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Epidemiology of poliomyelitis in a slum of Bombay
V B Mandke1, R M Pawar, D D Naik
1Enterovirus Research Centre (ICMR), Parel, Bombay.
Insights
A 1988 Bombay slum survey found high poliomyelitis incidence due to low oral polio vaccine (OPV) coverage. Poor health awareness and community participation hindered immunization efforts, leaving many children vulnerable.
Area of Science:
- Public Health
- Epidemiology
- Pediatrics
Background:
- Poliomyelitis remains a significant public health concern in developing urban areas.
- Understanding disease prevalence and immunization coverage is crucial for targeted interventions.
Purpose of the Study:
- To assess the prevalence of poliomyelitis and oral polio vaccine (OPV) coverage in a Bombay slum.
- To identify factors contributing to low immunization rates and high disease incidence.
Main Methods:
- Conducted a disease prevalence and immunization coverage survey in a representative Bombay slum in 1988.
- Included 14,439 children under 9 years of age, identifying those with residual poliomyelitis.
- Collected data on immunization status, healthcare-seeking behavior, and community health awareness.
Main Results:
- Identified 93 children with residual poliomyelitis, yielding an annual incidence of 33.0/100,000 population.
- Only 66.6% of affected children received hospital admission during the acute illness phase.
- Oral polio vaccine (OPV) coverage for 3 doses in children under 2 years was low at 43.5%.
Conclusions:
- Low OPV coverage and delayed immunization initiation significantly contributed to the high poliomyelitis incidence.
- Poor community participation in immunization programs, linked to low health awareness, is a critical barrier.
- Urgent need for improved health education and community engagement to enhance immunization coverage and control polio.
Abstract:
A disease prevalence and immunization coverage survey in a typical slum in Bombay in the year 1988 revealed 93 children with residual poliomyelitis amongst 14,439 children below 9 years of age, indicating high (33.0/100,000 population) annual incidence of poliomyelitis. Only 62 (66.6%) of these 93 lame children sought admission in hospital during the acute phase of illness. The high incidence was attributed to a low immunization (OPV) coverage level in the most vulnerable age group. The immunization coverage for 3 doses of oral polio vaccine below 2 years of age was 43.5%. A large number of children were not commencing their immunization schedule at the right age. The survey indicated a poor "community participation" in the immunization programmes due to a poor "health awareness".