Polio eradication overview
The programme is covering all Sudan including the Sudan People's Liberation Movement (SPLM)-controlled areas. The government-controlled area is looking after from Khartoum and the SPLM-controlled is covered from Nairobi.
Government-controlled polio eradication overview
The Polio eradication programme in areas under government control is integrated with the expanded Programme on Immunization. It is highly supported by WHO, UNICEF and donors community. The programme is composed of three components. These are routine immunization, supplementary immunization activities and Acute Flaccid Paralysis (AFP) surveillance. The coverage rate of OPV3 reached 79% in 2004 while it was 74% in 2003. The national immunization campaigns (SIAs) have been conducted house to house since 2000 until December 2002. The campaigns were stopped in 2003 and first half of 2004 because of the absence of poliovirus for 3 years and global shortage of funds. The SIAs have been resumed after the detection of the first poliovirus imported from Chad. Two mopping up rounds were conducted in Darfur states and West Kordofan. The number of children vaccinated during these rounds was 1.2 million. Since October 2004, four National Immunization Days (NIDs) rounds were conducted. Around 6 million children were vaccinated during each round. The last round was on 27 February 2005.
AFP surveillance performance indicators have reached the certification standard since 2001. These indicators remained above the target for the subsequent years. The rates of non-polio AFP detection and adequate specimens’ collection were 3.3 and 92% in 2004. The age distribution of AFP cases showed that 80% of cases fall below 5 years and 20% of cases are 5 years or above. The timeliness of collection of specimens shows the following figures:
Year | Average days between onset and stool collection | Average days between stool collection and arrival to lab. | Average days between stool arrival and culture result |
2002 | 8 | 2 | 26 |
2003 | 7 | 2 | 22 |
2004 | 8 | 2 | 20 |
Polio outbreak started in May 2004 in West Darfur and from there it spread to other states. The outbreak hit 18 states in 2004. In 2005, seven states remained infected. The total number of polio cases in 2004 and 2005 are 126 and 17 respectively. The last polio case was reported from Kassala on 12/2/2005. The response to this outbreak was prompt from both north and south teams. The major activities conducted in response to this out break were two mopping up rounds and four NIDs rounds, intensification of surveillance activities, organizing cross border coordination meeting between Sudan and its neighbouring countries and high level advocacy activities.
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Remaining challenges are:
Population movement to and from Darfur and the south
IDPs
Returnees
Ongoing conflict in Darfur
Bordering countries with poliovirus circulation:
Chad and Central African Republic
Ethiopia and Eritrea
Egypt
SPLM-controlled polio eradication overview
WHO south Sudan polio eradication covers all areas in the south under SPLM control. Due to the peace process and signing of a peace accord in January 2005 access has increased since 2002. There are two aspects of the programme AFP surveillance and supplementary immunization campaigns.
AFP surveillance - There are 272 Sudanese field staff working on the AFP surveillance. AFP surveillance indicators have reached certification standard since 2002. The rates of NPEV detection and adequate specimens’ collection in 2004 were 2.18 and 87%. There are 341 sentinel AFP reporting sites and 1523 other reporting sites.
Supplementary Immunisation Activities (SIA) – Beginning in 1998, SIA in the south have continued to reach significantly more children than the previous rounds. Since SNID 2002 over one million under fives have been vaccinated. The NID campaigns conducted in Spring 2003 reached almost 1.8m, and NID in Autumn 2004 1.99m. There were no NID conducted in spring 2004 due to lack of funding. Four rounds of NID are currently underway.
Mop up campaigns in response to the outbreak in Sudan have been conducted monthly in BEG and Upper Nile (those areas bordering on the cases of wild poliovirus) since August 2004.
Considerable challenges still exist for the effective implementation of polio eradication activities in the south, mainly from insecurity and inaccessibility and staffing and logistics shortages.
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As of 31/3/2005
