwide serological survey during November-December 2012 of 2154 women aged 15-39 years to assess immunity to polio, measles, and rubella and to estimate congenital rubella syndrome (CRS) incidence. Measles and rubella antibodies were detected by IgG ELISA and polio antibodies by microneutralization testing. Age-structured catalytic models were fitted to rubella serological data to predict CRS cases. Overall, 29.8% of women lacked immunity to at least one poliovirus (PV); seroprevalence to PV1, PV2 and PV3 was 85.9%, 93.4% and 83.3%, respectively. Rubella and measles antibody seroprevalence was 73.3% and 95.9%, respectively. In the 15-19 years age group, 48.2% [95% confidence interval (CI) 42.4-54.1] were susceptible to either PV1 or PV3, and 40.3% (95% CI 33.0-47.5) to rubella virus. Based on rubella antibody seroprevalence, we estimate that >600 infants are born with CRS in Cambodia annually. Significant numbers of Cambodian women are still susceptible to polio and rubella, especially those aged 15-19 years, emphasizing the need to include adults in VPD surveillance and a potential role for vaccination strategies targeted at adults.

  7. Experiences of falls and strategies to manage the consequences of falls in persons with late effects of polio: A qualitative study

    Directory of Open Access Journals (Sweden)

    Christina Brogårdh

    2017-08-01

    Full Text Available Objective: To explore how persons with late effects of polio experience falls and what strategies they use to manage the consequences of falls. Design: A qualitative study with face-to-face interviews. Data were analysed by systematic text condensation. Participants: Fourteen ambulatory persons (7 women; mean age 70 years with late effects of polio. Results: Analysis resulted in one main theme, “Everyday life is a challenge to avoid the consequences of falls”, and 3 categories with 7 subcategories. Participants perceived that falls were unpredictable and could occur anywhere. Even slightly uneven surfaces could cause a fall, and increased impairments following late effects of polio led to reduced movement control and an inability to adjust balance quickly. Physical injuries were described after the falls, as well as emotional and psychological reactions, such as embarrassment, frustration and fear of falling. Assistive devices, careful planning and strategic thinking were strategies to prevent falls, together with adaptation and social comparisons to mitigate the emotional reactions. Conclusion: Experiences of falls greatly affect persons with late effects of polio in daily life. To reduce falls and fall-related consequences both problem-focused and emotion-focused strategies are used. In order to increase daily functioning, these findings should be included in a multifaceted falls management programme.

  8. The virus and the vaccine: the true story of a cancer-causing monkey virus, contaminated polio vaccine, and the millions of Americans exposed

    National Research Council Canada - National Science Library

    Bookchin, Debbie; Schumacher, Jim

    2004-01-01

    .... But the story of the vaccine has a dark side, one that has never been fully told before... Between 1954 and 1963, close to 98 million Americans received polio vaccinations contaminated with a carcinogenic monkey virus, now known as SV40...

  9. The immunological effects of oral polio vaccine provided with BCG vaccine at birth: a randomised trial.

    Science.gov (United States)

    Jensen, Kristoffer Jarlov; Karkov, Hanne Sophie; Lund, Najaaraq; Andersen, Andreas; Eriksen, Helle Brander; Barbosa, Amarildo Gomes; Kantsø, Bjørn; Aaby, Peter; Benn, Christine Stabell

    2014-10-14

    Vaccines may have non-specific effects. An observational study from Guinea-Bissau suggested that oral polio vaccine at birth (OPV0) provided with Bacillus Calmette-Guérin (BCG) vaccine was associated with down-regulation of the immune response to BCG vaccine 6 weeks later. Based on the previous finding, we wanted to test our a priori hypothesis that OPV would dampen the immune response to BCG, and secondarily to test immune responses to other antigens. The study was conducted at the Bandim Health Project in Guinea-Bissau in 2009-2010. Infants were randomised to OPV0+BCG versus BCG alone at birth, and subsequently randomised to have a blood sample taken at 2, 4 or 6 weeks post-randomisation. Excreted levels of cytokines (IL-2, IL-5, IL-10, TNF-α and IFN-γ) were measured from whole blood in vitro stimulations with a panel of recall vaccine antigens (BCG, PPD, OPV), mitogen (PHA) or innate agonists (LPS, Pam3cys, PolyI:C). Additionally, we measured the local reaction to BCG, white blood cell distribution, C-reactive protein (CRP) and retinol-binding protein (RBP). Cytokine production was analysed as the prevalence ratios of responders above the median. Blood samples from 430 infants (209 OPV0+BCG; 221 BCG alone) were analysed. There were no strong differences in effects 2, 4 and 6 weeks post-randomisation and subsequent analyses were performed on the pooled data. As hypothesised, receiving OPV0+BCG versus BCG alone was associated with significantly lower prevalence of IFN-γ responses to PPD (prevalence ratio (PR): 0.84 (0.72-0.98)) and reduced IL-5 to PPD (PR: 0.78 (0.64-0.96)). No effects were observed for CPR, RBP, white blood cell distribution, or BCG scar prevalence. The results corroborate that OPV attenuates the immune response to co-administered BCG at birth. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. The effects of a home-based arm ergometry exercise programme on physical fitness, fatigue and activity in polio survivors: protocol for a randomised controlled trial

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    Murray Deirdre

    2012-12-01

    Full Text Available Abstract Background Many Polio survivors have reduced mobility, pain and fatigue, which make access to conventional forms of aerobic exercise difficult. Inactivity leads to increased risk of health problems, many of which are prevalent among Polio survivors. Aerobic exercise programmes in Polio survivors should utilise stable muscle groups and should be designed to minimise exacerbation of pain and fatigue. A home-based arm ergometry aerobic exercise programme may represent an affordable and accessible exercise modality, incorporating exercise prescription principles in this group. Methods/design This is a prospective, single blinded, randomised controlled trial. There are two arms; exercise intervention using arm ergometers and control. Polio survivors meeting eligibility criteria will be recruited and randomly allocated to intervention or control groups. Participants allocated to the intervention group will receive a small arm ergometer and a polar heart rate monitor. They will carry out a home-based moderate intensity (50-70% HRMax aerobic exercise programme for eight weeks, following instruction by the treating physiotherapist. Assessments will occur at baseline and after eight weeks and will include tests of physical fitness, activity, energy cost of walking, fatigue and quality of life. Clinically feasible assessment tools including the Six Minute Arm Test, the Physical Activity Scale for People with Physical Disabilities questionnaire, the Physiological Cost Index, Fatigue Severity Scale and the SF-36v2 will be utilised. Discussion The efficacy of a home-based arm ergometry programme in Polio survivors will be examined. No previous trial has examined such a programme using a wide range of outcome measures pertinent to Polio survivors. This study will provide new information on the impact of arm ergometry on physical fitness, activity, body composition, fatigue, pain, muscle strength, and health related quality of life. Also, the study

  11. The Global Great Society and the US commitment to smallpox eradication.

    Science.gov (United States)

    Reinhardt, Bob H

    2010-12-01

    In 1965, Lyndon B. Johnson announced that the United States would join the fledgling global program to eradicate smallpox, beginning with a program in West Africa. The American commitment to smallpox eradication represented a broader effort in the United States and the developing world to expand international health programs and build a Global Great Society. The Global Great Society came to grief, but global smallpox eradication would ultimately succeed. Copyright © 2010 Elsevier Ltd. All rights reserved.

  12. Attempts to enhance the eradication rate of Helicobacter pylori infection.

    Science.gov (United States)

    Bang, Chang Seok; Baik, Gwang Ho

    2014-05-14

    Increasing rates of antimicrobial resistance to clarithromycin and metronidazole present challenges in maintaining optimal eradication rates. Knowledge of local antibiotic resistance and consumption pattern is important in selecting a reliable regimen. In addition, adverse effect profiles of therapeutic regimens are important and must be addressed to enhance compliance rates. Various methods of enhancing the eradication rates of Helicobacter pylori (H. pylori) have been investigated, including changing combinations or durations of established drugs, adding adjuvant drugs, or development of new molecules or agents. Bismuth-containing quadruple, sequential, concomitant, and levofloxacin-based triple therapies are replacing the long-standing standard of the triple regimen. Despite the encouraging results of these regimens, individualized approaches like treatment after antibiotics resistance test or CYP2C19 genotyping would be the mainstream of future therapy. Because scientific, economic, and technical problems make these advance therapies unfit for widespread use, future development for H. pylori therapy should be directed to overcome individualized antibiotic resistance. Although various novel regimens and additive agents have indicated favorable outcomes, more studies or validations are needed to become a mainstream H. pylori therapy.

  13. Esophageal Adenocarcinoma Developing after Eradication of Helicobacter pylori

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    Yasuhiko Abe

    2011-07-01

    Full Text Available A 75-year-old man underwent endoscopic hemostatic therapy for hemorrhagic gastric ulcer in September 2002. After healing of the gastric ulcer, he underwent Helicobacter pylori eradication therapy in February 2003. In August 2007, an irregular tumor was detected in the lower esophagus at annual checkup for gastric cancer screening using X-ray. Endoscopic examination showed that the lower margin of the tumor almost coincided with the esophagogastric junction and that a short segment of Barrett’s epithelium existed near the tumor. Biopsies of the tumor showed moderately to poorly differentiated adenocarcinoma. Mild reflux esophagitis and minor hiatal hernia was also observed, and the previously treated gastric ulcer was not recurrent. Absence of H. pylori was confirmed by serum antibody and urea breath test. Surgical resection of the lower esophagus and proximal stomach was performed. The tumor invaded into the muscularis propria of the esophageal wall but had no evidence of lymph node metastasis. Based on macroscopic and pathological findings, the tumor was recognized as esophageal adenocarcinoma. Previous endoscopic examination did not detect any apparent signs of tumor in the esophagogastric junction. As far as we know, this is the first report documenting a newly developed esophageal adenocarcinoma after the successful eradication of H. pylori.

  14. Rituximab for eradicating inhibitors in people with acquired haemophilia A.

    Science.gov (United States)

    Zeng, Yan; Zhou, Ruiqing; Duan, Xin; Long, Dan

    2016-07-08

    Acquired haemophilia A is a rare bleeding disorder caused by the development of specific autoantibodies against coagulation factor VIII. Rituximab may be an alternative approach to the treatment of acquired haemophilia by eradicating FVIII autoantibodies. To assess and summarise the efficacy and adverse effects of rituximab for treating people with acquired haemophilia A. We searched the Cochrane Cystic Fibrosis and Genetic Disorders Group's trials registers, comprising references identified from comprehensive electronic database searches and handsearches of relevant journals and conference proceedings.Date of last search of the Cochrane Cystic Fibrosis and Genetic Disorders Group's trials registers: 01 March 2016. Randomised and quasi-randomised controlled trials of rituximab for people with acquired hemophilia A, with no restrictions on gender, age or ethnicity. No trials matching the selection criteria were eligible for inclusion. No trials matching the selection criteria were eligible for inclusion. No randomised clinical trials of rituximab for acquired hemophilia A were found. Thus, based on the highest quality of evidence, we are not able to draw any conclusions or make any recommendations on rituximab for eradicating inhibitors in people with acquired haemophilia A. Given that undertaking randomised controlled trials in this field is a complex task, the authors suggest that, while planning such trials, clinicians treating the disease continue to base their choices on alternative, lower quality sources of evidence. The authors plan, for a future update of this review, to appraise and incorporate any randomised controlled trials, as well as other high-quality non-randomised studies.

  15. Polymer-Immobilized Photosensitizers for Continuous Eradication of Bacteria

    Directory of Open Access Journals (Sweden)

    Anton Valkov

    2014-08-01

    Full Text Available The photosensitizers Rose Bengal (RB and methylene blue (MB, when immobilized in polystyrene, were found to exhibit high antibacterial activity in a continuous regime. The photosensitizers were immobilized by dissolution in chloroform, together with polystyrene, with further evaporation of the solvent, yielding thin polymeric films. Shallow reservoirs, bottom-covered with these films, were used for constructing continuous-flow photoreactors for the eradication of Gram-positive Staphylococcus aureus, Gram-negative Escherichia coli and wastewater bacteria under illumination with visible white light using a luminescent lamp at a 1.8 mW·cm−2 fluence rate. The bacterial concentration decreased by two to five orders of magnitude in separate reactors with either immobilized RB or MB, as well as in three reactors connected in series, which contained one of the photosensitizers. Bacterial eradication reached more than five orders of magnitude in two reactors connected in series, where the first reactor contained immobilized RB and the second contained immobilized MB.

  16. The palm weevil Rhynchophorus vulneratus is eradicated from Laguna Beach

    Directory of Open Access Journals (Sweden)

    Mark S. Hoddle

    2016-09-01

    Full Text Available In October 2010, Rhynchophorus vulneratus, originally identified as the red palm weevil, R. ferrugineus, was discovered infesting Canary Island date palms in Laguna Beach, California. The red palm weevil has caused extensive mortality of palms in the Mediterranean, the Middle East and North Africa, and its discovery in California caused concern for the state's ornamental palm and date industries and the many palms in Southern California landscapes. A rapid, coordinated effort led to the deployment of traps baited with the weevil's aggregation pheromone, coordinated pesticide applications to privately owned palms and destruction of palms at advanced stages of infestation. Research confirmed the chemical components of the aggregation pheromone, assessed the efficacy of trapping strategies and resolved the taxonomic identity, native range and putative region of origin for the population detected in Laguna Beach. The last confirmed detection of a live R. vulneratus was Jan. 20, 2012. USDA-APHIS declared this weevil eradicated from California on Jan. 20, 2015. The estimated cost of the eradication was $1,003,646.

  17. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    DEFF Research Database (Denmark)

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure of eradicat......To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure...

  18. Integrated human rights and poverty eradication strategy: the case of civil registration rights in Zimbabwe.

    Science.gov (United States)

    Musarandega, Reuben

    2009-01-01

    High poverty levels characterise sub-Saharan Africa, Zimbabwe included. Over 80 per cent of Zimbabwe's population lived below the total consumption poverty line and 70 per cent below the food poverty line in 2003. This plummeting of social indicators resulted from the freefall suffered by the country's economy from the 1990s, after unsuccessful attempts to implement structural adjustment programmes prescribed by international financial institutions. The ensuing socioeconomic decay, political crisis and international isolation of the country from the late 1990s reversed gains made in social indicators during the 1980s. Development theories attribute poverty to unchecked population growth, political, economic and environmental mismanagement, while developing countries' leaders attribute it to historical imbalances and global political and economic injustices. Despite this debate, poverty continues to evolve, expand and deepen and the need to eradicate it has become urgent. The complex question of what causes and what drives poverty is perpetually addressed and new ideas are emerging to answer the question. One recent view is that failure to centre development on people and to declare poverty a violation of human rights has allowed poverty to grow the world over. This study uses a hypothesised cause of poverty - civil registration - to exemplify the human right nature of poverty, and how a human rights' policy can be used as an instrument to eradicate poverty. The study demonstrates that civil registration is a right of instrumental relevance to poverty; and achieving civil registration grants people access to numerous other rights, some of which will lift them out of poverty, while the failure of civil registration deprives people of access to livelihoods, thereby entrenching them in poverty.

  19. Comparative analysis of measures of viral reservoirs in HIV-1 eradication studies.

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    Susanne Eriksson

    2013-02-01

    Full Text Available HIV-1 reservoirs preclude virus eradication in patients receiving highly active antiretroviral therapy (HAART. The best characterized reservoir is a small, difficult-to-quantify pool of resting memory CD4(+ T cells carrying latent but replication-competent viral genomes. Because strategies targeting this latent reservoir are now being tested in clinical trials, well-validated high-throughput assays that quantify this reservoir are urgently needed. Here we compare eleven different approaches for quantitating persistent HIV-1 in 30 patients on HAART, using the original viral outgrowth assay for resting CD4(+ T cells carrying inducible, replication-competent viral genomes as a standard for comparison. PCR-based assays for cells containing HIV-1 DNA gave infected cell frequencies at least 2 logs higher than the viral outgrowth assay, even in subjects who started HAART during acute/early infection. This difference may reflect defective viral genomes. The ratio of infected cell frequencies determined by viral outgrowth and PCR-based assays varied dramatically between patients. Although strong correlations with the viral outgrowth assay could not be formally excluded for most assays, correlations achieved statistical significance only for integrated HIV-1 DNA in peripheral blood mononuclear cells and HIV-1 RNA/DNA ratio in rectal CD4(+ T cells. Residual viremia was below the limit of detection in many subjects and did not correlate with the viral outgrowth assays. The dramatic differences in infected cell frequencies and the lack of a precise correlation between culture and PCR-based assays raise the possibility that the successful clearance of latently infected cells may be masked by a larger and variable pool of cells with defective proviruses. These defective proviruses are detected by PCR but may not be affected by reactivation strategies and may not require eradication to accomplish an effective cure. A molecular understanding of the discrepancy

  20. Sequential versus standard triple first-line therapy for Helicobacter pylori eradication.

    Science.gov (United States)

    Nyssen, Olga P; McNicholl, Adrian G; Megraud, Francis; Savarino, Vincenzo; Oderda, Giuseppina; Fallone, Carlo A; Fischbach, Lori; Bazzoli, Franco; Gisbert, Javier P

    2016-06-28

    also unreported.However, subgroup analyses as well as sensitivity analyses or funnel plots indicated that treatment outcomes were not influenced by the quality of the included studies. On the other hand, we rated 'length of STT' and AEs for the main outcome as high-quality according to GRADE classification; but we downgraded 'publication date' quality to moderate, and 'geographic region' and 'antibiotic resistance' to low- and very low-quality, respectively. Our meta-analysis indicates that prior to 2008 SEQ was more effective than STT, especially when STT was given for only seven days. Nevertheless, the apparent advantage of sequential treatment has decreased over time, and more recent studies do not show SEQ to have a higher efficacy versus STT when STT is given for 10 days.Based on the results of this meta-analysis, although SEQ offers an advantage when compared with STT, it cannot be presented as a valid alternative, given that neither SEQ nor STT regimens achieved optimal efficacy ( ≥ 90% eradication rate).

  1. Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning.

    Science.gov (United States)

    Garip, Yesim; Eser, Filiz; Bodur, Hatice; Baskan, Bedriye; Sivas, Filiz; Yilmaz, Ozlem

    To determine the impact of postpolio-syndrome on quality of life in polio survivors. Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. Total manual muscle testing score was 26.19±13.24 (median: 29) in postpolio-syndrome group and 30.08±8.9 (median: 32) in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  2. Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning

    Directory of Open Access Journals (Sweden)

    Yesim Garip

    Full Text Available ABSTRACT Objective: To determine the impact of postpolio-syndrome on quality of life in polio survivors. Methods: Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. Results: Total manual muscle testing score was 26.19 ± 13.24 (median: 29 in postpolio-syndrome group and 30.08 ± 8.9 (median: 32 in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. Conclusions: Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life.

  3. [Health related quality of life in Turkish polio survivors: impact of post-polio on the health related quality of life in terms of functional status, severity of pain, fatigue, and social, and emotional functioning].

    Science.gov (United States)

    Garip, Yesim; Eser, Filiz; Bodur, Hatice; Baskan, Bedriye; Sivas, Filiz; Yilmaz, Ozlem

    2015-02-07

    To determine the impact of postpolio-syndrome on quality of life in polio survivors. Forty polio survivors were included in the study. Twenty-one patients fulfilling the Halstead's postpolio-syndrome criteria participated in postpolio-syndrome group. The remaining nineteen patients formed non-postpolio-syndrome group. Control group was composed of forty healthy subjects. Quality of life was evaluated by Nottingham Health Profile, depression by Beck Depression Scale and fatigue by Fatigue Symptom Inventory. Isometric muscle strength was measured by manual muscle testing. Total manual muscle testing score was 26.19±13.24 (median: 29) in postpolio-syndrome group and 30.08±8.9 (median: 32) in non-postpolio-syndrome group. Total manual muscle testing scores of non-postpolio-syndrome group were significantly higher than that of postpolio-syndrome group. Patients with postpolio-syndrome reported significantly higher levels of fatigue and reduced quality of life in terms of physical mobility, pain and energy when compared with patients without postpolio-syndrome and control group. It was not reported a statistically significant difference in social and emotional functioning and sleep quality between postpolio-syndrome, non-postpolio-syndrome and control groups. Also it was not found any statistically significant difference in Beck Depression Scale scores among the groups. Postpolio-syndrome has a negative impact on quality of life in terms of functional status, severity of pain and energy. The identification, early recognition and rehabilitation of postpolio-syndrome patients may result in an improvement in their quality of life. Copyright © 2015 Elsevier Editora Ltda. All rights reserved.

  4. Changes in Metabolic Hormones in Malaysian Young Adults following Helicobacter pylori Eradication.

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    Theresa Wan-Chen Yap

    Full Text Available More than half of the world's adults carry Helicobacter pylori. The eradication of H. pylori may affect the regulation of human metabolic hormones. The aim of this study was to evaluate the effect of H. pylori eradication on meal-associated changes in appetite-controlled insulinotropic and digestive hormones, and to assess post-eradication changes in body mass index as part of a currently on-going multicentre ESSAY (Eradication Study in Stable Adults/Youths study.We enrolled 29 H. pylori-positive young adult (18-30 year-old volunteer subjects to evaluate the effect of H. pylori eradication on meal-associated changes on eight gastrointestinal hormones, using a multiplex bead assay. Changes in body mass index and anthropometric measurements were recorded, pre- and post-eradication therapy.Pre-prandial active amylin, total peptide YY (PYY and pancreatic polypeptide (PP levels were significantly elevated 12 months post-eradication compared with baseline (n = 18; Wilcoxon's signed rank test, p<0.05. Four of the post-prandial gut metabolic hormones levels (GLP-1, total PYY, active amylin, PP were significantly higher 12 months post-eradication compared to baseline (n = 18; p<0.05. Following H. pylori eradication, the BMI and anthropometric values did not significantly change.Our study indicates that H. pylori eradication was associated with long-term disturbance in three hormones (active amylin, PP and total PYY both pre- and post-prandially and one hormone (GLP-1 post-prandially. Longer post-eradication monitoring is needed to investigate the long-term impact of the observed hormonal changes on metabolic homeostasis.

  5. Flexion Osteotomy in Genu Recurvatum Following Post-Polio Syndrome: Use of an Old Technique in a New Condition

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    Abolfazle Bagherifard

    2017-05-01

    Full Text Available Introduction Post-polio syndrome (PPS can have devastating functional effects on the walking ability of patients decades after the acute disease. Genu recurvatum, as a consequence of PPS, is one such disability which can be treated through different measures. Case Presentation A 43-year-old woman with a history of supracondylar extension osteotomy of the left femur at the age of 22 was admitted to our hospital for a flexion contracture of the left knee due to poliomyelitis. She was able to walk without assistance for 20 years after the osteotomy until one year ago, when she started to experience progressive genu recurvatum. In the clinical and laboratory workup, she was diagnosed with PPS. Accordingly, we decided to perform supracondylar flexion osteotomy. Conclusions Supracondylar flexion osteotomy in patients with genu recurvatum, as a consequence of PPS, is a valuable treatment, which can relieve the patients' dependence on walking aids and improve their symptoms.

  6. The Introduction of Diphtheria-Tetanus-Pertussis and Oral Polio Vaccine Among Young Infants in an Urban African Community

    DEFF Research Database (Denmark)

    Mogensen, Søren Wengel; Andersen, Andreas; Rodrigues, Amabelia

    2017-01-01

    Background We examined the introduction of diphtheria-tetanus-pertussis (DTP) and oral polio vaccine (OPV) in an urban community in Guinea-Bissau in the early 1980s. Methods The child population had been followed with 3-monthly nutritional weighing sessions since 1978. From June 1981 DTP and OPV...... were offered from 3 months of age at these sessions. Due to the 3-monthly intervals between sessions, the children were allocated by birthday in a ‘natural experiment’ to receive vaccinations early or late between 3 and 5 months of age. We included children who were vaccinations...... started and children born until the end of December 1983. We compared mortality between 3 and 5 months of age of DTP-vaccinated and not-yet-DTP-vaccinated children in Cox proportional hazard models. Results Among 3–5-month-old children, having received DTP (± OPV) was associated with a mortality hazard...

  7. The World Health Organization and global smallpox eradication.

    Science.gov (United States)

    Bhattacharya, S

    2008-10-01

    This article examines the multifaceted structures and complex operations of the World Health Organization and its regional offices; it also reassesses the form and the workings of the global smallpox eradication programme with which these bodies were closely linked in the 1960s and 1970s. Using the case study of South Asia, it seeks to highlight the importance of writing nuanced histories of international health campaigns through an assessment of differences between official rhetoric and practice. The article argues that the detailed examination of the implementation of policy in a variety of localities, within and across national borders, allows us to recognise the importance of the agency of field managers and workers. This analytical approach also helps us acknowledge that communities were able to influence the shape and the timing of completion of public health campaigns in myriad ways. This, in turn, can provide useful pointers for the design and management of health programmes in the contemporary world.

  8. Evaluation of national leprosy eradication programme in Satara District, Maharashtra.

    Science.gov (United States)

    Mohite, R V; Durgawale, P M

    2011-01-01

    The aim of this study was to evaluate the impact of national leprosy eradication programme (NLEP) in Satara District. A retrospective record based study was conducted in the district leprosy control unit with evaluation indicators like prevalence rate (PR), new case detection rate (NCDR), percentage of cases released from treatment, proportion of female cases among new cases, proportion of multi bacillary (MB) cases among new cases, proportion of grade-2 disability among new cases and proportion of child cases among new cases and trend was analyzed for statistical significance by using Chi-square test. During study period from year March 2003-04 to March 2007-08, there was decrease in PR of leprosy from 2.46/10000 population to 0.62/10000 population, NCDR decreased from 3.46/10000 population to 0.77/10000 population and trend was statistically significant (pSatara District, Maharashtra.

  9. Can hepatitis C be eradicated in the United States?

    Science.gov (United States)

    Edlin, Brian R; Winkelstein, Emily R

    2014-10-01

    The advent of highly effective antiviral regimens will make the eradication of hepatitis C in high-income countries such as the United States technically feasible. But eradicating hepatitis C will require escalating our response to the epidemic in key domains, including surveillance and epidemiology, prevention, screening, care and treatment, policy, research, and advocacy. Surveillance must be nimble enough to quickly assess the magnitude of new transmission patterns as they emerge. Basic prevention strategies - community-based outreach and education, testing and counseling, and access to sterile injection equipment and opioid substitution therapies - must be scaled up and adapted to target groups in which new epidemics are emerging. All adults should be screened for hepatitis C, but special efforts must focus on groups with increased prevalence through community outreach and rapid testing. Government, industry, and payers must work together to assure full access to health services and antiviral drugs for everyone who is infected. Access to the new regimens must not be compromised by excessively high prices or arbitrary payer restrictions. Partnerships must be forged between hepatitis providers and programs that serve people who inject illicit drugs. Healthcare providers and systems, especially primary care practitioners, need education and training in treating hepatitis C and caring for substance-using populations. Services must be provided to the disadvantaged and stigmatized members of society who bear a disproportionate burden of the epidemic. Environments must be created where people who use drugs can receive prevention and treatment services without shame or stigma. Action is needed to end the policy of mass incarceration of people who use drugs, reduce the stigma associated with substance use, support the human rights of people who use drugs, expand social safety net services for the poor and the homeless, remove the legal barriers to hepatitis C prevention

  10. Eradication of Blastocystis in humans: Really necessary for all?

    Science.gov (United States)

    Kurt, Özgür; Doğruman Al, Funda; Tanyüksel, Mehmet

    2016-12-01

    Blastocystis (initially named as Blastocystis hominis) has long been known as a protist without any clinical significance. However, there is now a huge pile of case reports where Blastocystis is blamed for the symptoms and the infection described in the patients. Introduction of the presence of as many as 17 Blastocystis subtypes while many infected individuals are non-symptomatic initially brought about the correlation between the subtypes and pathogenicity; however, the outcomes of these trials were not consistent and did not explain its pathogenicity. Today, it is mostly acknowledged that Blastocystis may colonize many individuals but the infection's onset depends on the interaction between the virulence of parasites and host's immune competence. Eradication of Blastocystis is essential in some cases where it is the only infectious agent and patient is suffering from some symptoms. In such cases, metronidazole is the drug of choice but its efficacy is relatively low in some cases. Other agents used include trimethoprim-sulfamethoxazole, paromomycin, and furazolidone. Recent studies on the interactions between human health and the role of gut microbiota introduces new data which may significantly change our point of view against some protists, which we tend to see as "parasites requiring urgent eradication for cure". May the presence or absence of some Blastocystis subtypes necessary for human health, or is the absence or presence of certain Blastocystis subtypes in human gut is associated with certain diseases/infections? The answers of these questions will surely guide us to select patients requiring treatment against Blastocystis infection in future. Copyright © 2016. Published by Elsevier Ireland Ltd.

  11. Legal Policy Of Corruption Eradication At State-Owned Enterprises Sector In Indonesia

    Directory of Open Access Journals (Sweden)

    Zulkipli

    2015-08-01

    Full Text Available A mandate of the constitution of the Republic of Indonesia as the highest law is the creation of Indonesia people that is just and prosperous and then the development in all sectors becomes a necessity for achieving that goal. To achieve continuity and development success the enforcement of law supremacy in the form of prevention and eradication of corruption is a necessary condition condition sine qua non. Type of legal research conducted is normative. This research was carried out by discussion of concepts doctrine and theory principles as well as legislation which is correlated to the philosophical construction on state finances. The results of the research indicated that law enforcement of corruption against the management of limited state-owned enterprises during this that damage SEOs state is one of the important parts in the form of control the management of SOEs whose responsible and integrity. Though on the other hand the debate over the use of the criminal instruments in resolving the problems that occurred in the transaction of SOEs state that damage will continue to occur but against the actor of state-owned companies still put forward the principle of prudence in running the business because in some judicial practice has been expandingconstructing carelessness be a part of unlawful action in corruption crime.

  12. National Immunization Campaigns with Oral Polio Vaccine Reduce All-Cause Mortality: A Natural Experiment within Seven Randomized Trials

    Directory of Open Access Journals (Sweden)

    Andreas Andersen

    2018-02-01

    Full Text Available BackgroundA recent WHO review concluded that live BCG and measles vaccine (MV may have beneficial non-specific effects (NSEs reducing mortality from non-targeted diseases. NSEs of oral polio vaccine (OPV were not examined. If OPV vaccination campaigns reduce the mortality rate, it would suggest beneficial NSEs.SettingBetween 2002 and 2014, Guinea-Bissau had 15 general OPV campaigns and other campaigns with OPV plus vitamin A supplementation (VAS, VAS-only, MV, and H1N1 vaccine. In this period, we conducted seven randomized controlled trials (RCTs with mortality as main outcome.MethodsWithin these RCTs, we assessed whether the mortality rate was lower after-campaign than before-campaign. We used Cox models with age as underlying time and further adjusted for low birth-weight, season and time trend in mortality. We calculated the adjusted mortality rate ratio (MRR for after-campaign vs before-campaign.ResultsThe mortality rate was lower after OPV-only campaigns than before, the MRR being 0.81 (95% CI = 0.68–0.95. With each additional dose of campaign-OPV the mortality rate declined further (MRR = 0.87 (95% CI: 0.79–0.96 per dose (test for trend, p = 0.005. No other type of campaign had similar beneficial effects. Depending on initial age and with follow-up to 3 years of age, the number needed to treat with campaign-OPV-only to save one life was between 68 and 230 children.ConclusionBissau had no case of polio infection so the results suggest that campaign-OPV has beneficial NSEs. Discontinuation of OPV-campaigns in low-income countries may affect general child mortality levels negatively.

  13. The Effects of Synbiotic “Bifidobacterium lactis B94 plus Inulin” Addition on Standard Triple Therapy of Helicobacter pylori Eradication in Children

    Science.gov (United States)

    Altuntas, Halime; Soysal, Yasemin Dilek; Kokturk, Furuzan

    2017-01-01

    Aim The aim of this study is to evaluate the effects of the synbiotic Bifidobacterium lactis B94 plus inulin addition to the standard triple therapy on Helicobacter pylori (H. pylori) infection eradication rates. Methods Children aged 6–16 years who had biopsy proven H. pylori infection were randomly classified into two groups. The first group received the standard triple therapy consisting of amoxicillin + clarithromycin + omeprazole. The second group was treated with the standard triple therapy and Bifidobacterium lactis B94 (5 × 109 CFU/dose) plus inulin (900 mg) for 14 days, concurrently. Eradication was determined by 14C-urea breath test 4–6 weeks after therapy discontinuation. Results From a total of 69 H. pylori infected children (F/M = 36/33; mean ± SD = 11.2 ± 3.0 years), eradication was achieved in 20/34 participants in the standard therapy group and 27/35 participants in the synbiotic group. The eradication rates were not significantly different between the standard therapy and the synbiotic groups [intent-to-treat, 58.8% and 77.1%, resp., p = 0.16; per-protocol, 64.5% and 81.8%, resp., p = 0.19]. There was no difference between the groups in terms of symptom relief (p = 0.193). The reported side effects were ignorable. Conclusion Considering the eradication rates, synbiotic addition to therapy showed no superiority over the standard triple therapy conducted alone. This trial is registered with NCT03165253. PMID:28656129

  14. Eradication of Phytophthora ramorum from Oregon forests: status after 6 years

    Science.gov (United States)

    Alan Kanaskie; Ellen Goheen; Nancy Osterbauer; Mike McWilliams; Everett Hansen; Wendy Sutton

    2008-01-01

    Sudden oak death (SOD), caused by Phytophthora ramorum, was first discovered in Oregon forests in July 2001. Since then an interagency team has been working with landowners to eradicate the pathogen by cutting and burning all infected and nearby host plants. During the first two years of the eradication effort, all host vegetation within 15 to 30 m...

  15. Importance of post-treatment follow-up to secure sufficient eradication therapy for Helicobacter pylori

    DEFF Research Database (Denmark)

    Roug, Stine; Madsen, Lone Galmstrup

    2012-01-01

    To optimize the care for Helicobacter pylori-associated diseases, we wanted to evaluate the completeness of follow-up after H. pylori eradication therapy in a single Danish endoscopy unit. Furthermore, the eradication rates and possible clinical characteristics associated with failure...

  16. A safety rule approach to surveillance and eradication of biological invasions

    Science.gov (United States)

    Denys Yemshanov; Robert G. Haight; Frank H. Koch; Robert Venette; Kala Studens; Ronald E. Fournier; Tom Swystun; Jean J. Turgeon; Yulin Gao

    2017-01-01

    Uncertainty about future spread of invasive organisms hinders planning of effective response measures. We present a two-stage scenario optimization model that accounts for uncertainty about the spread of an invader, and determines survey and eradication strategies that minimize the expected program cost subject to a safety rule for eradication success. The safety rule...

  17. Eradication of Helicobacter pylori Is Associated with the Progression of Dementia: A Population-Based Study

    Directory of Open Access Journals (Sweden)

    Yang-Pei Chang

    2013-01-01

    Full Text Available Objective. To evaluate the effect of eradication of Helicobacter pylori (H. pylori on the progression of dementia in Alzheimer’s disease (AD patients with peptic ulcer. Methods. Participants with the diagnosis of AD and peptic ulcer were recruited between 2001 and 2008. We examined the association between eradication of H. pylori and the progression of AD using the multiple regression models. Medication shift from Donepezil, Rivastgmine, and Galantamine to Mematine is defined as progression of dementia according to the insurance of National Health Insurance (NHI under expert review. Results. Among the 30142 AD patients with peptic ulcers, the ratio of medication shift in AD patients with peptic ulcers is 79.95%. There were significant lower incidence comorbidities (diabetes mellitus, hypertension, cerebrovascular disease, coronary artery disease, congestive heart failure and hyperlipidemia in patients with H. pylori eradication as compared with no H. pylori eradication. Eradication of H. pylori was associated with a decreased risk of AD progression (odds ratio [OR] 0.35 [0.23–0.52] as compared with no H. pylori eradication, which was not modified by comorbidities. Conclusions. Eradication of H. pylori was associated with a decreased progression of dementia as compared to no eradication of H. pylori in AD patients with peptic ulcers.

  18. Farmer and Veterinarian Attitudes towards the Bovine Tuberculosis Eradication Programme in Spain: What Is Going on in the Field?

    Science.gov (United States)

    Ciaravino, Giovanna; Ibarra, Patricia; Casal, Ester; Lopez, Sergi; Espluga, Josep; Casal, Jordi; Napp, Sebastian; Allepuz, Alberto

    2017-01-01

    The effectiveness of health interventions against bovine tuberculosis (bTB) is influenced by several “non-biological” factors that may hamper bTB detection and control. Although the engagement of stakeholders is a key factor for the eradication programme’s success, social factors have been often ignored in the control programmes of animal diseases, especially in developed countries. In this study, we used a qualitative approach to investigate perceptions, opinions, attitudes, and beliefs of farmers, and veterinarians who may influence the effectiveness of the Spanish bTB eradication programme. The study was carried out in two phases. First, 13 key representatives of different groups involved in the programme were interviewed through exploratory interviews to identify most relevant themes circulating in the population. Interviews focused on strong and weak points of the programme; reasons for failure to achieve eradication; benefits of being disease free; future perspectives, and proposed changes to the programme. Based on these results, a thematic guide was developed and detailed information was gained through face-to-face in-depth interviews conducted on a purposive sample of 39 farmers and veterinarians. Data were analysed following an ethnographic methodology. Main results suggested that the bTB programme is perceived as a law enforcement duty without an adequate motivation of some stakeholders and a general feeling of distrust arose. The complexity of bTB epidemiology combined with gaps in knowledge and weak communication throughout stakeholders contributed to causing disbeliefs, which in turn generated different kinds of guesses and interpretations. Low reliability in the routine skin test for bTB screening was expressed and the level of confidence on test results interpretation was linked with skills and experience of public and private veterinarians in the field. Lack of training for farmers and pressure faced by veterinarians during field activities

  19. Farmer and Veterinarian Attitudes towards the Bovine Tuberculosis Eradication Programme in Spain: What Is Going on in the Field?

    Directory of Open Access Journals (Sweden)

    Giovanna Ciaravino

    2017-11-01

    Full Text Available The effectiveness of health interventions against bovine tuberculosis (bTB is influenced by several “non-biological” factors that may hamper bTB detection and control. Although the engagement of stakeholders is a key factor for the eradication programme’s success, social factors have been often ignored in the control programmes of animal diseases, especially in developed countries. In this study, we used a qualitative approach to investigate perceptions, opinions, attitudes, and beliefs of farmers, and veterinarians who may influence the effectiveness of the Spanish bTB eradication programme. The study was carried out in two phases. First, 13 key representatives of different groups involved in the programme were interviewed through exploratory interviews to identify most relevant themes circulating in the population. Interviews focused on strong and weak points of the programme; reasons for failure to achieve eradication; benefits of being disease free; future perspectives, and proposed changes to the programme. Based on these results, a thematic guide was developed and detailed information was gained through face-to-face in-depth interviews conducted on a purposive sample of 39 farmers and veterinarians. Data were analysed following an ethnographic methodology. Main results suggested that the bTB programme is perceived as a law enforcement duty without an adequate motivation of some stakeholders and a general feeling of distrust arose. The complexity of bTB epidemiology combined with gaps in knowledge and weak communication throughout stakeholders contributed to causing disbeliefs, which in turn generated different kinds of guesses and interpretations. Low reliability in the routine skin test for bTB screening was expressed and the level of confidence on test results interpretation was linked with skills and experience of public and private veterinarians in the field. Lack of training for farmers and pressure faced by veterinarians during

  20. Early Development of Refl ux Esophagitis after Successful Helicobacter Pylori Eradication in Superfi cial Gastritis

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    H H Jeon

    2011-10-01

    Full Text Available The relationship between gastroesophageal refl ux disease (GERD and Helicobacter pylori (H. pylori eradication is still debated. Recently, we had a patient of GERD who had developed it shortly after H. pylori eradication therapy. A 72-year-old man was diagnosed by endoscopy as suffering from severe superfi cial gastritis in the stomach body. A rapid urease test showed H. pylori infection. He was then started on proton pump inhibitor (PPI based therapy for two weeks eradicating H.pylori. After completion of H. pylori eradication, he complained of a heart-burn sensation. Follow-up endoscopy showed refl ux esophagitis, of grade B according to the Los Angeles classifi cation. Since the patient had developed GERD after completion of the triple therapy, their suggests that H. pylori eradication must have triggered the development of de novo GERD after a short period of time. Keywords: GERD, Helicobacter pylori, PPI.

  1. Efficacy and safety of Helicobacter pylori eradication therapy immediately after endoscopic submucosal dissection.

    Science.gov (United States)

    Takahashi, Yoshiaki; Takeuchi, Toshihisa; Kojima, Yuichi; Nagami, Yasuaki; Ominami, Masaki; Uedo, Noriya; Hamada, Kenta; Suzuki, Haruhisa; Oda, Ichiro; Miyaoka, Youichi; Yamanouchi, Satoshi; Tokioka, Satoshi; Tomatsuri, Naoya; Yoshida, Norimasa; Naito, Yuji; Nonaka, Takashi; Kodashima, Shinya; Ogata, Shinichi; Hongo, Yasushi; Oshima, Tadayuki; Li, Zhaoliang; Shibagaki, Kotaro; Oikawa, Tomoyuki; Tominaga, Kazunari; Higuchi, Kazuhide

    2017-12-19

    In the treatment of patients after endoscopic submucosal dissection (ESD), there is no consensus on the optimum time to start Helicobacter pylori (H. pylori) eradication therapy or on whether eradication therapy improves ulcer healing rate after ESD. The aim of this study was to examine the effect of immediate eradication of H. pylori on ulcer healing after ESD in patients with early gastric neoplasms. A total of 330 patients who underwent ESD for early gastric neoplasms were enrolled. Patients were assigned to either H. pylori eradication group (Group A: H. pylori eradication + proton pump inhibitor 7 weeks) or non-eradication group (Group B: proton pump inhibitor 8 weeks). The primary endpoint was gastric ulcer healing rate (Group A vs Group B) determined on Week 8 after ESD. Patients in Group A failed to meet non-inferiority criteria for ulcer scarring rate after ESD compared with that in Group B (83.0% vs 86.5%, p for non-inferiority=0.0599, 95% CI: -11.7% to 4.7%). There were, however, neither large differences between the two groups in the ulcer scarring rate nor the safety profile. This study failed to demonstrate the non-inferiority of immediate H. pylori eradication therapy after ESD to the non-eradication therapy in the healing rate of ESD-caused ulcers. However, since the failure is likely to attributable to small number of patients enrolled, immediate eradication therapy may be a treatment option for patients after ESD without adverse effects on eradication therapy in comparison with the standard therapy. This article is protected by copyright. All rights reserved.

  2. Do orally administered antibiotics reach concentrations in the middle ear sufficient to eradicate planktonic and biofilm bacteria? A review.

    Science.gov (United States)

    Belfield, Katherine; Bayston, Roger; Birchall, J P; Daniel, Matija

    2015-03-01

    Infectious conditions of the middle ear are a common and significant cause of morbidity and mortality worldwide. Systemic antibiotics are frequently used, but their effectiveness will depend on whether an adequate antibiotic concentration is achieved in the middle ear; this is especially important in biofilm infections such as otitis media with effusion (OME), where high antibiotic concentrations are typically required for effective treatment. This review examines what antibiotic levels can be reached in the middle ear with oral administration, as a means of guiding rational antibiotic choice in the clinic and future research, and to determine whether levels high enough for biofilm eradication are reached. A literature search of studies measuring levels of antibiotics in the plasma and in the middle ear after oral administration was conducted. These levels were compared to the minimum inhibitory concentrations (MIC) provided by the European Committee for Antimicrobial Susceptibility Testing (EUCAST) to determine if antibiotic doses were reaching sufficient levels to inhibit planktonic bacteria. The middle ear concentrations were then calculated as a multiple of the MIC to determine if the concentrations were reaching biofilm eradication concentrations (typically up to 1000×MIC). The highest antibiotic levels against Staphylococcus aureus reach 8.3×MIC, against Moraxella catarrhalis 33.2×MIC, against Haemophilus influenzae 31.2×MIC, and against Streptococcus pneumoniae 46.2×MIC. The macrolide antibiotics reach higher levels in the middle ear than in plasma. Orally administered antibiotics reach levels above the MIC in the middle ear. However, they do not reach levels that would be likely to eradicate biofilms. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  3. The effect of prophylaxis with chloroquine and proguanil on delayed-type hypersensitivity and antibody production following vaccination with diphtheria, tetanus, polio, and pneumococcal vaccines

    DEFF Research Database (Denmark)

    Gyhrs, A; Pedersen, B K; Bygbjerg, I

    1991-01-01

    (1,000 mg/week), or 4) proguanil hydrochloride (200 mg/day) for six weeks. Skin testing was performed on days 0 and 28. Vaccinations with diphtheria, tetanus, polio, and pneumococcal polysaccharide antigen vaccines were performed on day 28, and the presence of specific antibodies was determined...... dosages, does not induce any detectable suppression of delayed-type hypersensitivity or vaccination responses to diphtheria, tetanus, polio, or pneumococcal polysaccharide antigens....... with seven delayed-type common antigens (Multitest) and 2) humoral immunity by measurement of specific antibody response to vaccination. Sixty healthy young individuals were randomized into four groups and given 1) no treatment (controls), 2) chloroquine diphosphate (500 mg/week), 3) chloroquine diphosphate...

  4. Stable isotope analysis as an early monitoring tool for community-scale effects of rat eradication

    Science.gov (United States)

    Nigro, Katherine M.; Hathaway, Stacie A.; Wegmann, Alex; Miller-ter Kuile, Ana; Fisher, Robert N.; Young, Hillary S.

    2017-01-01

    Invasive rats have colonized most of the islands of the world, resulting in strong negative impacts on native biodiversity and on ecosystem functions. As prolific omnivores, invasive rats can cause local extirpation of a wide range of native species, with cascading consequences that can reshape communities and ecosystems. Eradication of rats on islands is now becoming a widespread approach to restore ecosystems, and many native island species show strong numerical responses to rat eradication. However, the effect of rat eradication on other consumers can extend beyond direct numerical effects, to changes in behavior, dietary composition, and other ecological parameters. These behavioral and trophic effects may have strong cascading impacts on the ecology of restored ecosystems, but they have rarely been examined. In this study, we explore how rat eradication has affected the trophic ecology of native land crab communities. Using stable isotope analysis of rats and crabs, we demonstrate that the diet or trophic position of most crabs changed subsequent to rat eradication. Combined with the numerical recovery of two carnivorous land crab species (Geograpsus spp.), this led to a dramatic widening of the crab trophic niche following rat eradication. Given the established importance of land crabs in structuring island communities, particularly plants, this suggests an unappreciated mechanism by which rat eradication may alter island ecology. This study also demonstrates the potential for stable isotope analysis as a complementary monitoring tool to traditional techniques, with the potential to provide more nuanced assessments of the community- and ecosystem-wide effects of restoration.

  5. Effect of Helicobacter pylori eradication on the regression of gastric polyps in National Cancer Screening Program.

    Science.gov (United States)

    Nam, Su Youn; Park, Bum Joon; Ryu, Kum Hei; Nam, Ji Hyung

    2017-12-14

    Western guidelines recommend Helicobacter pylori eradication in H. pylori-associated gastric polyps; however, there is no standard guideline in Korea. The aim of this study is to assess the effect of H. pylori eradication on the regression of gastric hyperplastic polyps in National Cancer Screening Cohort, representative of general population. Among participants in National Cancer Screening Program, subjects who had H. pylori positive gastric hyperplastic polyps less than 10 mm and underwent follow-up endoscopy and H. pylori testing were enrolled. The effect of H. pylori eradication on hyperplastic gastric polyps was estimated using odds ratios (ORs) and 95% confidence intervals (CIs). A total of 183 H. pylori infected subjects with hyperplastic polyp at baseline underwent follow-up endoscopy and H. pylori test after mean of 2.2 years. Successful H. pylori eradication markedly induced the disappearance of hyperplastic polyps comparing to non-eradication group (83.7% vs. 34.1%, p = 0.001). Successful eradication increased the possibility of disappearance of hyperplastic polyps (adjusted OR, 5.56; 95% CI, 2.63 to 11.11). Polyp size was inversely related with the disappearance of hyperplastic polyps (adjusted OR, 59; 95% CI, 0.48 to 0.71). Eradication of H. pylori infection may induce disappearance of gastric hyperplastic polyps in National Cancer Screening Cohort.

  6. Diabetes, insulin use and Helicobacter pylori eradication: a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Tseng Chin-Hsiao

    2012-05-01

    Full Text Available Abstract Background Diabetic patients may have a higher risk of gastric cancer. However, whether they have a higher incidence of Helicobacter pylori (HP eradication is not known. Furthermore, whether insulin use in patients with type 2 diabetes may be associated with a higher incidence of HP eradication has not been investigated. Methods This is a retrospective cohort study. The reimbursement databases from 1996 to 2005 of 1 million insurants of the National Health Insurance in Taiwan were retrieved. After excluding those aged Results In 2005, there were 10,051 incident cases receiving HP eradication. HP eradication was significantly increased with age, male sex, diabetes status, insulin use, use of calcium channel blocker, panendoscopic examination, hypertension, dyslipidemia, chronic obstructive pulmonary disease, stroke, nephropathy, ischemic heart disease and peripheral arterial disease. Significant differences were also seen for occupation and living region. Medications including statin, fibrate, angiotensin-converting enzyme inhibitor/angiotensin receptor blocker and oral anti-diabetic agents were not associated with HP eradication. The adjusted odds ratios for diabetes, insulin use and use of calcium channel blocker was 1.133 (1.074, 1.195, 1.414 (1.228, 1.629 and 1.147 (1.074, 1.225, respectively. Conclusions Type 2 diabetes and insulin use in the diabetic patients are significantly associated with a higher incidence of HP eradication. Additionally, use of calcium channel blocker also shows a significant association with HP eradication.

  7. Effect of Helicobacter pylori eradication on metachronous recurrence after endoscopic resection of gastric neoplasm.

    Science.gov (United States)

    Bae, Suh Eun; Jung, Hwoon-Yong; Kang, June; Park, Young Soo; Baek, Seunghee; Jung, Ji-Hoon; Choi, Ji Young; Kim, Mi-Young; Ahn, Ji Yong; Choi, Kwi-Sook; Kim, Do Hoon; Lee, Jeong Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Kim, Jin-Ho

    2014-01-01

    Although many epidemiologic studies have shown that Helicobacter pylori (H. pylori) eradication has prophylactic effects on gastric cancer, their results are less clear in high-risk populations. We conducted this study to examine whether H. pylori eradication would affect the occurrence of metachronous gastric cancer after endoscopic resection in patients with early gastric cancer. We retrospectively analyzed 2,089 adults who underwent endoscopic resection of gastric low-grade neoplasia, high-grade neoplasia, or differentiated invasive neoplasia from 2004 to 2008 at Asan Medical Center. Of these, a total of 1,007 patients with early gastric cancer were enrolled in this study. We evaluated the demographic data, the pathology, and the incidence of metachronous recurrence by dividing them into three groups: those without active H. pylori infection (Hp negative group, n=340), those who successfully underwent H. pylori eradication (eradicated group, n=485), and those who failed or did not undergo H. pylori eradication (noneradicated group, n=182). Metachronous recurrence was diagnosed in 75 patients, including 17 in the Hp, 34 in the eradicated, and 24 in the noneradicated groups. Median time to metachronous recurrence was 18 months (range, 7-75 months). The incidence of metachronous gastric cancer was 10.9 cases per 1,000 person-years in the Hp negative group, 14.7 cases per 1,000 person-years in the eradicated group, and 29.7 cases per 1,000 person-years in the noneradicated group. The hazard ratios in the noneradicated group compared with the Hp negative and eradicated groups were 2.5 (Pneoplasm, which was also shown in the secondary analysis of 1,487 patients with low-grade neoplasia and early gastric cancer. Successful H. pylori eradication may reduce the occurrence of metachronous gastric cancer after endoscopic resection in patients with early gastric cancer.

  8. Progress in control of H5N1 highly pathogenic avian influenza and the future for eradication.

    Science.gov (United States)

    Sims, L D

    2012-12-01

    Three broad factors, occurring concurrently, prevent elimination of highly pathogenic avian influenza caused by viruses of the H5N1 subtype (H5N1 HPAI) in countries and subregions where infection has remained endemic. These factors are the nature of the poultry sector, the quality of veterinary and animal production services (both public and private) serving the poultry industry, and the extent and level of commitment at all levels to virus elimination. Most of these countries have developed and adopted programs for progressive control of H5N1 HPAI, focused on the local factors hindering elimination of the viruses. Based on the rate of implementation of these measures over the last 5 to 7 yr (during which time there has been unprecedented financial and technical support from the international donor community), it is not expected that global eradication of H5N1 HPAI viruses can be achieved within the next 10 yr. If the "classical" approach to control, based around early case detection and culling, were adopted in a zone containing millions of free-running ducks, the work load required to complete even the first round of testing would exceed existing capacity. There would be no guarantees of sustained success locally, especially if the viruses are not eradicated regionally.

  9. Nanomedicines Eradicating Cancer Stem-like Cells in Vivo by pH-Triggered Intracellular Cooperative Action of Loaded Drugs.

    Science.gov (United States)

    Kinoh, Hiroaki; Miura, Yutaka; Chida, Tsukasa; Liu, Xueying; Mizuno, Kazue; Fukushima, Shigeto; Morodomi, Yosuke; Nishiyama, Nobuhiro; Cabral, Horacio; Kataoka, Kazunori

    2016-06-28

    Nanomedicines capable of control over drug functions have potential for developing resilient therapies, even against tumors harboring recalcitrant cancer stem cells (CSCs). By coordinating drug interactions within the confined inner compartment of core-shell nanomedicines, we conceived multicomponent nanomedicines directed to achieve synchronized and synergistic drug cooperation within tumor cells as a strategy for enhancing efficacy, overcoming drug resistance, and eradicating CSCs. The approach was validated by using polymeric micellar nanomedicines co-incorporating the pan-kinase inhibitor staurosporine (STS), which was identified as the most potent CSC inhibitor from a panel of signaling-pathway inhibitors, and the cytotoxic agent epirubicin (Epi), through rationally contriving the affinity between the drugs. The micelles released both drugs simultaneously, triggered by acidic endosomal pH, attaining concurrent intracellular delivery, with STS working as a companion for Epi, down-regulating efflux transporters and resistance mechanisms induced by Epi. These features prompted the nanomedicines to eradicate orthotopic xenografts of Epi-resistant mesothelioma bearing a CSC subpopulation.

  10. Design and evaluation of gastroretentive levofloxacin floating mini-tablets-in-capsule system for eradication of Helicobacter pylori.

    Science.gov (United States)

    El-Zahaby, Sally A; Kassem, Abeer A; El-Kamel, Amal H

    2014-12-01

    Gastroretentive levofloxacin (LVF) floating mini-tablets for the eradication of Helicobacter pylori (H. pylori) were prepared using the matrix forming polymer hydroxypropyl methylcellulose (HPMC K100M), alone or with Carbopol 940P in different ratios by wet granulation technique. Buoyancy of mini-tablets was achieved by an addition of an effervescent mixture consisting of sodium bicarbonate and anhydrous citric acid to some formulations. The prepared mini-tablets were evaluated for weight variation, thickness, friability, hardness, drug content, in vitro buoyancy, water uptake and in vitro release. The optimized formula was subjected to further studies: FT-IR, DSC analysis and in vivo examination in healthy volunteers. The prepared mini-tablets exhibited satisfactory physicochemical characteristics. Incorporation of gas-generating agent improved the floating parameters. HPMC K100M mini-tablet formulation (F1) offered the best controlled drug release (>8 h) along with floating lag time 24 h. The obtained DSC thermograms and FT-IR charts indicated that there is no positive evidence for the interaction between LVF and ingredients of the optimized formula. The in vivo test confirmed the success of the optimized formula F1 in being retained in the stomach of the volunteers for more than 4 h. LVF floating mini-tablets based on HPMC K100M is a promising formulation for eradication of H. pylori.

  11. Strategy to control the invasive alien tree Miconia calvescens in Pacific islands: Eradication, containment or something else?

    Science.gov (United States)

    Meyer, Jean-Yves; Loope, Lloyd; Goarant, Anne-Claire; Veitch, C.R.; Clout, M.N.; Towns, D. R.

    2011-01-01

    Miconia calvescens (Melastomataceae) is a notorious plant invader in the tropical islands of French Polynesia, Hawaii and New Caledonia. A small tree native to Central and South America, it was first introduced as an ornamental in private botanic gardens in Tahiti (1937), Honolulu (1961), and Nouméa (1970s) where it escaped, became naturalised, and formed dense monospecific stands. More than 80,000 ha are currently invaded in French Polynesia, 10,000 ha in the Hawaiian Islands and 140 ha in New Caledonia. Control programmes have been under way in the Hawaiian Islands (Oahu, Maui, Hawaii, Kauai) and French Polynesia (Raiatea, Tahaa, Nuku Hiva, Fatu Hiva) since the early 1990s, and in New Caledonia (Province Sud) since 2006. Despite more than 15 years of intensive control efforts and millions of plants destroyed, eradication has not been achieved in any of these islands, mainly because the species has multiple features that thwart its elimination (e.g., prolific seed production, active dispersal by alien and native frugivorous birds, large and persistent soil seed bank, shade-tolerance), combined with the difficulty of detecting and destroying plants on rough terrain and steep slopes, insufficient control frequency, and limited financial and human resources. Miconia’s life cycle requires at least four years growth from seedling to fruiting. Consequently, prevention of fruit production may be an effective management strategy for small populations. This “juvenilization” process may allow the eradication of small populations when carefully conducted over a quarter century. 

  12. Depression and life satisfaction in aging polio survivors versus age-matched controls: relation to postpolio syndrome, family functioning, and attitude toward disability.

    Science.gov (United States)

    Kemp, B J; Adams, B M; Campbell, M L

    1997-02-01

    To compare depressive symptoms and life satisfaction in aging polio survivors with age-matched controls and to relate these outcomes to scores to psychosocial and disability-related variables. A planned medical, functional, and psychosocial study with multivariate analyses. A large, urban rehabilitation center. A volunteer sample of 121 polio survivors and an age-matched control group of 60 people with similar sociodemographic backgrounds. Depression as measured by the Geriatric Depression Scale and an 11-item life satisfaction scale. The prevalence of depressive disorders was not significantly different in the two groups, although the postpolio group tended to have more symptomatology and an overall depressive disorder prevalence of 28%. Some life satisfaction scale scores were significantly lower in the postpolio group, especially those concerned with health. People with postpolio syndrome scored significantly higher on depression scales and lower on some life satisfaction scales than people with a history of polio but without postpolio syndrome. Several psychosocial variables, most notably family functioning and attitude toward disability, helped to mediate this effect. Among people with significant depression, there was little, evidence of adequate treatment in the community. Postpolio by itself does not relate to higher depression scores or lower life satisfaction. Postpolio syndrome has some relation to depression, but family functioning and attitude toward disability are more important. There is a need for better community-based psychological services.

  13. Una enfermedad lejana: la información sobre poliomielitis y síndrome post-polio en la prensa hispanolusa, 1995-2009

    Directory of Open Access Journals (Sweden)

    Juan Antonio Rodríguez Sánchez

    2015-09-01

    Full Text Available Se explora el cambio en la percepción social de la polio en la Península Ibérica a través del análisis de contenidos, entre 1995 y 2009, de dos periódicos de gran tirada. La desaparición en la agenda periodística de la polio y de las personas que viven con sus secuelas influyó en el olvido de la misma en la agenda pública. La poliomielitis se vinculó a la pobreza y la ignorancia en países lejanos, susceptibles de acciones de cooperación, siendo objeto de atención solo cuando es percibida como amenaza para Occidente, vinculada a crisis sanitarias o en un sentido metafórico. Así, el síndrome post-polio fue invisibilizado en el caso portugués y débilmente representado en España por el movimiento asociativo.

  14. The "Performance of Rotavirus and Oral Polio Vaccines in Developing Countries" (PROVIDE) study: description of methods of an interventional study designed to explore complex biologic problems.

    Science.gov (United States)

    Kirkpatrick, Beth D; Colgate, E Ross; Mychaleckyj, Josyf C; Haque, Rashidul; Dickson, Dorothy M; Carmolli, Marya P; Nayak, Uma; Taniuchi, Mami; Naylor, Caitlin; Qadri, Firdausi; Ma, Jennie Z; Alam, Masud; Walsh, Mary Claire; Diehl, Sean A; Petri, William A

    2015-04-01

    Oral vaccines appear less effective in children in the developing world. Proposed biologic reasons include concurrent enteric infections, malnutrition, breast milk interference, and environmental enteropathy (EE). Rigorous study design and careful data management are essential to begin to understand this complex problem while assuring research subject safety. Herein, we describe the methodology and lessons learned in the PROVIDE study (Dhaka, Bangladesh). A randomized clinical trial platform evaluated the efficacy of delayed-dose oral rotavirus vaccine as well as the benefit of an injectable polio vaccine replacing one dose of oral polio vaccine. This rigorous infrastructure supported the additional examination of hypotheses of vaccine underperformance. Primary and secondary efficacy and immunogenicity measures for rotavirus and polio vaccines were measured, as well as the impact of EE and additional exploratory variables. Methods for the enrollment and 2-year follow-up of a 700 child birth cohort are described, including core laboratory, safety, regulatory, and data management practices. Intense efforts to standardize clinical, laboratory, and data management procedures in a developing world setting provide clinical trials rigor to all outcomes. Although this study infrastructure requires extensive time and effort, it allows optimized safety and confidence in the validity of data gathered in complex, developing country settings. © The American Society of Tropical Medicine and Hygiene.

  15. The “Performance of Rotavirus and Oral Polio Vaccines in Developing Countries” (PROVIDE) Study: Description of Methods of an Interventional Study Designed to Explore Complex Biologic Problems

    Science.gov (United States)

    Kirkpatrick, Beth D.; Colgate, E. Ross; Mychaleckyj, Josyf C.; Haque, Rashidul; Dickson, Dorothy M.; Carmolli, Marya P.; Nayak, Uma; Taniuchi, Mami; Naylor, Caitlin; Qadri, Firdausi; Ma, Jennie Z.; Alam, Masud; Walsh, Mary Claire; Diehl, Sean A.; Petri, William A.

    2015-01-01

    Oral vaccines appear less effective in children in the developing world. Proposed biologic reasons include concurrent enteric infections, malnutrition, breast milk interference, and environmental enteropathy (EE). Rigorous study design and careful data management are essential to begin to understand this complex problem while assuring research subject safety. Herein, we describe the methodology and lessons learned in the PROVIDE study (Dhaka, Bangladesh). A randomized clinical trial platform evaluated the efficacy of delayed-dose oral rotavirus vaccine as well as the benefit of an injectable polio vaccine replacing one dose of oral polio vaccine. This rigorous infrastructure supported the additional examination of hypotheses of vaccine underperformance. Primary and secondary efficacy and immunogenicity measures for rotavirus and polio vaccines were measured, as well as the impact of EE and additional exploratory variables. Methods for the enrollment and 2-year follow-up of a 700 child birth cohort are described, including core laboratory, safety, regulatory, and data management practices. Intense efforts to standardize clinical, laboratory, and data management procedures in a developing world setting provide clinical trials rigor to all outcomes. Although this study infrastructure requires extensive time and effort, it allows optimized safety and confidence in the validity of data gathered in complex, developing country settings. PMID:25711607

  16. Eradication of Salmonella Yoruba in an integrated pig herd.

    Science.gov (United States)

    Østerberg, J; Ekwall, S J; Nilsson, I; Stampe, M; Engvall, A; Wallgren, P

    2001-01-01

    An integrated SPF herd with 320 sows was found infected with Salmonella Yoruba during an annual control among sows, aiming to verify freedom from Salmonella infections. It is believed that the infection was introduced to the herd by purchase of feed. The herd performed an age segregated rearing system. Sows and piglets were reared at a central farm, while growers (25-100 kg body weight) were reared at sub-estates. The growers were free from the infection, and as a consequence a specially designed eradication program was designed. Farrowing and weaning were defined as periods of risk for sows and piglets, respectively. Consequently sows were isolated and individually tested for presence of Salmonella one week before and one week after farrowing. The offspring were tested one week post weaning. To verify freedom from disease among piglets they were also tested another time before transfer to the uninfected sub-estates. Piglets with undefined status regarding Salmonella were denoted animals at risk and not transferred to the sub-estates. Instead they were transferred to a third estate, rented to house pigs at risk. The program was successful. It allowed full production during performance, and the herd was declared free from S. Yoruba seven and a half months after the initial diagnosis.

  17. Eradicating Squatters through Resettlement Programme: A Conceptual Paper

    Directory of Open Access Journals (Sweden)

    Keuk Julieven Nonoi

    2016-01-01

    Full Text Available The existence of squatters had caused many issues including poverty, increasing social problems, drug addiction, criminal and low education level. Sadly, the State of Johor is still among a few other states in Peninsular Malaysia with the highest numbers of squatter families. These squatter settlements are not only inhabited by the local people, but consist of foreigners too. The environmental condition is not fitting, with poor sewage system and unplanned housing construction. Consequently, these issues had caused bad images and perception to the general public, as well as to the tourists. In Malaysia, Resettlement Programme is one of the most significant mechanisms in tackling squatters" settlements issue. Hence, the Johor State Government had taken various approaches in trying to eradicate the squatter settlements by relocating them to new locations with planned and better housing. This conceptual paper aims to examine the current literature and assess previous similar study in order to establish an understanding of the crucial provision of resettlement area in trying to eliminate squatters. It employs a qualitative design through assessment related literature and studies. The results confirmed for a further review of resettlement program. Findings from this study further suggest a comprehensive study of the issues revealed.

  18. Special features of gram-positive bacterial eradication by photosensitizers.

    Science.gov (United States)

    Nitzan, Yeshayahu; Nisnevitch, Marina

    2013-08-01

    Antibiotic resistance of pathogenic bacteria is a major concern and presents a special challenge for development of alternative antibacterial modalities. One of these alternative approaches is based on using the photodynamic therapy (PDT) for eradicating bacteria. Photosensitizer-induced PDT exhibits unique properties and demonstrates efficient microbe-killing effects. The efficient and irreversible antimicrobial effects of PDT are not dependent on the antibiotic susceptibility of the pathogenic bacteria to antibiotics. Gram-positive bacteria exhibit efficient binding of the photosensitizer to the bacterial barriers, leading to immediate photoinactivation of the bacteria. Photoinactivation of Gram-positive bacteria by various photosensitizers has become a high priority, since these bacteria are responsible for life-threatening infections in humans, especially in the elderly and in compromised hosts in whom they cause hospital-acquired infections. The present review concentrates on the photoinactivation of Staphylococi, Streptococci, Propionibacterium acnes, Deinococcus radiodurans, aerobic spore-forming Bacilli by various photosensitizers and by various methods described in numerous works and patents.

  19. Book review: Mosquito eradication: The story of killing Campto

    Science.gov (United States)

    Lapointe, Dennis

    2015-01-01

    In 1826, the paradise that was the Hawaiian Islands was changed forever when the first mosquito species was accidentally introduced to the island of Maui. Though it has not lived up to its potential as a vector of human disease in the islands, Culex quinquefasciatus and the avian pathogens it transmits laid waste to perhaps the world's most remarkable insular avifauna. Today the lowland native forests, once deafening with birdsong, are largely devoid of native birds and Cx. quinquefasciatus has become an inextricable part of our natural areas. In the Hawaiian Islands, the conservation community struggles to keep invasive species out and to control a number of species that have become naturalized. Despite the millions of dollars spent, these efforts never seem enough to slow the erosion of our native biota. The restoration and long-term preservation of Hawaiian forest birds depend on the nearly complete control of mosquito-borne avian disease, an obstacle that to many land managers appears insurmountable. To rally hope in Hawai`i, the conservation community needs to see a success. As a Pacific island, Hawai`i shares similar conservation problems with New Zealand and has often looked to that nation for innovation and inspiration. Mosquito Eradication: The Story of Killing Campto may be our latest inspiration.

  20. [Vaccinology in armed conflicts: a punctual intervention in poliomyelitis eradication in Afghanistan].

    Science.gov (United States)

    López-González, Juan M; Tuells, José

    2006-01-01

    The situations of armed conflict suppose a handicap for the eradication of the poliomyelitis due to the difficulties to access the susceptible population. In Afghanistan, after the military operation which put an end to the Taliban regime, Spanish military sanitarians made an intervention in order to immunize the children of the zone where they were conducting their mission, against poliomyelitis. After having solved planning and logistic problems, two rounds of vaccination with IPV were made. A local translator helped to fill out a questionnaire about the state of immunization in that zone, providing information regarding the socio-demographic data of the children that showed up, their immunization status, their knowledge about vaccines and the efficacy of the various social mobilization activities utilized. 293 and 321 children were vaccinated in two different rounds. Very few of them had received a prior vaccination (10%) and they showed very little knowledge regarding immunization. Parents didn't involve themselves in the campaign, and knowledge about it was achieved better with the use of posters (70%) than with the use of radio ads (10%). Immunization is a health initiative that helps to improve the chances for peace.