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. 2024 Mar 27:12:1384410.
doi: 10.3389/fpubh.2024.1384410. eCollection 2024.

Exploring the path to polio eradication: insights from consecutive seroprevalence surveys among Pakistani children

Imtiaz Hussain #  1 , Muhammad Umer #  1 , Ahmad Khan #  1 , Muhammad Sajid  1 , Imran Ahmed  1 , Kehkashan Begum  2 , Junaid Iqbal  2 , Muhammad M Alam  3 , Rana M Safdar  4 , Shahzad Baig  4 , Arie Voorman  5 , Jeffrey Partridge  5 , Sajid Soofi  1   2
Affiliations

Exploring the path to polio eradication: insights from consecutive seroprevalence surveys among Pakistani children

Imtiaz Hussain et al. Front Public Health. .

Abstract

Introduction: After trivalent oral poliovirus vaccine (tOPV) cessation, Pakistan has maintained immunity to type 2 poliovirus by administering inactivated polio vaccine (IPV) in routine immunization, alongside monovalent OPV type 2 (mOPV2) and IPV in supplementary immunization activities (SIAs). This study assesses the change in poliovirus type 2 immunity after tOPV withdrawal and due to SIAs with mOPV2 and IPV among children aged 6-11 months.

Methods: Three cross-sectional sequential serological surveys were conducted in 12 polio high-risk areas of Pakistan. 25 clusters from each geographical stratum were selected utilizing probability proportional to size.

Results: Seroprevalence of type 2 poliovirus was 49%, with significant variation observed among surveyed areas; <30% in Pishin, >80% in Killa Abdullah, Mardan & Swabi, and Rawalpindi. SIAs with IPV improved immunity from 38 to 57% in Karachi and 60 to 88% in Khyber. SIAs with IPV following mOPV2 improved immunity from 62 to 65% in Killa Abdullah, and combined mOPV2 and IPV SIAs in Pishin improved immunity from 28 to 89%. Results also reflected that immunity rates for serotypes 1 and 3 were consistently above 90% during all three phases and across all geographical areas.

Conclusion: The study findings highlight the importance of implementing effective vaccination strategies to prevent the re-emergence of poliovirus. Moreover, the results provide crucial information for policymakers working toward achieving global polio eradication.

Keywords: Pakistan; eradication; poliovirus; seroprevalence; type 2 immunity.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Study profile.
Figure 2
Figure 2
Seroprevalence by survey areas of Pakistan, 2016–2019. The points denote seroprevalence estimates, and lines indicate 95% confidence intervals. The x-axis represents the median month of the blood draw for children in the survey round.
Figure 3
Figure 3
Seroprevalence by birth cohorts. The points denote seroprevalence estimates, and lines indicate 95% confidence intervals. The x-axis represents birth in year-month format.
Figure 4
Figure 4
Seroprevalence of type 2 OPV in routine immunization, by study area. Bar heights represent seroprevalence, and lines show 95% confidence intervals.
Figure 5
Figure 5
Seroprevalence of type 2 OPV in areas targeted for mOPV2 campaigns. Bar heights represent seroprevalence, and lines show 95% confidence intervals.
Figure 6
Figure 6
Type 2 immunity by eligibility for SIA contain IPV. The bar heights represent seroprevalence, and lines show 95% confidence intervals.
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The author(s) declare that financial support was received for the research, authorship, and/or publication of this article. The study was supported by the Bill & Melinda Gates Foundation (grant number OPP1156736).

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