Resurgence of poliomyelitis in Nigeria: a big blow to the world eradication efforts?

doi:10.15406/mojph.2016.04.00099

MOJ

eISSN: 2379-6383

Public Health

Editorial Volume 4 Issue 6

Resurgence of poliomyelitis in Nigeria: a big blow to the world eradication efforts?

Koffitse Atchon

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Department of Community, Systems and Mental Health Nursing, Rush University Medical Center, USA

Correspondence: Koffitse Atchon, Department of Community, Systems and Mental Health Nursing Rush University Medical Center, 600 S Paulina St., #1060A, Chicago, IL, USA, Tel 1 (312) 4735692, Fax 1 (312) 9426226

Received: August 19, 2016 | Published: September 14, 2016

Citation: Atchon K. Resurgence of poliomyelitis in Nigeria: a big blow to the world eradication efforts? MOJ Public Health. 2016;4(6):175–176. DOI: 10.15406/mojph.2016.04.00099

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Editorial

After more than 2years without poliovirus, Nigeria, one of the biggest countries in West Africa, has registered two new cases of wild poliomyelitis (also known as polio), first cases since July 2014. The major implication on the country’s public health is that a strengthened surveillance is needed to aid in the quick discovery and confirmation of any polio outbreaks in case any arise in the future.

According to the Centers for Disease Control and Prevention (2015), Polio is a crippling and potential fatal infectious disease caused by poliovirus. Since 1988, the World Health Organization has been committed to eradicate polio worldwide. For more than the last 2years African countries have not reported any case of wild polio, putting them in the road of polio free certification. However, Afghanistan and Pakistan have reported six and 13 cases of wild polio respectively, as of July 27 2016.^1,2

After more than 2years without poliovirus, Nigeria, one of the biggest countries in West Africa, has registered two new cases of wild poliomyelitis (also known as polio), first cases since July 2014.³ Multiple factors may be to blame for the reported cases of the poliovirus which paralyzed two children in Nigeria. Despite its progress toward the polio eradication as a result of concerted efforts by all levels of government, civil society, religious and opinion leaders, traditional and community leaders, and tens of thousands dedicated health care professionals and workers, both nationally and internationally. This resurgence of poliomyelitis thus constituted a global concern of public health importance.

As a global concern of public health importance, it is important for the stakeholders of the global public health, and specifically the Nigerian public health professional to understand how the new polio cases emerged when the country was a year away from being awarded the certification of being polio free. According to Professor Oyewale Tomori, the president of the Nigerian Academy of Science, the two reported polio outbreaks can be attributed to the government’s reluctant or reduced commitment on the eradication of polio from the country. According to Tomori, the country’s National Assembly, the local government chairpersons, and the governors had started to place inadequate and timely backing on polio eradication initiatives and activities. With this inadequate backing, it meant that insufficient funding were accorded to the initiative and this translated into gaps in surveillance activities and the quality of polio immunization, thus giving room for new polio cases as experienced in the Nigeria’s north-eastern state of Borno.

According to Dr. Adekunle Adenji, the Director of World Health Organization National Polio Library, Department of Virology, University of Ibadan, in Nigeria, it is apparent that the resurgence would need to wait until the year 2019 without experiencing new outbreaks for it to be certified as a polio free nation. It is important to point out that the new outbreaks proved to be a very serious setback to the country’s polio eradication campaign. In his statement, Adenji stated that “So we are starting all over again. Those two years are now gone with all money and efforts put to work. So that is the problem.” It apparent from his words that the resurgence took the country several steps back in the campaign to fight polio out of the country and thus new initiatives would need to be devised and implemented to ensure that polio is completely eradicated and no future outbreaks experienced in the country.

Considering the region where the two cases were reported, which the north-eastern region of Nigeria that is facing a lot of insecurity issues arising from Boko Haram, the problem does not solely lie on the reluctance of the Nigeria authorities involved in financing the public health initiatives. The problem might also be rooted in the insecurity facing the north-eastern region of the country where the two cases were reported. One inevitable fact regarding the region is that health care workers find it very hard to access the region, with some health workers having been killed in the region. The insurgency of Boko Haram in the region could mean poor immunization coverage in the region, which would in turn translate into more new polio cases as evidenced by the two already diagnosed polio cases.

As former World Health Organization Consultant and Ambassador for poliomyelitis in West and Central African countries (also known as Stop Transmitting Polio Team), I witnessed during my work in 2000s, the parental attitudes and believes regarding the poliomyelitis immunization and its potential effects on the children or future generation. This parental misconception and misinformation has an important impact on the routine immunization of the children and the mass vaccinations such as Synchronized National Immunization Days organized regularly to reinforce and increase the poliomyelitis coverage.

The fight is not over; the world will not rest without achieving the polio eradication goals. We need to be stronger and reassess our strategies to curtain this disease once for all. Nigeria and other African countries will need to improve routine immunization, strengthen surveillance systems, and enhance the quality of poliomyelitis vaccination campaigns in order to reach every last child.⁴ If the rest of Africa and the world maintain a strong surveillance and vaccination coverage, the world could be certified polio free in the years to come. This will require a sustained political and financial commitments at all levels of the stakeholders. It is important to point out here that in the year 2012, more than half of all the global cases of polio had been reported in Nigeria according to the report by the World Health Organization. Nigeria had since then implemented campaign initiatives aimed at eradicating polio in the country and it saw the country progress 2years without any polio case being diagnosed before the 24th of July, 2016. These two cases have had serious public health implications and the country would need to put concerted efforts by all the involved stakeholders that include all the levels of the Nigerian government, the religious leaders, Nigerian civil society, and all the involved health workers around the country.

One important implication on the country’s public health is that a strengthened surveillance is needed to aid in the quick discovery and confirmation of any polio outbreaks in case any arise in the future. The most immediate answer to the polio outbreak problem should be an up to date vaccination of all the children in the country. This is because having any unvaccinated children would mean that polio virus would survive and this would increase its chances of spreading. All the parents should be urged to take the immunization practice with a lot of seriousness as failure to vaccinate the children not only promotes the survival and the spread of Polio, but also increases the chances of paralysis caused by the polio virus. The country should also place sufficient efforts on the eradication of polio by offering adequate funds for the campaigns and initiatives that are aimed at polio eradication in the country.⁵