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Background As a WHO member state, Indonesia is committed to
Global Polio Eradication. The last indigenous polio case was found in 1995. However, we faced a big challenge with the occurrence of polio outbreak, beginning with a polio case caused by imported wild poliovirus (WPV) type 1 in Sukabumi in 2005. The virus was originated from Sudan and impo...
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Background
To describe in chronological detail Pakistan’s decades long battle against poliovirus and evaluate the multiple factors impacting it.
Main body
Pakistan’s fight is documented through various published research articles and reports on Pakistan’s progress in eradication of polio published by international agencies involved in elimination...
Background:
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 servi...
Since the introduction of the Plan of Actions Aimed to the Achievement of the Certificate of Polio Eradication in 1998, and the development of the Acute Flaccid Paralysis (AFP) Surveillance System in Spain, the sensitivity of the system has gradually decreased from the objective stated by WHO of 1 case per 100,000 population under 15 years. In 2013...
Background:
Since the World Health Assembly (WHA) resolved in 1988 to eradicate poliovirus, several rounds of immunization campaigns have been conducted by member states. By 2000, with the support of the Global Polio Eradication Initiative (GPEI) partners, the number of polio cases decreased by 99%. Eradicating the remaining 1% proved to be more c...
Interrupting wild poliovirus transmission and stopping circulating vaccine-derived poliovirus (cVDPV) outbreaks have been proposed as two global goals by the World Health Organization in the Global Polio Eradication Initiative (GPEI). This analysis, based on the 28-year acute flaccid paralysis (AFP) surveillance and 8-year environmental surveillanc...
Citations
... At the initial stage, the main strategy was to prepare immunization infrastructure and to implement the program at the lowest level (Puskesmas). After EPI's initiation program in 1977, the inclusion of the OPV became part of routine immunization in 1981 [17]. Polio was first introduced into routine immunization with 3 doses of OPV in 1983 and then in 1993 the number of doses increased to 4 [18]. ...
Background
The scaling up of public health interventions has received greater attention in recent years; however, there remains paucity of systematic investigations of the scaling up processes. We aim to investigate the overall process, actors and contexts of polio immunization scaling up in Indonesia from 1988 until 2018.
Methods
A mixed method study with sequential explanatory design was conducted. We carried out a quantitative survey of 323 actors involved in the polio program at national and sub-national levels, followed by Key Informant Interviews (KII)s. Document review was also carried out to construct a timeline of the polio eradication program with milestones. We carried out descriptive statistical analysis of quantitative data and thematic analysis of qualitative data.
Results
The scaling up of polio immunization in Indonesia started as a vertical expansion approach led by the Ministry of Health within a centralized health system. The coverage of immunization increased dramatically from 5% in the earlier 80s to 67.5% in 1987; incremental increases followed until achieving Universal Child Immunization (UCI) in 1990 and subsequently 95% coverage in 1995. Engagement of stakeholders and funding made the scaling up of polio immunization a priority. There was also substantial multisector involvement, including institutions and communities. Local area monitoring (LAM) and integrated health posts ( Posyandu ) were key to the polio immunization implementation strategy. Challenges for scaling up during this centralized period included cold chain infrastructure and limited experience in carrying out mass campaigns. Scaling up during the decentralized era was slower due to expansion in the number of provinces and districts. Moreover, there were challenges such as the negative perception of immunization side-effects, staff turnover, and the unsmooth transition of centralization towards decentralization.
Conclusion
Vertical scaling up of polio immunization program intervention was successful during the centralized era, with involvement of the president as a role model and the engine of multi sector actors. Posyandu (integrated health posts) played an important role, yet its revitalization after the reform-decentralization era has not been optimum.
... At the initial stage, the main strategy was to prepare immunization infrastructure and to implement the program at the lowest level (Puskesmas). After EPI's initiation program in 1977, the inclusion of the OPV became part of routine immunization in 1981 (17). Polio was rst introduced into routine immunization with 3 doses of OPV in 1983 and then in 1993 the number of doses increased to 4 (18). ...
Background: The scaling up of public health interventions has received greater attention in recent years; however, there remains paucity of systematic investigations of the scaling up processes. We aim to investigate the overall process, actors and contexts of polio immunization scaling up in Indonesia from 1988 until 2018.
Methods: A mixed method study with sequential explanatory design was conducted. We carried out a quantitative survey of 323 actors involved in the polio program at national and sub-national levels, followed by Key Informant Interviews (KII)s. Document review was also carried out to construct a timeline of the polio eradication program with milestones. We carried out descriptive statistical analysis of quantitative data and thematic analysis of qualitative data.
Results: The scaling up of polio immunization in Indonesia started as a vertical expansion approach led by the Ministry of Health within a centralized health system. The coverage of immunization increased drastically from 5% in the earlier 80s to 67.5% in 1987; incremental increases followed until achieving Universal Coverage Immunization (UCI) in 1990 and subsequently 95% coverage in 1995. Engagement of stakeholders and funding made the scaling up of polio immunization a priority. There was also substantial multisector involvement, including institutions and communities. Local area monitoring (LAM) and integrated health posts (Posyandu) were key to the polio immunization implementation strategy. Challenges for scaling up during this centralized period included cold chain infrastructure and limited experience in carrying out mass campaigns. Scaling up during the decentralized era was slower due to expansion in the number of provinces and districts. Moreover, there were challenges such as the negative perception of immunization side-effects, staff turnover, and the unsmooth transition of centralization towards decentralization.
Conclusion: Vertical scaling up of polio immunization program intervention was successful during the centralized era, with involvement of the president as a role model and the engine of multi sector actors. Posyandu (integrated health posts) played an important role, yet its revitalization after the reform-decentralization era has not been optimum.
... In Indonesia, this programme have been implemented in Indonesia since 1995. [7][8][9] In Indonesia, indigenous wild poliovirus circulation has not been found any more after 1995. However, Indonesia still faces threat of the wild poliovirus importation from polio-endemic countries as the last previous outbreak in 2005. ...
... Moreover polio immunization program in Indonesia utilize Oral Polio Vaccine containing live attenuated vaccines which might become another threat because the vaccine polio virus may experience mutations in the human body (Vaccine Derived Polio Virus/ VDPV) and cause symptoms such as wild polio virus infections. 1,7,10 The sensitive and active surveillance in finding AFP cases and laboratory quality is crucial role in ensuring that poliovirus transmission has been interrupted and immunization programme has worked. Documentation of the cessation of the poliovirus transmission is needed in the certification of polio eradication globally. ...
... Active and sensitive surveillance can cause cases to be found in certain areas and in large numbers. 7 Along with the AFP cases due to wild poliovirus, AFP cases due to type 1 VDPV were found in Madura, East Java in 2005. This finding was different from other countries in the world as the type of poliovirus that mutates and becomes VDPV generally is type 2 polio virus. ...
Latar belakang: Virus Polio Liar dapat menyebabkan kelumpuhan dan dapat dicegah dengan imunisasi. Untuk memonitor transmisi virus polio liar dilakukan surveilans Acute Flaccid Paralysis (AFP) dan investigasi laboratorium yang telah dimulai sejak tahun 1995 di Indonesia. Virus polio liar Indigenous terakhir ditemukan di Indonesia tahun 1995. Indonesia masih memiliki ancaman importasi virus polio liar dari negara endemis dan mutasi virus polio dari vaksin yang menyebakan kelumpuhan yang sama seperti virus polio liar. Artikel ini bertujuan untuk memberikan gambaran mengenai surveilans AFP berbasis laboratorium di Indonesia pada tahun 2003-2013 sehingga mengantarkan Indonesia sebagai negara bebas polio pada tahun 2014. Metode: Data yang dianalisis adalah data kasus AFP seluruh Indonesia periode tahun 2003-2013. Data didapat dari laboratorium jejaring laboratorium Polio di Jakarta, Bandung, Surabaya dan Sub Direktorat Surveilans, Direktorat Surveilans dan Karantina Kesehatan, Direktorat Jenderal Pencegahan dan Pengendalian Penyakit. Data di analisis menggunakan program Microsoft Excel. Hasil: Sebanyak 305 kasus AFP yang disebabkan oleh infeksi virus polio liar tipe 1 impor ditemukan pada tahun 2005 dan 2006. Terdapat 39 kasus AFP yang disebabkan cVDPV tipe 1 ditemukan di Pulau Madura pada tahun 2005. Virus polio liar tipe 1 hanya ditemukan di pulau Sumatera dan Jawa. Penyebaran Virus polio berhasil dihentikan pada tahun 2006 dan sudah tidak ditemukan lagi hingga tahun 2013. Kesimpulan: Surveilans AFP berbasis laboratorium yang baik berhasil memantau dan mendeteksi sirkulasi virus polio. Peningkatan kinerja surveillance AFP diperlukan untuk membuktikan terhentinya transmisi virus polio sehingga eradikasi polio secara global dapat diraih. Kata kunci: surveilans, laboratorium polio, Acute Flaccid Paralysis Abstract Background: Wild Poliovirus can cause flaccid paralysis and can be prevented by immunization. To monitor wild polio virus transmission, Acute Flaccid Paralysis (AFP) surveillance and laboratory investigations was initiated in 1995 in Indonesia. The last indigenous wild poliovirus found at 1995 in Indonesia. Indonesia still has the threat of imported wild polio viruses from endemic countries and poliovirus mutation from vaccine that can cause paralytic as well as wild poliovirus. The aim of this article is to describe the laboratory-based AFP surveillance in Indonesia from 2003-2013 so that it had led the Indonesia certified for polio free in 2014. Methods: Data analysis performed on AFP cases data from all provinces in Indonesia period of 2013-2014. Data were collected from polio laboratories network in Jakarta, Bandung, Surabaya and the Sub Directorate of Surveillance, Directorate of Surveillance and Health Quarantine, Directorate General of Disease Prevention and Control. Data were analyzed using Microsoft Excel program. Results: 305 paralysis cases were caused by imported type 1 wild poliovirus infection were found in 2005 and 2006. 39 paralysis cases caused by type 1 cVDPV infection were also found on Madura Island in 2005. Type 1 wild polioviruses only found on the Sumatra and Java island. The wild poliovirus transmission was stopped in 2006 and was no longer found until 2013. Conclusion: Good laboratory-based AFP surveillance has been successfully monitoring and detecting the circulation of the poliovirus. Improved AFP surveillance performance is needed to prove cessation of poliovirus transmission so that eradication of poliovirus can be achieved globally. Keywords: surveillance, polio laboratory, Acute Flaccid Paralysis
... Nigeria responded by developing and implementing a national polio emergency plan to addresses the situation. Despite the significant improvement in supplemental immunization activities (SIAs) quality and remarkable reduction of 58% of polio cases in 2014 compared to 2013, the targets were not achieved due to various challenges responsible for periodic outbreaks within endemic countries and virus importations to non-endemic countries globally [2]. ...
... Geographical location of LGAs where DOPV was implementednorthern Nigeria, 2014-2016 implemented. Kano state had the highest number ofLGAs (26), while Zamfara state had the lowest[2].There was a decline in the percentage of missed children in the 90 LGAs from n 2014-16.Figure 2shows that the missed children due to child absent declined from 2.4% in August 2014 to 1.1% in May 2016. Similarly, the missed children due to noncompliance declined from 0.6% in September 2014 to 0.4% in May 2016. ...
Background
The declaration of poliomyelitis eradication as a programmatic emergency for global public health by the 65th World Health Assembly in 2012 necessitated innovations and strategies to achieve results. Review of the confirmed polio cases in 2013 showed that most of the cases were from non-compliant households, where parents connived with vaccinators to finger mark the children without actually vaccinating the children with oral polio vaccine or children were absent from home at the time of the visit of vaccinators.
Methods
We used pre-post design to quantify the outcomes of directly observed vaccination in 90 local government areas from 12 northern Nigeria states at very high risk of polio transmission.
The strategy is an intervention, vaccinating children under the direct supervision of an independent supervisor to ensure compliance. Attractive incentives (pluses) were used to make parents willingly submit their children for vaccination or directly attract children to the vaccination teams or post as part of this strategy.
Results
There was a steady increase in population immunity in all the 90 DOPV implementing LGAs since the introduction of DOPV in 2013. The number of states in which > 90% of children received > 4 OPV doses increased from 7 in 2013 to 11 states by July 2016.
Yobe state reported the highest proportional increase from 75 to 99% by July 2016 (22% increase), while Kano state reported 17% increase, from 82 to 99% by July 2016.
Conclusion
Directly observed polio vaccination strategy improved uptake of polio vaccines and population immunity in high-risk areas for polio transmission.
Background: Poliomyelitis is a disease caused by the poliovirus which causes abnormalities in the nervous system, commonly affects children and can be prevented by immunization. Since March 27 th , 2014, Indonesia has been declared to be free of polio and anticipate the mutation of poliovirus type 2 (vaccine-derived polioviruses / VDPV). Indonesia will change the use of policy vaccines from triOPV to biOPV by erasing the P2 type before switching from OPV to IPV. Before the policy was implemented, it is needed to have research to determine the level of immunity of children against poliovirus and type of poliovirus which circulate in the area of OPV and IPV in Indonesia. Methods: The research study was conducted in five cities in five provinces in Indonesia in 2015. The serum was taken on 100 children between 12-59 months and feces were taken towards 150 children in the same age range. The examination of antibody titers in serum performed using the method of neutralization.
