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WHO
Collaborative Programme
Polio
Eradication
Back
Polio
campaign 2003
Situation Analysis:
A high level (98%) of routine OPV3 immunization coverage has been achieved and sustained because of high political commitment, the role of non-governmental organizations, civil society and effective social mobilization strategy. Poliomyelitis cases have not been reported since 16 June 1994. However, the polio reporting system and confirmation are still sluggish.
There are four districts out of 26 that continue to have low vaccination coverage; this is due to low socioeconomic levels and the loss of medical infrastructure in these regions. Concerning these four areas with low coverage, a special activity plan has been implemented, coverage is currently around 80% and results are being sustained.
The general high percentage of vaccination coverage is due to the National Immunization Days that have been conducted since 1995 to cover all population in Lebanon including Palestininans through the involvement of UNRWA.
In some developed regions parents do not comply with NIDs as they prefer to vaccinate their children at their family physicians. These districts are well served with high involvement of the private sector.
Routine AFP/Polio surveillance started in 1995. In 1998, active surveillance was launched to cover 16 sentinel hospitals representing different geographical areas. During the first three years (1995 through 1997), the surveillance system was very weak due to the inability to discover the expected number of non-polio AFP cases. Reported cases of AFP for 1996 and 1997 were not accurate because of self-reporting in those years. However, in 1998 an active search was conducted by a national team that showed good results.
Among the main activities implemented in 1998 concerning active AFP surveillance was the organization of a workshop in August 1998 for 15 health inspectors who are working in the AFP surveillance system in all Lebanese regions.
The workshop was very effective judging the number of cases that have been detected through the review of hospital records and interviews with doctors. Seven cases of AFP were detected retrospectively at universities and hospitals and were suspected to be Guillian-Barre syndrome.
A national workshop for measles elimination and AFP/Polio Surveillance was held in July 1999.
Three seminars were conducted for pediatricians to provide briefing and technical update on poliomyelitis eradication with emphasis on AFP surveillance, measles elimination strategies and planned activities for Lebanon.
The number of reported AFP cases has been raised up to 14 cases annually. Also, it is important to note that this average is now higher than the average recommended by WHO (1/100 000 case for children under 15 years old)
The Poliomyelitis National Certification Committee formulated since 1994 was not productive for several reasons mainly the lack of coordination with the national programme. This Committee was reformulated in 2000 to review the cases revised by the National Expert Committee and prepare the national polio report that is to be submitted to the Regional Certification Committee to declare Lebanon Polio free. Due to incomplete reports on the cases detected, the Certification of Lebanon as Polio free has been delayed. The Regional office supported in 2000-2001 two experts mission to assist nationals in solving the problematic cases. It is expected that a national report on the AFP cases will be submitted by the end of 2001 to the Regional Certification Committee.
A National AFP/Polio expert Committee has been formulated in August 1999.
In 2001, an expert undertook a mission related to Wild Polio Virus Laboratory Containment. A national committee, headed by the Central Public Health Laboratory (CPHL) was established to develop a plan of action and implement it. This has been initiated, consisting essentially of checking all the laboratories in the country for AFP related body secretion still stored and destroy them.
The main purpose of WHO support at this time is to certify and maintain, Lebanon polio free. Therefore, efforts should concentrate on:
- Support immunization efforts
- Support development of an efficacious Surveillance System
- Support Wild Polio Virus Lab Containment
Objective:
To sustain zero polio case reporting confirmed by reliable surveillance system
To prepare the national polio eradication initiative for certification of wild poliovirus eradication
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