1
|
Edukugho AA, Etapelong SG, Gidado S, Abbott SL, Hamisu AW, Hassan IA, Mawashi KY, Erbeto TB, Waziri NE, Nguku P, Omotayo B, Adamu US. Innovative strategies developed to mitigate the impact of COVID-19 pandemic on polio surveillance in Nigeria, 2020. Pan Afr Med J 2023; 45:10. [PMID: 38370097 PMCID: PMC10874093 DOI: 10.11604/pamj.supp.2023.45.2.38261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 09/07/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction following the spread of the COVID-19 pandemic to Nigeria, the Federal Government of Nigeria restricted human and vehicular movements to curb the spread of the disease. This action had a negative impact on Acute Flaccid Paralysis (AFP) surveillance, with a resultant reduction in the number of AFP cases reported. This paper describes the impact of the COVID-19 pandemic on poliovirus surveillance in Nigeria and the proactive interventions by Nigeria´s polio program to mitigate the impact of COVID-19 on polio surveillance. Methods nine innovative strategies were implemented in all 774 Local Government Areas (LGA) of the 36 states and Federal Capital Territory (FCT) of the country. These strategies were developed by the national surveillance officers and operationalized by sub-national surveillance officers with different strategies starting at different epidemiological weeks from week 14 to 23, 2020. Many of the strategy innovations were technology-based and included: the use of mobile phones to send the AFP case definition and video by WhatsApp or by SMS, the use of state-specific toll-free numbers and Mobile Telephone Network (MTN) (mobile service provider) CallerfeelTM to community informants (CI) who were the main targets of the interventions to increase case detection and reporting. Others included the use of abridged e-surveillance integrated supportive supervision (ISS) checklists, virtual monthly DSNO meetings, and batched AFP stool specimen transportation network. Results compared to the same period in 2019, the cumulative rate of AFP case detection and reporting had gradually declined from 39.1% in January to 16.7% before the commencement of the interventions in week 20, 2020. However, the detection and reporting increased by 57.% from week 20 to week 47 compared to the same period in 2019. This is because with COVID-19, hospital visitation dropped, and the sick remained in the communities, so the CI network was relied on to detect and report AFP cases. The cumulative proportion of AFP cases reported by community informants as of week 47 increased from 13% in 2018 to 21% in 2020. This indicates an increase of 38%. Thirty-five AFP cases were detected and reported using the MTN Caller Feel strategy, while 15 cases were reported through state-specific toll-free numbers. Conclusion the implementation of the innovative strategies was able to mitigate the low AFP case detection and reporting observed at the initial stage of the COVID-19 pandemic. The use of technology facilitated reaching the CI network, which was more instrumental in detecting and reporting the cases.
Collapse
Affiliation(s)
| | | | - Saheed Gidado
- African Field Epidemiology Network, Federal Capital Territory (FCT), Abuja, Nigeria
| | - Samuel Luka Abbott
- African Field Epidemiology Network, Federal Capital Territory (FCT), Abuja, Nigeria
| | | | | | - Kabir Yusuf Mawashi
- National Primary Healthcare Development Authority, Federal Capital Territory (FCT), Abuja, Nigeria
| | | | | | - Patrick Nguku
- African Field Epidemiology Network, Federal Capital Territory (FCT), Abuja, Nigeria
| | - Bolu Omotayo
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Usman Said Adamu
- National Primary Healthcare Development Authority, Federal Capital Territory (FCT), Abuja, Nigeria
| |
Collapse
|
2
|
Hamisu AW, Etapelong SG, Ayodeji I, Richard B, Fiona B, Gidado S, Abbott SL, Edukugho AA, Bolu O, Adeyelu A, Mawashi KY, Adamu US, Nsubuga P, Shuaib F. Experience and findings from surveillance peer review in Nigeria, August 2017-May 2019. Pan Afr Med J 2023; 45:9. [PMID: 38370096 PMCID: PMC10874099 DOI: 10.11604/pamj.supp.2023.45.2.39450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 08/23/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction acute flaccid paralysis (AFP) surveillance is the gold standard of the Global Polio Eradication Initiative (GPEI) for detecting cases of poliomyelitis and tracking poliovirus transmission. Nigeria's AFP surveillance performance indicators are among the highest in countries of the World Health Organization (WHO) African Region. The primary AFP surveillance performance indicators are the rate of non-polio AFP among children and the proportion of timely, adequate specimen collection. The surveillance working group of the National Emergency Operations Centre assessed the quality of AFP surveillance data in some reportedly high-performing states. Methods we conducted a retrospective review of AFP surveillance performance indicators in Nigeria for 2010-2019. We also reviewed data in reports from four groups of surveillance peer reviews and validation visits (conducted by in-country GPEI partners) during August 2017-May 2019 in 16 states with high primary AFP surveillance indicators; the validation visits reviewed clinical information and the dates of specimen collection and onset of paralysis with caretakers. Results there were consistently increasing AFP surveillance primary performance indicators during 2010-2016, followed by declines during 2017-2019. From the data for 16 states with peer reviews conducted from August 2017-May 2019, overall concordance of reported and "true" (validated) AFP indicator data in peer review investigations was highly variable. True AFP concordance ranged from 58%-100%, and stool timeliness concordance ranged from 56%-95%. The most common clinical causes of reported AFP cases that were not true AFP were spastic paralysis, malaria, sickle cell disease, and malnutrition. All the states that participated in peer reviews developed surveillance improvement plans based on the gaps identified. Conclusion Nigeria has highly sensitive AFP surveillance according to reported primary AFP performance indicators. The findings of peer reviews indicate that the AFP surveillance system needs to be strengthened and well-supervised to enhance data quality.
Collapse
Affiliation(s)
| | | | - Isiaka Ayodeji
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Banda Richard
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Braka Fiona
- World Health Organization, Nigeria Country Office, Abuja, Nigeria
| | - Saheed Gidado
- National Stop Transmission of Polio (NSTOP)/African Field Epidemiology Network (AFENET), Aso, Federal Capital Territory, Abuja, Nigeria
| | - Samuel Luka Abbott
- National Stop Transmission of Polio (NSTOP)/African Field Epidemiology Network (AFENET), Aso, Federal Capital Territory, Abuja, Nigeria
| | - Aboyowa Arayuwa Edukugho
- National Stop Transmission of Polio (NSTOP)/African Field Epidemiology Network (AFENET), Aso, Federal Capital Territory, Abuja, Nigeria
| | - Omotayo Bolu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Asekun Adeyelu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | | | - Usman Said Adamu
- National Primary Healthcare Development Authority, Abuja, Nigeria
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, United States
| | - Faisal Shuaib
- National Primary Healthcare Development Authority, Abuja, Nigeria
| |
Collapse
|
3
|
Bammeke P, Adamu US, Bolu O, Waziri N, Erberto T, Aregay A, Nsubuga P, Wiesen E, Shuaib F. Descriptive epidemiology of poliomyelitis cases due to wild poliovirus type 1 and wild poliovirus type 3 in Nigeria, 2000-2020. Pan Afr Med J 2023; 45:4. [PMID: 38370099 PMCID: PMC10874097 DOI: 10.11604/pamj.supp.2023.45.2.38079] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 12/18/2022] [Indexed: 02/20/2024] Open
Abstract
Introduction in August 2020, the World Health Organization African Region was certified free of wild poliovirus (WPV) when Nigeria became the last African country to interrupt wild poliovirus transmission. The National Polio Emergency Operations Center instituted in 2012 to coordinate and manage Nigerian polio eradication efforts reviewed the epidemiology of WPV cases during 2000-2020 to document lessons learned. Methods we analyzed reported WPV cases by serotype based on age, oral poliovirus vaccine immunization history, month and year of reported cases, and annual geographic distribution based on incidence rates at the Local Government Area level. The observed trends of cases were related to major events and the poliovirus vaccines used during mass vaccination campaigns within the analysis period. Results a total of 3,579 WPV type 1 and 1,548 WPV type 3 laboratory-confirmed cases were reported with onset during 2000-2020. The highest WPV incidence rates per 100,000 population in Local Government Areas were 19.4, 12.0, and 11.3, all in 2006. Wild poliovirus cases were reported each year during 2000-2014; the endemic transmission went undetected throughout 2015 until the last cases in 2016. Ten events/milestones were highlighted, including insurgency in the northeast which led to a setback in 2016 with four cases from children previously trapped in security-compromised areas. Conclusion Nigeria interrupted WPV transmission despite the challenges faced because of the emergency management approach, implementation of mass vaccination campaigns, the commitment of the government agencies, support from global polio partners, and special strategies deployed to conduct vaccination and surveillance in the security-compromised areas.
Collapse
Affiliation(s)
- Philip Bammeke
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | | | - Omotayo Bolu
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | | | | | | | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, Georgia, United States
| | - Eric Wiesen
- Centers for Disease Control and Prevention, Atlanta, Georgia, United States
| | - Faisal Shuaib
- National Primary Healthcare Development Agency, Abuja, Nigeria
| |
Collapse
|
4
|
Bammeke P, Erbeto T, Aregay A, Kamran Z, Adamu US, Damisa E, Usifoh N, Nsubuga P, Waziri N, Bolu O, Dagoe E, Shuaib F. Assessment of open data kit mobile technology adoption to enhance reporting of supportive supervision conducted for oral poliovirus vaccine supplementary immunization activities in Nigeria, March 2017-February 2020. Pan Afr Med J 2023; 45:5. [PMID: 38370103 PMCID: PMC10874101 DOI: 10.11604/pamj.supp.2023.45.2.38140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 03/03/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction in Nigeria, supportive supervision of Supplementary Immunization Activities (SIA) is a quality improvement strategy for providing support to vaccination teams administering the poliovirus vaccines to children under 5 years of age. Supervision activities were initially reported in paper forms. This had significant limitations, which led to Open Data Kit (ODK) technology being adopted in March 2017. A review was conducted to assess the impact of ODK for supervision reporting in place of paper forms. Methods issues with paper-based reporting and the benefits of ODK were recounted. We determined the average utilization of ODK per polio SIA rounds and assessed the supervision coverage over time based on the proportion of local government areas with ODK geolocation data per round. Results a total of 17 problematic issues were identified with paper-based reporting, and ODK addressed all the issues. Open Data Kit-based supervision reports increased from 3,125 in March 2017 to 51,060 in February 2020. Average ODK submissions for national rounds increased from 84 in March 2017 to 459 in February 2020 and for sub-national rounds increased from 533 in July 2017 to 1,596 in October 2019. Supportive supervision coverage improved from 42.5% in March 2017 to 97% in February 2020. Conclusion the use of digital technologies in public health has comparative advantages over paper forms, and the adoption of ODK for supervision reporting during polio SIAs in Nigeria experienced the advantages. The visibility and coverage of supportive supervision improved, consequentially contributing to the improved quality of polio SIAs.
Collapse
Affiliation(s)
- Philip Bammeke
- Centers for Disease Control and Prevention, Atlanta, United States
| | | | | | | | | | - Eunice Damisa
- National Primary Health Care Development Agency, Abuja, Nigeria
| | - Nnamdi Usifoh
- Centers for Disease Control and Prevention, Atlanta, United States
| | - Peter Nsubuga
- Global Public Health Solutions, Atlanta, United States
| | | | - Omotayo Bolu
- Centers for Disease Control and Prevention, Atlanta, United States
| | - Edward Dagoe
- Centers for Disease Control and Prevention, Atlanta, United States
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| |
Collapse
|
5
|
Abba B, Abdullahi S, Bawa S, Getso KI, Bello IW, Korir C, Musa A, Braka F, Ningi A, Nsubuga P, Banda R, Tegegne SG, Shuaib F, Adamu US, Haladu S. Mobilizing political support proved critical to a successful switch from tOPV to bOPV in Kano, Nigeria 2016. BMC Public Health 2018; 18:1302. [PMID: 30541496 PMCID: PMC6291921 DOI: 10.1186/s12889-018-6195-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Kano is one of the high-risk states for polio transmission in Northern Nigeria. The state reported more cases of wild polioviruses (WPVs) than any other state in the country. The Nigeria Demographic and Health Survey of 2013 indicated that OPV3 coverage in the routine immunization (RI) programmewas 57.9%. Additionally, serial polio seroprevalence studies conducted from 2011 to 2015 in the eightmetropolitan LGAs indicated low immunity levels against all three polio serotypes in children below one year. Areas with sub-optimal RI coverage such as Kanothat fail to remove all tOPV during the tOPV-bOPV switchwill be at increased risk of VDPV2 circulation. METHODS We assessed the impact of political leadership engagement in mobilizing other stakeholders on the outcomes of the bOPV-tOPV switch in Kano State from February to May 2016 using nationally-selected planning and outcome indicators. RESULTS A total of 670 health facilities that provide RI services were assessed during the pre-switch activities. Health workers were aware of the switch exercise in 520 (95.1%) of the public health facilities assessed. It was found that health workers knew what to do should tOPV be found in any of the 521 (95.2%)public health facilities assessed. However, there was a wide disparity between the public and private health practitioners' knowledge on basic concepts of the switch. There was 100% withdrawal of tOPV from the state and the seven zonal cold stores. Unmarked tOPVwas found in the cold chain system in 2 (4.5%) LGAs. Only one health facility (0.8%) had tOPV in the cold chain. No tOPVwas identified outside the cold chain without the "Do not use" sticker in any of the health facilities. CONCLUSION The engagement of the political leadership to mobilize other key stakeholders facilitated successful implementation of the tOPV-bOPVswitch exercise and provided opportunity to strengthen partnerships with the private health sector in Kano State.
Collapse
Affiliation(s)
- Bashir Abba
- World Health Organization, Country Representative Office, Abuja, Nigeria.
| | - Sule Abdullahi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Samuel Bawa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | | | - Charles Korir
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Audu Musa
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Fiona Braka
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Adamu Ningi
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | | | - Richard Banda
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Sisay G Tegegne
- World Health Organization, Country Representative Office, Abuja, Nigeria
| | - Faisal Shuaib
- National Primary Health Care Development Agency, Abuja, Nigeria
| | | | - Sulaiman Haladu
- Africa Field Epidemiology Network, Hospital Road, Kano, Kano State, Nigeria
| |
Collapse
|