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J Infect Dis. 2014 Nov 1;210 Suppl 1:S162-72. doi: 10.1093/infdis/jiu022.

Polio eradication initiative in Afghanistan, 1997-2013.

Author information

1
Centers for Disease Control and Prevention, Center for Global Health, Global Immunization Division, Atlanta, Georgia.
2
Directorate of General Preventive Medicine, Afghanistan Ministry of Public Health.
3
Office of the Ministry of Advising for the President on Health and Education Affairs and National Focal Point for Polio Eradication.
4
Centers for Disease Control and Prevention.
5
Polio Eradication Unit, World Health Organization.
6
Polio Eradication Unit, United Nations Children's Fund, Kabul, Afghanistan.
7
Communications Program, United Nations Children's Fund, New York, New York.
8
Pakistan Polio Regional Reference Laboratory, Islamabad, Pakistan.
9
World Health Organization, Regional Office for the Eastern Mediterranean, Cairo, Egypt.
10
National Center for Immunizations and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.

Abstract

BACKGROUND:

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.

METHODS:

Published reports and unpublished national data on polio cases, AFP surveillance, and SIAs were analyzed.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.

RESULTS:

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 <15 years improved over time, achieving rates>8 per 100,000 population. Since 2001, at least 6 SIAs have been conducted annually.

CONCLUSIONS:

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.

KEYWORDS:

Afghanistan; disease eradication; epidemiology; polio; strategies

PMID:
25316832
DOI:
10.1093/infdis/jiu022
[Indexed for MEDLINE]

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