TY - JOUR
T1 - Seroprevalence of Anti-polio Antibodies in Children from Polio High-risk Areas of Pakistan
T2 - A Cross-Sectional Survey 2015-2016
AU - Hussain, Imtiaz
AU - MacH, Ondrej
AU - Habib, Atif
AU - Bhatti, Zaid
AU - Suhag, Zamir
AU - Oberste, M. Steven
AU - Weldon, William C.
AU - Sutter, Roland W.
AU - Soofi, Sajid B.
AU - Bhutta, Zulfiqar A.
N1 - Funding Information:
From the *Department of Peadiatrics and Child Health, Aga Khan University, Karachi, Pakistan; †Polio Eradication Department, World Health Organiza-tion, Geneva, Switzerland; and ‡Polio and Picornavirus Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, Georgia. Supported by the World Health Organization. The authors have no conflicts of interest to disclose. The findings and conclusions in this report are those of the authors and do not nec-essarily represent the official position of CDC or other contributing agencies. Address for Correspondence: Sajid B. Soofi, FCPS, Department of Paediatrics and Child Health, Aga Khan University, Karachi-74800, Pakistan. E-mail: sajid.soofi@aku.edu or Ondrej Mach, MD, Polio Eradication Department, World Health Organization, Geneva, Switzerland. E-mail: macho@who.int. Copyright 2017 Wolters Kluwer Health, Inc. All rights reserved. ISSN: 0891-3668/17/3609-e230 DOI: 10.1097/INF.0000000000001622
Publisher Copyright:
© 2017 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.
PY - 2017/9/1
Y1 - 2017/9/1
N2 - Background: Pakistan is one of the 3 remaining wild poliovirus endemic countries. We collected sera from children to assess the prevalence of poliovirus antibodies in selected high-risk areas for poliovirus transmission. Methods: Children in 2 age groups (6-11 and 36-48 months) were randomly selected between November 2015 and March 2016 in 6 areas of Pakistan (Sindh Province: Karachi and Kashmore; Khyber Pakhtunkhwa Province: Peshawar, Bannu and Nowshera; Punjab Province: Faisalabad). After obtaining informed consent, basic demographic and vaccination history data were collected, 1 peripheral venipuncture was obtained, and assays to detect poliovirus (PV)-neutralizing antibodies were performed. Results: A total of 1301 children were enrolled and had peripheral blood drawn that analyzed. Study subjects were evenly distributed among survey sites and age groups. Anti-polio seroprevalence differed significantly among geographic areas (P < 0.001); in the 6-11 months group, it ranged between 89% and 98%, 58% and 95%, and 74% and 96% for PV serotypes 1, 2 and 3, respectively; in 36-48 months group, it ranged between 99% and 100%, 95% and 100%, and 92% and 100% for PV 1, 2, and 3, respectively. Having received inactivate poliovirus vaccine, malnourishment (stunting) and educational level of parents were found to be associated with presence of anti-polio antibodies. Conclusion: The polio eradication program achieved overall high serologic protection; however, immunity gaps in young children in the high polio risk areas remain. These gaps enable sustained circulation of wild poliovirus type 1, and pose risk for emergence of vaccine-derived polioviruses. Focusing on the lowest socioeconomic strata of society, where malnutrition is most prevalent, could accelerate poliovirus eradication.
AB - Background: Pakistan is one of the 3 remaining wild poliovirus endemic countries. We collected sera from children to assess the prevalence of poliovirus antibodies in selected high-risk areas for poliovirus transmission. Methods: Children in 2 age groups (6-11 and 36-48 months) were randomly selected between November 2015 and March 2016 in 6 areas of Pakistan (Sindh Province: Karachi and Kashmore; Khyber Pakhtunkhwa Province: Peshawar, Bannu and Nowshera; Punjab Province: Faisalabad). After obtaining informed consent, basic demographic and vaccination history data were collected, 1 peripheral venipuncture was obtained, and assays to detect poliovirus (PV)-neutralizing antibodies were performed. Results: A total of 1301 children were enrolled and had peripheral blood drawn that analyzed. Study subjects were evenly distributed among survey sites and age groups. Anti-polio seroprevalence differed significantly among geographic areas (P < 0.001); in the 6-11 months group, it ranged between 89% and 98%, 58% and 95%, and 74% and 96% for PV serotypes 1, 2 and 3, respectively; in 36-48 months group, it ranged between 99% and 100%, 95% and 100%, and 92% and 100% for PV 1, 2, and 3, respectively. Having received inactivate poliovirus vaccine, malnourishment (stunting) and educational level of parents were found to be associated with presence of anti-polio antibodies. Conclusion: The polio eradication program achieved overall high serologic protection; however, immunity gaps in young children in the high polio risk areas remain. These gaps enable sustained circulation of wild poliovirus type 1, and pose risk for emergence of vaccine-derived polioviruses. Focusing on the lowest socioeconomic strata of society, where malnutrition is most prevalent, could accelerate poliovirus eradication.
KW - antibodies titer
KW - eradication program
KW - polio
KW - serosurvey
UR - http://www.scopus.com/inward/record.url?scp=85029667625&partnerID=8YFLogxK
U2 - 10.1097/INF.0000000000001622
DO - 10.1097/INF.0000000000001622
M3 - Article
C2 - 28806355
AN - SCOPUS:85029667625
SN - 0891-3668
VL - 36
SP - e230-e236
JO - Pediatric Infectious Disease Journal
JF - Pediatric Infectious Disease Journal
IS - 9
ER -
