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    Area of Science:

    • Global Health
    • Infectious Disease Epidemiology
    • Virology

    Background:

    • Global polio eradication initiatives, launched in 1988, have significantly reduced wild poliovirus (WPV) transmission worldwide.
    • WPV transmission persists in only two World Health Organization (WHO) regions: the African and Eastern Mediterranean Regions, primarily in Afghanistan, Nigeria, and Pakistan.
    • Imported WPV outbreaks occurred in the Horn of Africa, Central Africa, and the Middle East during 2013-2014, underscoring ongoing transmission risks.

    Purpose of the Study:

    • To present and analyze poliovirus surveillance data for 2013 and 2014.
    • To focus on the African and Eastern Mediterranean Regions, where WPV transmission is endemic.
    • To identify surveillance gaps and assess progress towards polio eradication goals.

    Main Methods:

    • Utilized surveillance for acute flaccid paralysis (AFP) cases, the primary polio symptom.
    • Conducted laboratory testing of stool specimens for WPV and vaccine-derived poliovirus (VDPV) through the Global Polio Laboratory Network (GPLN).
    • Supplemented AFP surveillance with environmental surveillance (sewage testing) and genomic sequencing for poliovirus characterization and transmission mapping.

    Main Results:

    • In 2013, 20 out of 23 African countries met primary surveillance quality indicators; this number decreased to 15 in 2014.
    • In the Eastern Mediterranean Region, five out of six countries met indicators in 2013, with all six meeting them in 2014.
    • Genomic sequencing was crucial for mapping transmission and identifying surveillance gaps by measuring genetic divergence.

    Conclusions:

    • Polio eradication requires sustained global efforts and robust surveillance systems.
    • Strengthening surveillance activities, including supervision, monitoring, and specimen collection, is critical in endemic regions.
    • Addressing identified surveillance gaps is essential to achieve and certify global polio eradication.