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H F Hull

Publications and source records attributed to H F Hull.

At least 19 recordsLinked to original sources
PubMed1998

Perspectives from the global poliomyelitis eradication initiative.

Ten years after the year 2000 target was set by the World Health Assembly, the global poliomyelitis eradication effort has made significant progress towards that goal. The success of the initiative is built on political commitment within the endemic countries. A partnership of international organizations and donor countries works to support the work of the countries. Interagency coordinating committees are used to ensure that all country needs are met and to avoid duplication of donor effort. Private sector support has greatly expanded the resources available at both the national and international level. At the programmatic level, rapid implementation of surveillance is the key to success, but the difficulty of building effective surveillance programmes is often underestimated. Mass immunization campaigns must be carefully planned with resources mobilized well in advance. Programme strategies should be simple, clear and concise. While improvements in strategy and technology should be continuously sought, changes should be introduced only after careful consideration. Careful consideration should be given in the planning phases of a disease control initiative on how the initiative can be used to support other health initiatives.

Global Health↗
PubMed1997

Pax polio.

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Child↗
PubMed1997

Poliomyelitis surveillance: the compass for eradication.

Effective disease surveillance is a key strategy of the global polio eradication initiative. In an effort to strengthen the quality of polio surveillance as a prerequisite to achieving and certifying eradication, surveillance assessments were conducted in 28 countries in the World Health Organization African, Eastern Mediterranean, and European Regions from 1992 to 1995 using a standard protocol and evaluation guidelines. Six general recommendations were made: Use surveillance data for public health decision-making and action, improve timeliness of information exchange and dissemination, standardize the data collected, ensure adequate surveillance infrastructure, improve local data analysis, and enhance teamwork among surveillance partners. The experience gained will position the Expanded Programme on Immunization to address the challenges of disease prevention in the 21st century.

Adolescent↗
PubMed1997

National immunization days: state of the art.

National immunization days (NIDs) are nationwide mass campaigns to deliver supplemental doses of oral poliovirus vaccine to interrupt the circulation of wild polioviruses. They constitute one of the critical strategies for global poliomyelitis eradication and should be implemented in all countries with widespread poliovirus transmission. The certification of wild poliovirus eradication from the Western Hemisphere in September 1994 verified the effectiveness of this aspect of the World Health Organization's (WHO) overall strategy for polio eradication by the year 2000. NIDs require careful advanced planning and orchestration by each country. WHO provides specific guidelines for NIDs regarding the season, target age group, duration, frequency, inclusion of other interventions, vaccine delivery strategies, and evaluation. With strong routine immunization programs and the effective implementation of NIDs, "mop-up" campaigns, and acute flaccid paralysis surveillance, the goal of global polio eradication will be achieved.

Global Health↗
PubMed1997

The clinical efficacy of trivalent oral polio vaccine in The Gambia by season of vaccine administration.

An epidemic of poliomyelitis caused by poliovirus type 1 occurred in The Gambia in 1986. To determine if a relationship existed between the failure of trivalent oral poliovirus vaccine (OPV) to prevent poliomyelitis and the season when children were vaccinated, 46 children 1-7 years old with poliomyelitis who had received three card-documented doses of OPV were compared with 260 controls who had also received three card-documented doses. Controls were individually matched with children who had poliomyelitis by age, sex, and residence. Children with poliomyelitis were more likely to have received doses in the rainy season (odds ratio describing the linear trend of each additional dose in the rainy season, 1.7; 95% confidence interval, 1.05-2.9). This finding extends previous observations of seasonal difference in the immunogenicity of OPV in The Gambia by showing that season of administration was associated with increased risk of vaccine failure nationwide for a several-year period.

Case-Control Studies↗
PubMed1997

Progress toward global polio eradication.

Significant progress is being made towards the global eradication of poliomyelitis by the year 2000. The strategies recommended by the World Health Organization for polio eradication are as follows: maintaining high routine immunization coverage; conducting nationwide mass immunization campaigns; building effective, laboratory-based surveillance for acute flaccid paralysis; and conducting localized immunization campaigns directed at the final reservoirs of virus transmission. Sixty-three countries have conducted nationwide anti-polio immunization campaigns. Three hundred million children were immunized in these campaigns worldwide in 1995. The reported incidence of poliomyelitis has fallen by approximately 80% since the global target was set in 1988, and the geographic range of polio is being restricted. The major challenges for achieving eradication are establishing effective surveillance systems in all countries and mobilizing the resources needed to fully implement the recommended strategies in the 67 countries in which polio remains endemic.

Global Health↗
PubMed1997

Outbreak of paralytic poliomyelitis in a highly immunized population in Jordan.

Between November 1991 and March 1992, 37 cases of paralytic poliomyelitis occurred in Jordan, where none had been reported since 1988. Of these, 17 (50%) of 34 patients had received at least three doses of oral poliovirus vaccine (OPV3). The first and 2 subsequent case-patients were children of Pakistani migrant workers, and the first 8 and a total of 27 (75%) case-patients resided in or near the Jordan Valley. A seroepidemiologic study of 987 children in all regions of Jordan was performed to assess OPV3 coverage and immune response to OPV. Although OPV3 coverage by 12 months of age was high (96%) in the general population, coverage was lower among Pakistani (21%), Bedouin (63%), and Gypsy (9%) children (P < .001). Seroprevalences for poliovirus type 3 were 71% in the Jordan Valley versus 81% in other regions after 3 doses of OPV (P < .06) and 77% in the Jordan Valley versus 98% in other regions after 5 doses of OPV (P < .001). This outbreak demonstrates the importance of achieving high seroimmunity to infection in all geographic areas to prevent the reintroduction and spread of imported strains of wild poliovirus.

Case-Control Studies↗
PubMed1997

Current status of the global eradication of poliomyelitis.

Substantial progress towards the global eradication of poliomyelitis by the year 2000 has been achieved since May 1988 when WHO Member States adopted this goal at the Forty-first World Health Assembly. Virtually all polio-endemic countries have begun to implement the WHO-recommended strategies to eradicate polio and it is expected that, by the end of 1997, all endemic countries in the world will have conducted full National Immunization Days (NID), providing supplemental oral polio vaccine (OPV) to nearly two-thirds of all children < 5 years. In contrast, although globally acute flaccid paralysis (AFP) surveillance was being conducted in 126 (86%) of 146 countries where polio is or recently was endemic, surveillance remains incomplete and untimely. A global network of polio laboratories, capable of detecting wild poliovirus when and where it occurs, has been developed. Furthermore, in countries where polio virus circulation has been limited to focal areas, and surveillance is adequate, mopping-up campaigns are being conducted to eliminate the final chains of transmission. The process for certification of polio eradication has been established in each WHO region as well as at the global level. The impact of the eradication initiative is evident, with an 88% decrease in the number of reported cases globally since 1988. In order to achieve the goal of eradication, the rapid development of complete and timely AFP surveillance and the continuation of effective NIDs constitute an urgent priority. This is of particular relevance in the remaining polio-endemic countries, especially in those that are affected by war or politically isolated and are important remaining reservoirs from where wild poliovirus continues to spread into bordering or even distant polio-free countries. External support will continue to be required by those countries and regions where the incidence of polio has reached low levels to ensure that final chains of poliovirus transmission are interrupted and to permit the eventual certification of eradication. The year 2000 objective for achieving poliomyelitis eradication remains a feasible target.

Adolescent↗
PubMed1995

Polio eradication.

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Developing Countries↗
PubMed1994

Paralytic poliomyelitis: seasoned strategies, disappearing disease.

With more than 2 years having elapsed since the last case of paralytic poliomyelitis occurred in the Western Hemisphere, significant progress has been made towards the global eradication of wild polioviruses. Poliomyelitis is disappearing from Europe, North Africa, Southern Africa, the Middle East, China, and the Pacific. Reported poliomyelitis cases declined to 15,587 cases in 1992. Current eradication strategies recommended by the World Health Organization include national mass campaigns administering oral poliovaccine to all children under 5 years of age, enhanced surveillance to detect cases of acute flaccid paralysis, creating a network of laboratories for viral diagnosis, and targeted immunisation to areas and populations where poliovirus transmission is likely to persist. The major obstacles to eradication include inadequate political support for eradication and insufficient funding, especially for the purchase of vaccine. With additional support for the international eradication effort, epidemics of poliomyelitis will cease in developing countries, and industrialised countries will be able to save the large sums spent each year on poliovaccine and rehabilitation.

Global Health↗
PubMed1993

The WHO-EPI initiative for the global eradication of poliomyelitis.

Since the development of attenuated oral polio vaccine, Dr Albert Sabin consistently maintained that the global eradication of wild poliovirus was possible, but that to achieve polio eradication in developing countries would require the mass administration of the oral vaccine. Experience in Cuba and Czechoslovakia proved the effectiveness of this technique, but it was only with its deployment in Brazil in 1980 that its role in eradicating the virus from a broad geographical area started to be realized. With the declaration in 1985 of a target of regional polio eradication, extension of this policy, allied with the development of effective surveillance of acute flaccid paralysis in children, with laboratory confirmation of diagnosis rapidly led to apparent interruption of wild poliovirus transmission throughout the Americas. The World Health Assembly in 1988 committed WHO to the global eradication of poliomyelitis. Based on experience in the Americas and building on the solid foundation established by the Expanded Programme on Immunization, WHO has defined the strategies through which the global target could be achieved. Progress is encouraging and where the advocated strategies have been fully implemented, the incidence of poliomyelitis has declined dramatically. Significant geographical areas in Western Europe, the Maghreb, the Arabian peninsula, the Pacific basin and Southern Africa, each incorporating several countries, are now thought to be free of the disease caused by wild poliovirus. The target of a world free of polio by the year 2000 can be achieved.

Developing Countries↗
PubMed1992

Screening of cases of acute flaccid paralysis for poliomyelitis eradication: ways to improve specificity.

The Pan American Health Organization in 1985 adopted an initiative to eradicate poliomyelitis from the Western Hemisphere. In 1990, over 2000 cases of acute flaccid paralysis (AFP) were reported in this region, of which < 1% were determined to be caused by wild poliovirus. At present, the eradication programme uses AFP as the criterion for surveillance of children aged < 15 years; this is 100% sensitive, but not specific. To minimize unnecessary diagnostic investigations, we studied all 4333 cases of AFP reported to the programme during 1989 and 1990 in order to develop more efficient operational screening criteria for cases of AFP. Among children with AFP, the use of criteria such as age < 6 years and either presence of fever at the onset of paralysis or a < 4-day period for complete development of paralysis resulted in a sensitivity of 96% (95% C.I. 90-103%) and specificity of 49% (C.I. 47-52%). With criteria of age < 6 years and fever present at the onset of paralysis the sensitivity was 75% (C.I. 61-89%) and specificity was 73% (C.I. 71-75%). These results suggest that by screening young children with AFP who either had fever at the onset or showed a rapid progression of paralysis, the number of cases of AFP requiring investigation can be reduced by one half, with minimal compromise in the sensitivity of confirmed poliomyelitis case detection.

Adolescent↗