Katsina’s polio troubles

This alarming rate necessitated several interventions from government and other relevant agencies aimed at reducing the trend. By March 2012, the number of polio cases reduced to 18, but still accounted for more than 40% of the entire national burden of polio at the time. By the end of the same year, no single case […]

This alarming rate necessitated several interventions from government and other relevant agencies aimed at reducing the trend.
By March 2012, the number of polio cases reduced to 18, but still accounted for more than 40% of the entire national burden of polio at the time. By the end of the same year, no single case was recorded.
According to the World Health Organisation, poliomyelitis (polio) is a highly infectious viral disease, which mainly affects young children. The virus is transmitted by person to person, spread mainly through the oral route or, less frequently, by a common vehicle (e.g. contaminated water or food) and multiplies in the intestine, from where it can invade the nervous system and can cause paralysis.
Initial symptoms of polio include fever, fatigue, headache, vomiting, stiffness in the neck, and pain in the limbs. In a small proportion of cases, the disease causes paralysis, which is often permanent. There is no cure for polio; it can only be prevented by immunization.
In an interview with the state Executive Secretary Primary Health Care Development Agency, Dr. Maawuya Aliu, said several approaches across sectors were adopted against polio.
These were aimed at addressing the issues which started with the the “Yellow Fever and Infectious Diseases (Immunisation) Law Cap 144 Laws of Katsina State: Katsina State of Nigeria Order 1 of 2005,” signed by the then state governor, late Umaru Musa Yar’adua in April. The order makes polio immunization compulsory for all children less than 5 years and prescribes penalties for offenders.
A special programme tagged REW (Reach Every Ward) was adopted as the platform of enhancing routine immunization under which vaccines were made available to every ward at any time where special refrigerators and cooling system were provided in all 361 wards of the state.  Under this programme there was also a mobile ambulance equipped with primary health care. This programme helped reach many children previously left out during past immunization exercises.
Health camps were equally introduced so that each village is given special attention by providing the local populace primary health services for malaria and cough—common ailments for which residents said they needed urgent help with, not polio, which they considered alien to them.
Special immunization teams were constituted to move not only from house to house but roam the streets, targeting children not at home during the immunization exercise by following them to the streets, markets, farms and motor parks to immunize them on the spot.
Polio-affected persons were engaged to sensitize parents about their experiences and predicaments which include living on wheels and crutches. The main purpose was to intimate them on the need to avoid such for their wards. The use of jesters, musicians and dancers played significant roles as children thronged such places, and got vaccinated as they watch the shows.
In time, as communities began to see government pressure, polio became an avenue for trade bargain. Several communities began to ask for projects in return for making their kids available for immunization. The Sayyaya community asked for a road, which the government had to provide. Several others asked for potable water and school rehabilitation.
By its own estimate, Katsina considers itself polio free, given that all the available indicators and analysis used in determining polio issues have been used and the result showed that the polio virus is no more, according to Aliu. But a certification to that effect is yet to come.
According to him, since 2012 the virus has disappeared in the state as one surest way of determination is the increase in polio immunization outreach as no fewer than 2.5 million children are immunized during any immunization days apart from special immunization days.
“After every round a survey is conducted and analyzed which usually gives us above 90 percent coverage.”
Routine immunisation on average reaches 92% coverage, Aliu said, noting a strong routine immunisation is needed to tackle polio.
“Several surveillance were carried out in each ward looking out for children with symptoms so that they are picked and tested by taking sample of their stools and they all turned out negative. This is another strong indicator, children with signs and turning out negative,” he said.
“We went further to start examining the environment by collecting samples of sewage, refuse dump site inseminators, to test for the virus and for the past twelve months this has continued to be negative. We then took the samples to the clinics to test children who were in the hospital for other ailment. We get level of protection—that is, antibody immunity—which should at least be around 80%, but ours usually exceeds 85%,” he added.
“Only recently there was a suspected polio case reported at Bindawa Local Government Area of the state which turned out to be negative according to state health officials and other expert analysis. The case was found out not to be that of  Wild Polio Virus WPV but a case  circulating vaccine derived virus(cVDPV).”
Aliu said this single recorded case of circulating vaccine derived virus (cVDPV)  is not the same as a  crippling, dangerous wild polio virus (WPV), but it prompted a mop-up immunisation in seven local government areas— Bindawa, Rimi, Mani, Kankia, Ingawa, Kusada, and Charanchi.