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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Effectiveness of immunization against paralytic poliomyelitis in Nigeria
New England Journal of Medicine, Volume 359, No. 16, Year 2008
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Description
BACKGROUND: The number of cases of paralytic poliomyelitis has declined in Nigeria since the introduction of newly licensed monovalent oral poliovirus vaccines and new techniques of vaccine delivery. Understanding the relative contribution of these vaccines and the improved coverage to the decline in incident cases is essential for future planning. METHODS: We estimated the field efficacies of monovalent type 1 oral poliovirus vaccine and trivalent oral poliovirus vaccine, using the reported number of doses received by people with poliomyelitis and by matched controls as identified in Nigeria's national surveillance database, in which 27,379 cases of acute flaccid paralysis were recorded between 2001 and 2007. Our estimates of vaccine coverage and vaccine-induced immunity were based on the number of doses received by children listed in the database who had paralysis that was not caused by poliovirus. RESULTS: The estimated efficacies per dose of monovalent type 1 oral poliovirus vaccine and trivalent oral poliovirus vaccine against type 1 paralytic poliomyelitis were 67% (95% confidence interval [CI], 39 to 82) and 16% (95% CI, 10 to 21), respectively, and the estimated efficacy per dose of trivalent oral poliovirus vaccine against type 3 paralytic poliomyelitis was 18% (95% CI, 9 to 26). In the northwestern region of Nigeria, which reported the majority of cases during the study period, coverage with at least one dose of vaccine increased from 59 to 78%. Between 2005 and 2007, vaccine-induced immunity levels among children under the age of 5 years more than doubled, to 56%. CONCLUSIONS: The higher efficacy of monovalent type 1 oral poliovirus vaccine (four times as effective as trivalent oral poliovirus vaccine) and the moderate gains in coverage dramatically increased vaccine-induced immunity against serotype 1 in northern Nigeria. Further increases in coverage in Nigerian states with infected populations are required to achieve the levels of vaccine-induced immunity associated with the sustained elimination achieved in other parts of the country. Copyright © 2008 Massachusetts Medical Society. All rights reserved.
Authors & Co-Authors
Jenkins, Helen Elizabeth
United Kingdom, London
Imperial College London
Aylward, Raymond Bruce
Switzerland, Geneva
Organisation Mondiale de la Santé
Gasasira, Alex Ntale
Nigeria, Abuja
Nigeria Police
Donnelly, Christl A.
United Kingdom, London
Imperial College London
Abanida, Emmanuel Ade
Nigeria, Abuja
National Primary Health Care Development Agency
Koleosho-Adelekan, Titi
Nigeria, Abuja
National Primary Health Care Development Agency
Grassly, Nicholas C.
United Kingdom, London
Imperial College London
Statistics
Citations: 35
Authors: 7
Affiliations: 4
Identifiers
Doi:
10.1056/NEJMoa0803259
ISSN:
00284793
e-ISSN:
15334406
Research Areas
Health System And Policy
Maternal And Child Health
Study Locations
Nigeria