Polio, a constatant threat to Nigerian Children

Current polio situation

Nigeria would have been counting down to being declared polio free but has been cut short following the discovery of a new polio virus type 2 in Bauchi State recently.

The country had remained polio free for over 25 months as at October 2018, since the last four cases of the wild polio virus was discovered in the North East in 2016, but it will remain a polio endemic nation following this recent discovery.

As the risk factors accounting for all strains of polio continue to exist, experts say the journey to a polio free Nigeria may be within reach but still daunting. 

According to the Global Polio Eradication Initiative website, Nigeria has never stopped circulating the indigenous wild polio virus and is also affected by the circulation of vaccine-derived poliovirus type 2 (cVDPV2) outbreaks.

Recently, a WHO State coordinator, Adamu Ningi, said the polio virus type 2 was found at Gwallaga mosque area linking three wards of Makama B, Hardo and Dankade of Bauchi State.

The appearance of the type 2 virus has been blamed on several years of low Routine Immunization (RI) coverage and insufficient population immunity to the virus. 

The Executive Director, National Primary Health Development Agency, Dr Faisal Shuaib says the type 2 strains are largely from environmental samples, but still presents similar symptoms. 

Eradication efforts and success

For over two years, no case of the wild poliovirus was reported in Nigeria; that apparent success was attributed to a number of reasons but mostly to the drop in the number of children lacking access to polio vaccines. 

In June 2018, Nigeria’s Health Minister, Prof. Isaac Adewale, said “Fewer than 100,000 children now lack access to vaccines and 30 per cent of inaccessible areas in the North East are now being accessed with the help of the military.’’

In March 2017, Nigeria keyed into a regional polio immunisation campaign targeting about one hundred and sixteen million under five children across West Africa.

There was also an intensive outbreak response campaigns in two phases which commenced in May, September and October 2018.

To also boost population immunity, government scheduled a Fractional Injectable Polio Vaccine (fIPV) campaign across 92 targeted LGAs in November 2018. 

According to the Global Polio Eradication Initiative, Nigeria has continued to conduct acute flaccid paralysis surveillance strengthening activities in response to the circulating vaccine-derived poliovirus type 2. 

Outbreak response to wild polio virus is also in force, including efforts to address surveillance in parts of Borno state.

The most rewarding of efforts is the Nigeria/GAVI joint investment of over $3Billion in support of routine immunisation and health system strengthening, according to the National primary healthcare development agency

What Nigeria must do

Despite successes, eradicating polio in Nigeria will require greater effort.

According to experts, increased surveillance remains a first in the list of many solutions

Innovative immunisation strategy is another tool needed to bridge the gap isolating children in high-risk areas.

Community sampling to identify children who miss vaccination and detect immunity gaps in populations that have previously been inaccessible must also be employed. 

But most importantly Nigeria must eliminate the risk of complacency amid perceived success.

According to the WHO Regional Director for Africa, Dr Matshidiso Moeti  ‘‘ Polio eradication requires political commitment and adequate resources.’’

For now Nigeria remains a polio endemic nation, it can only loose that title if it stays free of the wild virus and its infections for three years consecutively.