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A Lobanov

Publications and source records attributed to A Lobanov.

5 recordsLinked to original sources

Overview of poliomyelitis in the African Region and current regional plan of action.

The African Region of the World Health Organization includes a diverse membership of 48 countries and territories that has made substantial progress toward controlling poliomyelitis. The coverage with three doses of oral poliovirus vaccine among 1-year-old children reached 58% in 1995, a substantial increase from 49% in 1993, and the incidence of poliomyelitis decreased from 5126 cases in 1980 to 1597 in 1995. To interrupt poliovirus circulation, 29 countries planned to conduct either national immunization days (25 countries) or subnational immunization days (4 countries) during 1996. To ensure the success of these efforts, high-level political commitment has been obtained in many countries, and the campaign to "Kick polio out of Africa" is supported by some of the most respected African politicians. Provided the necessary resources can be obtained from internal and external sources, the African Region may be able to achieve the eradication of poliomyelitis by the year 2000 or shortly thereafter.

Africa↗

Status of polio eradication in the seven countries of the Eastern Africa Epidemiological Block.

The progress that Burundi, Eritrea, Kenya, Rwanda, Tanzania, Uganda, and Zambia, the seven countries of the Eastern Africa Epidemiological Block (EAEB), have made toward polio eradication is summarized. Despite low per capita gross national product, poor infrastructure (especially for communication and transportation), and civil unrest, the EAEB has made significant progress toward polio eradication. Five of the seven countries have achieved high levels of routine coverage with at least three doses of oral polio vaccine. Virologic surveillance is established in Tanzania, Uganda, Zambia, and Kenya; will be established in Eritrea in 1997; and will be resumed in Rwanda as soon as civil unrest abates. Political support for polio eradication is strong in the region, and all of the EAEB countries, except Burundi, held either national or subnational immunization days in 1996.

Adolescent↗

Polio outbreaks in Namibia, 1993-1995: lessons learned.

In 1993, a nationwide outbreak of 53 cases of paralytic poliomyelitis occurred in Namibia. The World Health Organization-recommended supplemental vaccination strategy of national immunization days (NIDs), providing two doses of oral polio vaccine (OPV) to all children <5 years, was implemented to control the epidemic. A second focal outbreak of 16 confirmed polio cases occurred during 1994-1995 in northeast Namibia. "Mopping-up" vaccination was implemented to control the second outbreak, followed by NIDs. Both epidemics appeared to be associated with wild poliovirus importation from Angola, where polio is endemic. Although supplemental vaccination measures achieved suboptimal OPV coverage, surveillance of acute flaccid paralysis has not detected wild poliovirus in Namibia since April 1995. Future NIDs should aim to ensure OPV coverage >90% in each round of NIDs in each district. Nevertheless, the risk of new poliovirus importations will continue until efforts in Angola to increase routine coverage with three doses of OPV and extend supplemental vaccination activities can be implemented.

Adolescent↗

Observations on the application of EPI cluster survey methods for estimating disease incidence.

The present study attempted to assess the incidence of target diseases of the Expanded Programme on Immunization (poliomyelitis, tetanus, measles, pertussis, neonatal tetanus, diphtheria), using cluster samples and a household interview form. The results suggest that this method can indeed serve to estimate the incidence of these diseases with reasonable precision and may also be used to demonstrate reduction in incidence for the more common diseases. Analysis of 37 surveys for poliomyelitis and neonatal tetanus in India revealed a relative uniformity in the design effect (i.e., the ratio of the variance for the cluster estimate to the variance for the binomial estimate) for diseases with low incidence and prevalence. Diseases with higher prevalence tend to have a larger design effect, which may be indicative of the epidemic and "clustered" nature of the disease. A large design effect, therefore, does not necessarily indicate a need for a larger sample size, particularly if precision is acceptable. There is no one single design that is ideal for all surveys of disease incidence and decisions must be made in the light of local conditions and available resources.

Child↗