Poliomyelitis in India: past, present and future.

Area of Science:

• Epidemiology
• Public Health
• Pediatrics

Background:

• Poliomyelitis studies from temperate climates may not be applicable to polio-endemic regions like the Indian subcontinent.
• Polio prevalence in India has shown complex trends, with rapid decreases near effective vaccination centers but potential increases overall.
• A significant proportion of polio cases in India may be aggravated by unnecessary intramuscular injections given to febrile children.

Purpose of the Study:

• To review changes in polio epidemiology in India since 1940.
• To examine the impact of unnecessary intramuscular injections on polio paralysis severity and prevalence.
• To analyze gender disparities in polio prevalence and rehabilitation.

Main Methods:

• Review of existing data on polio in India, including prevalence surveys and sentinel center data.
• Analysis of the National Baseline Prevalence survey figures.
• Examination of factors influencing polio paralysis, such as unnecessary injections and physical activity.

Main Results:

• Unnecessary injections may cause more severe paralysis in 45% of cases and convert non-paralytic to paralytic polio in 30% of Indian children annually.
• The median age of polio paralysis has decreased, potentially due to vaccinations and injections.
• A significant gender gap in polio prevalence and rehabilitation exists, possibly due to higher mortality in girls with paralysis.

Conclusions:

• A national campaign against unnecessary injections for febrile children is urgently needed to reduce polio severity and prevalence.
• Rehabilitation services for polio survivors have been neglected and require significant improvement.
• Further research should focus on infants and adult polio cases, while prohibiting research with virulent strains.