Interruption of Poliovirus Transmission in Ghana: Molecular Epidemiology of Wild-Type 1 Poliovirus Isolated from 1995 to 2008

Odoom, John Kofi; Forrest, Lindsay; Dunn, Glynis; Osei-Kwasi, Mubarak; Obodai, Evangeline; Arthur-Quarm, Jacob; Barnor, Jacob Samson; Minor, Philip D.; Martı́n, Javier

doi:10.1093/infdis/jis474

Cited by 11 publications

(12 citation statements)

References 16 publications

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“…The low number of NPEVs isolated in our study was, however, lower than the 34% and 20% NPEVs isolated from acute poliomyelitis cases, both reported in India, and the 5.3% reported in Nigeria [15,17,18]. The variations observed may be attributed to factors such as differences in sample size; geographical location of the study; specificity and sensitivity of laboratory methods; stool specimen collection, handling, and transportation; stage/degree of poliovirus endemicity in the study area(s); and the time when those studies were conducted.…”

Section: Discussioncontrasting

confidence: 82%

Absence of poliovirus in apparently healthy school children in Bauchi state, Nigeria

Abdullahi

Shehu

Yunusa

2016

J Infect Dev Ctries

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Introduction: Poliovirus infections have been established to be in circulation in the remaining three polio-endemic nations. These pathogens have been associated with several chronic diseases, particularly acute flaccid paralysis of children. This study sought to ascertain whether polioviruses are silently shed by apparently healthy schoolchildren in Bauchi, Katagum, and Misau local government areas of Bauchi state, Nigeria. Methodology: This was a cross-sectional prospective study that involved 200 stool samples collected from apparently healthy schoolchildren. All samples were processed and inoculated onto rhabdomyosarcoma (RD) and L20B cell-lines. Inoculated cell lines were monitored for cytopathic effects (CPEs) for 10 days with one subculture after first 5 days. Results: None of the samples came down with CPEs on L20B, and thus all samples were negative for poliovirus; however, three were positive for non-polio enteroviruses (NPEVs) on RD and not on the L20B cell line: one coxsackie B virus from a seven-year-old male, and two others were untypeable isolates, one each from a male and a female child. The coxsackie B virus was identified by microneutralization test using polyclonal sera as described by the World Health Organization. Conclusions: Findings from this investigation indicate the absence of polioviruses in the children studied. This is an indication of good polio immunization coverage in these communities. However, more intensive and periodic surveillance is required to confirm the presence or exclude the absence of polioviruses in these communities and other parts of Nigeria.

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Section: Discussioncontrasting

confidence: 82%

Absence of poliovirus in apparently healthy school children in Bauchi state, Nigeria

Abdullahi

Shehu

Yunusa

2016

J Infect Dev Ctries

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“…This is evident in Table 4 that OPV vaccination coverage for both routine and SIA are high. It is also significant to note that reduced immunization coverage may also have serious consequences in countries that use OPV, as was recently demonstrated by two outbreaks of wild poliovirus in Ghana in 2003 and 2008 when there was a reduced NIDs activity in 2002 and 2007 in the country [16]. …”

Section: Discussionmentioning

confidence: 99%

“…The last known case of poliomyelitis caused by indigenous WPV transmission occurred in a 13-year old boy from Bole in the Northern region of the country on October 16, 1999 [16]. However, eight cases each due to importations from neighbouring countries caused polio outbreaks in 2003 and 2008 in Ghana.…”

Section: Introductionmentioning

confidence: 99%

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

Odoom

Ntim

Sarkodie³

et al. 2014

BMC Public Health

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BackgroundGhana 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.MethodsWe 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.ResultsOf 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.ConclusionBoth 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.

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“…However, various studies have shown that wild polio virus can circulate in a well-vaccinated population with or without clinical cases [11]. This has been exemplified by recent outbreaks of poliomyelitis in some parts of Africa which suggested that wild poliovirus can replicate asymptomatically in well-immunized persons and eventually infect susceptible individuals [12], as there is a continuous chain of person-to-person transmission [13]. Our study is aimed at determining the prevalence of human enteroviruses among apparently healthy school children less than 8 years of age in the Ablekuma South community.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of human enteroviruses among apparently healthy nursery school children in Accra

et al. 2014

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IntroductionHuman enteroviruses are common in children causing asymptomatic infections ranging from mild to severe illnesses. In Ghana, information on the prevalence of non-polio enterovirus causing acute flaccid paralysis is available but data on surveillance of these viruses in school children is scanty. Here, the prevalence of human enteroviruses among apparently healthy children in selected school in Accra was studied.MethodsStool samples from 273 apparently healthy children less than eight years of age in 9 selected nursery schools were collected between December 2010 and March 2011and processed for human enteroviruses on L20B, RD and Hep-2 cell lines. Positive Isolates were characterized by microneutralisation assay with antisera pools from RIVM, the Netherlands according to standard methods recommended by WHO.ResultsOf the 273 samples processed, 66 (24.2%) non-polio enteroviruses were isolated. More growth was seen on Hep-2C (46%) only than RD (18%) only and on both cell lines (34%). No growth was seen on L20B even after blind passage. Excretion of non-polio enteroviruses was found in all the schools with majority in BD school. Serotyping of the isolates yielded predominantly Coxsackie B viruses followed by echoviruses 13 and 7. More than half of the isolates could not be typed by the antisera pools.ConclusionThe study detected 13 different serotypes of non-polio enteroviruses in circulation but no poliovirus was found. BD school was found to have the highest prevalence of NPEV. Complete identification through molecular methods is essential to establish the full range of NPEVs in circulation in these schools.

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Interruption of Poliovirus Transmission in Ghana: Molecular Epidemiology of Wild-Type 1 Poliovirus Isolated from 1995 to 2008

Cited by 11 publications

References 16 publications

Absence of poliovirus in apparently healthy school children in Bauchi state, Nigeria

Absence of poliovirus in apparently healthy school children in Bauchi state, Nigeria

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

Prevalence of human enteroviruses among apparently healthy nursery school children in Accra

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