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Alied M, Salam A, Sediqi SM, Kwaah PA, Tran L, Huy NT. Disaster after disaster: the outbreak of infectious diseases in Pakistan in the wake of 2022 floods. Ann Med Surg (Lond) 2024; 86:891-898. [PMID: 38333326 PMCID: PMC10849431 DOI: 10.1097/ms9.0000000000001597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 11/27/2023] [Indexed: 02/10/2024] Open
Abstract
In June 2022, Pakistan witnessed catastrophic floods, affecting millions of people. The ensuing epidemics of cholera, cryptosporidiosis, rotavirus infections, generalized diarrhoea, typhoid and paratyphoid fevers, as well as the frequency of vector-borne diseases including malaria and dengue fever, are studied in this investigation. It also explores the latest outbreak of poliomyelitis and the frequency of respiratory diseases such COVID-19, diphtheria, and tuberculosis, as well as how floods have contributed to skin and eye problems. The report also describes the obstacles governments must overcome in order to manage these health emergencies and offers possible solutions for reducing the effects of ongoing and anticipated epidemics. This flood emphasizes the pressing need for international action and acts as an alarming indicator of the significant impact of climate change. It emphasizes how crucial it is to have effective flood response and preparation strategies in developing nations that are vulnerable to natural disasters.
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Affiliation(s)
- Marcel Alied
- Faculty of Pharmacy, University of Aleppo, Aleppo, Syria
- Online Research Club (www.onlineresearchclub.org)
| | - Abdus Salam
- Online Research Club (www.onlineresearchclub.org)
- General Surgery department, Khyber Teaching Hospital, Peshawar, Pakistan
| | - Sayed Mansoor Sediqi
- Online Research Club (www.onlineresearchclub.org)
- NOOR Eye Training Center, International Asistance Mission, Kabul, Afghanistan
| | - Patrick Amanning Kwaah
- Online Research Club (www.onlineresearchclub.org)
- Department of Internal Medicine, Yale School of Medicine, Yale-Waterbury Internal Medicine Program, Waterbury, Connecticut
| | - Linh Tran
- Institute of Fundamental and Applied Sciences, Duy Tan University, Ho Chi Minh City
- Faculty of Natural Sciences, Duy Tan University, Da Nang City, Vietnam
| | - Nguyen Tien Huy
- Online Research Club (www.onlineresearchclub.org)
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan
- Institute of Fundamental and Applied Sciences, Duy Tan University, Ho Chi Minh City
- Faculty of Natural Sciences, Duy Tan University, Da Nang City, Vietnam
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Habib MA, Tabassum F, Hussain I, Khan TJ, Syed N, Shaheen F, Soofi SB, Bhutta ZA. Exploring Knowledge and Perceptions of Polio Disease and Its Immunization in Polio High-Risk Areas of Pakistan. Vaccines (Basel) 2023; 11:1206. [PMID: 37515022 PMCID: PMC10386680 DOI: 10.3390/vaccines11071206] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Revised: 06/15/2023] [Accepted: 06/27/2023] [Indexed: 07/30/2023] Open
Abstract
Pakistan is one of the few countries where poliovirus transmission still persists, despite intensive efforts to eradicate the disease. Adequate vaccination coverage is essential to achieve polio eradication, but misconceptions about polio vaccines have hindered vaccination efforts. To address this issue, we conducted a mixed-methods study to explore knowledge and perceptions regarding polio disease and immunization in high-risk areas of Pakistan. We collected quantitative data from 3780, 1258, and 2100 households in Karachi, Bajaur, and Pishin, respectively, and supplemented this with qualitative data from focus group discussions and in-depth interviews. Our findings reveal a high level of awareness about polio and its immunization; however, misperceptions about the polio vaccine persist, leading to refusal for both polio vaccines and routine immunizations. Our study provides up-to-date data on knowledge and perceptions of polio and its immunization and identifies critical gaps. These findings can inform the development of future strategies and innovative approaches to improve the success of the polio program in Pakistan.
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Affiliation(s)
- Muhammad Atif Habib
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Farhana Tabassum
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Imtiaz Hussain
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Tooba Jawed Khan
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Nazia Syed
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Fariha Shaheen
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
| | - Sajid Bashir Soofi
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
| | - Zulfiqar A Bhutta
- Centre of Excellence in Women and Child Health, Aga Khan University, Karachi 74800, Pakistan
- Institute for Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
- Centre for Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 0A4, Canada
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Lohiniva AL, Nurzhynska A, Alhassan H, Shetye M, Ayiku P. Understanding Factors Influencing Polio Vaccine Uptake in Ghana-Developing Meaningful Community Mobilization and Engagement Strategies in Collaboration with Religious Leaders. Am J Trop Med Hyg 2022; 107:1345-1350. [PMID: 36315999 PMCID: PMC9768250 DOI: 10.4269/ajtmh.22-0271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 09/05/2022] [Indexed: 12/30/2022] Open
Abstract
This qualitative study explores how religious leaders in Ghana view polio and polio vaccine-related knowledge and perceptions of the community members. It also examines the personal characteristics of those who are most likely to accept or reject the vaccine. On the basis of the findings, this study provides a set of evidence-based recommendations to support religious leaders' efforts to create polio vaccine demand in their communities. The study is based on focus group discussions conducted with religious leaders from various geographic locations across Ghana. The discussions were transcribed verbatim and analyzed thematically. Twenty religious leaders, including Christian, Muslim, and leaders of traditional African religions, participated in the study. The findings show that both religious leaders and community members lack knowledge and have multiple culturally and religiously influenced explanations for polio. In addition, the findings reveal that vaccine safety and efficacy are linked to emotional narratives, and receiving the polio vaccine is not a social norm in all communities. Educated mothers in urban settings were identified as those most receptive to the polio vaccine. To create polio vaccine demand, religious leaders need to combat misinformation and the negative perceptions about the vaccine. Recommendations include conveying high-quality information to community members, developing tactics to address culturally and religiously sensitive matters, using emotionally inspired personal accounts to enhance positive attitudes toward polio vaccines and act as catalysts for positive social norms towards the polio vaccine. Educated mothers from urban areas can be engaged as champions in vaccine demand creation.
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Affiliation(s)
- Anna-Leena Lohiniva
- UNICEF Ghana, Accra, Ghana;,Address correspondence to Anna-Leena Lohiniva, UNICEF Country Office, P.O. Box 5051, 4-8 Rangoon Close, Accra-North, Ghana. E-mail:
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Ahmad S, Babar MS, Ahmadi A, Essar MY, Khawaja UA, Lucero-Prisno DE. Polio Amidst COVID-19 in Pakistan: What are the Efforts Being Made and Challenges at Hand? Am J Trop Med Hyg 2020; 104:446-448. [PMID: 33269673 PMCID: PMC7866369 DOI: 10.4269/ajtmh.20-1438] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2020] [Accepted: 11/20/2020] [Indexed: 11/07/2022] Open
Abstract
Poliomyelitis, a crippling viral disease, has been affecting many children in Pakistan despite the numerous efforts that have been taken to curb its spread. The COVID-19 pandemic has halted mass polio vaccination campaigns globally, including Pakistan, resulting in a resurgence of new cases. Pakistan managed to flatten the COVID-19 curve from July to October that made three immunization drives possible, but the COVID-19 cases are on the rise again which can again complicate the polio situation in the country if left unmonitored. The efforts of Pakistan have been effective with no significant rise in polio cases in 2020 as compared with 2019. We discuss the numerous challenges faced by the polio eradication program in Pakistan. To help eliminate polio, Pakistan needs to enhance its efforts in the struggle against polio with the same zeal and stringency used to flatten the curve of COVID-19 in these challenging times.
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Affiliation(s)
| | | | | | | | | | - Don Eliseo Lucero-Prisno
- Faculty of Management and Development Studies, University of the Philippines (Open University), Los Baños, Laguna, Philippines.,Department of Global Health and Development, London School of Hygiene and Tropical Medicine, London, United Kingdom
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Lazarus JV, Wyka K, Rauh L, Rabin K, Ratzan S, Gostin LO, Larson HJ, El-Mohandes A. Hesitant or Not? The Association of Age, Gender, and Education with Potential Acceptance of a COVID-19 Vaccine: A Country-level Analysis. JOURNAL OF HEALTH COMMUNICATION 2020; 25:799-807. [PMID: 33719881 DOI: 10.1080/10810730.2020.1868630] [Citation(s) in RCA: 140] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
In December 2020, the first COVID-19 vaccines were approved. Despite more than 85 million reported cases and 1.8 million known deaths, millions worldwide say they may not accept it. This study assesses the associations of age, gender, and level of education with vaccine acceptance, from a random sample of 13,426 participants selected from 19 high-COVID-19 burden countries in June 2020. Based on univariable and multivariable logistic regression, several noteworthy trends emerged: women in France, Germany, Russia, and Sweden were significantly more likely to accept a vaccine than men in these countries. Older (≥50) people in Canada, Poland, France, Germany, Sweden, and the UK were significantly more favorably disposed to vaccination than younger respondents, but the reverse trend held in China. Highly educated individuals in Ecuador, France, Germany, India, and the US reported that they will accept a vaccine, but higher education levels were associated with lower vaccination acceptance in Canada, Spain, and the UK. Heterogeneity by demographic factors in the respondents' willingness to accept a vaccine if recommended by employers were substantial when comparing responses from Brazil, Ecuador, France, India, Italy, Mexico, Poland, Russia, South Africa, South Korea, Sweden, and the US. This information should help public health authorities target vaccine promotion messages more effectively.
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Affiliation(s)
- Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona Spain
| | - Katarzyna Wyka
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
| | - Lauren Rauh
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
| | - Kenneth Rabin
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
| | - Scott Ratzan
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
| | | | - Heidi J Larson
- The Vaccine Confidence Project, Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Ayman El-Mohandes
- Graduate School of Public Health & Health Policy, City University of New York (CUNY), New York, USA
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Shah SFA, Ginossar T, Weiss D. “This is a Pakhtun disease”: Pakhtun health journalists’ perceptions of the barriers and facilitators to polio vaccine acceptance among the high-risk Pakhtun community in Pakistan. Vaccine 2019; 37:3694-3703. [DOI: 10.1016/j.vaccine.2019.05.029] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2019] [Revised: 04/22/2019] [Accepted: 05/09/2019] [Indexed: 11/16/2022]
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Shakeel SI, Brown M, Sethi S, Mackey TK. Achieving the end game: employing "vaccine diplomacy" to eradicate polio in Pakistan. BMC Public Health 2019; 19:79. [PMID: 30654797 PMCID: PMC6337835 DOI: 10.1186/s12889-019-6393-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 01/03/2019] [Indexed: 11/21/2022] Open
Abstract
Background On April 28, 2014, the World Health Organization (WHO) declared polio a “Public Health Emergency of International Concern” (PHIC) under the authority of the International Health Regulations. Although polio has been eradicated from nearly every nation on earth, Pakistan is one of three countries where wild polio and vaccine-derived polio strains remain, thwarting global eradication efforts. Aims Polio eradication progress is complicated by security and conflict issues at the border area between Pakistan and Afghanistan. In addition to security issues, other critical challenges, such as maintaining cold supply chain for vaccines, active and sentinel surveillance, false beliefs about vaccines, distrust of healthcare workers, and accessibility to conflict areas due to terrorist activities, all play a role in the continued persistence of Polio. In response to these challenges, we assess the local and international policy environment and its impact on polio eradication in Pakistan. Findings Based on our analysis of existing barriers and challenges associated with polio eradication in Pakistan, this study discusses why employing “vaccine diplomacy” represents a key policy and advocacy strategic approach to achieve the overall end game of polio eradication. Specifically, we identify a set of concrete public health, international development, and diplomatic and policy recommendations that can act synergistically under the umbrella of health and vaccine diplomacy to finally put an end to polio.
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Affiliation(s)
- Shahella Idrees Shakeel
- Joint Master's Program in Health Policy and Law, University of California, San Diego School of Medicine - California Western School of Law, San Diego, CA, USA
| | - Matthew Brown
- National Institutes of Health, National Cancer Institute, U.S. Embassy, China Office, Beijing, China
| | | | - Tim K Mackey
- Department of Anesthesiology and Division of Infectious Diseases and Global Public Health, University of California, San Diego School of Medicine, San Diego, CA, USA. .,Global Health Policy Institute, 8950 Villa La Jolla Drive, A124, La Jolla, San Diego, CA, 92037, USA.
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Knowledge and perceptions of polio and polio immunization in polio high-risk areas of Pakistan. J Public Health Policy 2018; 38:16-36. [PMID: 28077864 DOI: 10.1057/s41271-016-0056-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Pakistan and Afghanistan remain the only countries where polio is endemic, and Pakistan reports the most cases in the world. Although the rate is lower than in previous years, the situation remains alarming. We conducted a mixed methods study in high-risk areas of Pakistan to identify knowledge, attitudes, and practices of target populations about polio vaccine and its eradication, and to estimate coverage of routine immunization and oral polio vaccine. We surveyed 10,685 households in Karachi, 2522 in Pishin, and 2005 in Bajaur. Some knowledge of polio is universal, but important misconceptions persist. The findings of this study carry strategic importance for program direction and implementation.
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Geo-spatial reporting for monitoring of household immunization coverage through mobile phones: Findings from a feasibility study. Int J Med Inform 2017; 107:48-55. [DOI: 10.1016/j.ijmedinf.2017.09.004] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Revised: 08/13/2017] [Accepted: 09/13/2017] [Indexed: 11/21/2022]
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10
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Epidemiology of polio virus infection in Pakistan and possible risk factors for its transmission. ASIAN PAC J TROP MED 2016; 9:1044-1047. [DOI: 10.1016/j.apjtm.2016.09.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2016] [Revised: 08/20/2016] [Accepted: 09/10/2016] [Indexed: 11/22/2022] Open
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11
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Hussain SF, Boyle P, Patel P, Sullivan R. Eradicating polio in Pakistan: an analysis of the challenges and solutions to this security and health issue. Global Health 2016; 12:63. [PMID: 27729081 PMCID: PMC5059991 DOI: 10.1186/s12992-016-0195-3] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 09/08/2016] [Indexed: 11/23/2022] Open
Abstract
Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988 the global incidence of poliomyelitis has fallen by nearly 99 %. From a situation where wild type poliovirus was endemic in 125 countries across five continents, transmission is now limited to regions of just three countries – Pakistan, Afghanistan and Nigeria. A sharp increase in Pakistan’s poliomyelitis cases in 2014 prompted the International Health Regulations Emergency Committee to declare the situation a ‘public health emergency of international concern’. Global polio eradication hinges on Pakistan’s ability to address the religious, political and socioeconomic barriers to immunisation; including discrepancies in vaccine coverage, a poor health infrastructure, and conflict in polio-endemic regions of the country. This analysis provides an overview of the GPEI, focusing on the historical and contemporary challenges facing Pakistan’s polio eradication programme and the impact of conflict and insecurity, and sheds light on strategies to combat vaccine hesitancy, engage local communities and build on recent progress towards polio eradication in Pakistan.
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Affiliation(s)
- Shoaib Fahad Hussain
- Conflict and Health Research Group, King's Centre for Global Health, King's College London, Suite 2.13 Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK.
| | - Peter Boyle
- International Prevention Research Institute, Lyon, France.,University of Strathclyde Institute of Global Public Health @iPRI, Lyon, France
| | - Preeti Patel
- Department of War Studies and Conflict and Health Research Group, King's College London, London, UK
| | - Richard Sullivan
- Conflict and Health Research Group, King's Centre for Global Health, King's College London, Suite 2.13 Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK
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Eradication and Current Status of Poliomyelitis in Pakistan: Ground Realities. J Immunol Res 2016; 2016:6837824. [PMID: 27517055 PMCID: PMC4967708 DOI: 10.1155/2016/6837824] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 06/23/2016] [Indexed: 11/25/2022] Open
Abstract
Pakistan is among the last three countries along with Afghanistan and Nigeria, where polio virus is still endemic. More or less, with some fluctuations, numbers of reported cases in the past few years have shown a rising trend. Year 2014 pushed the country into the deep sea of difficulties, as number of cases rose to red alert level of 328. Security situation has adversely affected the whole immunization coverage campaign. In a country where 40 polio vaccinators have been killed since 2012, such a big number of cases is not a surprising outcome. Worse perception of parents about polio vaccine as in Karachi and FATA, the high risk zones, makes 100% coverage a dream. Minor and perhaps delayed payments to polio workers make them frustrated, resulting in decline of trained manpower for vaccination. Strong implementation of policies is required and those found guilty of attack on polio workers need to be punished. Targeted community awareness programme, strong surveillance network, and involvement of influential religious entities can help to root out polio disease from country. Present review is aimed at analyzing all barriers on the road to success in eradication of polio from Pakistan.
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Qazi J. End of Year 2015 in Polio Endemic Pakistan: Yet Another Beginning Towards End. FOOD AND ENVIRONMENTAL VIROLOGY 2016; 8:109-111. [PMID: 26872639 DOI: 10.1007/s12560-016-9230-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2016] [Accepted: 02/06/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Javaria Qazi
- Quaid-i-Azam University, Islamabad, Pakistan.
- National Institute for Biotechnology and Genetic Engineering, PAEC, Faisalabad, Pakistan.
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Why is Pakistan a threat to “The Polio Eradication and Endgame Strategic Plan 2013–2018”? A look into the past decade. Int J Infect Dis 2016; 42:4-6. [DOI: 10.1016/j.ijid.2015.11.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2015] [Accepted: 11/09/2015] [Indexed: 11/19/2022] Open
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Manya S, Qazi J. From Pakistan a line of hope for ‘The Polio Eradication and Endgame Strategic Plan 2013–2018’. Infect Dis (Lond) 2015; 48:167-8. [DOI: 10.3109/23744235.2015.1092050] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Sarmad Manya
- From the Department of Biotechnology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
| | - Javaria Qazi
- From the Department of Biotechnology, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad, Pakistan
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Ahmad SO, Yousuf F, Bux AS, Abu-Zaid A. Pakistan: the final frontier for global polio eradication: Table 1. J Epidemiol Community Health 2015; 70:109-10. [DOI: 10.1136/jech-2015-205530] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2015] [Accepted: 07/19/2015] [Indexed: 11/04/2022]
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17
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Ayukekbong JA. Current goals and prospects of the global polio eradication initiative. J Epidemiol Community Health 2015; 69:1133-4. [DOI: 10.1136/jech-2015-205529] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 05/21/2015] [Indexed: 11/04/2022]
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18
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Shaukat S, Angez M, Alam MM, Sharif S, Khurshid A, Malik F, Rehman L, Zaidi SSZ. Molecular characterization and phylogenetic relationship of wild type 1 poliovirus strains circulating across Pakistan and Afghanistan bordering areas during 2010-2012. PLoS One 2014; 9:e107697. [PMID: 25229826 PMCID: PMC4168008 DOI: 10.1371/journal.pone.0107697] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2013] [Accepted: 08/20/2014] [Indexed: 11/19/2022] Open
Abstract
Pakistan and Afghanistan share a long uncontrolled border with extensive population movement on both sides. Wild poliovirus transmission has never been interrupted in this block due to war against terrorism, poor public health infrastructure, misconceptions about polio vaccines and inadequate immunization activities. All these issues complicate the eradication operations and reinforce the complexity of wiping out poliomyelitis from this region. This study illustrates the origins and routes of cross-border wild poliovirus type 1 (WPV1) transmission during 2010-2012 between Pakistan and Afghanistan. Sequence analyses were conducted based on complete VP1 capsid protein sequences for WPV1 study strains to determine the origin of poliovirus genetic lineages and their evolutionary relationships. Phylogenetic tree was constructed from VP1 gene sequences applying Maximum Likelihood method using Kimura 2- parameter model in MEGA program v 5.0. A total of 72 (14.3%) out of 502 wild-type 1 polioviruses were found circulating in border areas of both countries during 2010-2012. Molecular phylogenetic analysis classified these strains in to two sub-genotypes with four clusters and 18 lineages. Genetic data confirmed that the most of WPV1 lineages (12; 66.6%) were transmitted from Pakistan to Afghanistan. However, the genetic diversity was significantly reduced during 2012 as most of the lineages were completely eliminated. In conclusion, Pakistan-Afghanistan block has emerged as a single poliovirus reservoir sharing the multiple poliovirus lineages due to uncontrolled movement of people across the borders between two countries. If it is neglected, it can jeopardize the extensive global efforts done so-far to eradicate the poliovirus infection. Our data will be helpful to devise the preventive strategies for effective control of wild poliovirus transmission in this region.
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Affiliation(s)
- Shahzad Shaukat
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Mehar Angez
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Muhammad Masroor Alam
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Salmaan Sharif
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Adnan Khurshid
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Farzana Malik
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
| | - Lubna Rehman
- Department of Virology, National Institute of Health, Chak Shahzad, Islamabad, Pakistan
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Khan T, Qazi J. Measles outbreaks in pakistan: causes of the tragedy and future implications. ACTA ACUST UNITED AC 2014. [DOI: 10.7243/2054-9911-2-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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