The Menace of Poliomyelitis in Northern Nigeria

Background

The poliovirus belongs to the enterovirus family and has three serotypes: serotype 1, 2 and 3. In addition, the 3 serotypes do not have cross immunity (Shors 2011). Therefore, immunity against one serotype does not provide immunity against another (WHO 2014c). It is noteworthy that Nigeria has not recorded any incidence of serotype 3 for about one year although the other serotypes still exist in the country (National Primary Healthcare Development Agency-NPHDA 2013). In addition, the incidence of wild polio has been recorded to be 9 cases in Nigeria at 2014 (CDC 2014b)

The polio vaccine is used to prevent Poliomyelitis and this vaccine is either inactivated (IPV) or live attenuated (OPV) (WHO 2014b). Although this vaccine prevents the disease, paralytic polio which is a serious complication of poliovirus infection can also be caused by the live  attenuated vaccine in a minute group of healthy individuals, or people they come into contact with, resulting in vaccine-derived polio (WHO 2014b). This occurs at the rate of 1 in 2.7 million children that receive the vaccine (Global Polio Eradication Initiative 2010b). For this reason, some public health scholars have argued against polio prevention through vaccination (Tagbo 2012). However, Khan and Ehreth (2003) estimated that the prevention of polio through effective immunization programmes between 1970 to 2050 could prevent 39.5 million disability-adjusted life years (DALYs) , 855,000 deaths and 4 million incidences of paralysis globally. Furthermore, UNICEF (2009) indicate that in areas of poverty, immunization is the cheapest and most effective means of reducing childhood morbidity and mortality. In this sense, then, it appears most advantageous to promote the global prevention of polio using the polio vaccine.

This essay aims to review critically the burden of polio in Nigeria as one of the endemic countries, with an emphasis on the northern part of Nigeria. The essay also hopes to draw out relevant interventions from countries that have eradicated the disease, taking particular consideration of India which is the most recent country to have eradicated polio (WHO 2014b).