scholarly journals In-Country Acute Flaccid Paralysis Surveillance Review, Nasarawa State, Nigeria, 2017

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Maureen O Anyanwu ◽  
Ndubuisi Akpuh ◽  
Adewole Adefisoye
Keyword(s):  
Peer Review ◽  
Stool Specimen ◽  
Acute Flaccid Paralysis ◽  
World Health Organisation ◽  
Flaccid Paralysis ◽  
World Health ◽  
Residual Paralysis ◽  
Case Investigation ◽  
Specimen Collection ◽  
The World

Objective: In August, 2017, we conducted a peer review evaluation of the reported high stool adequacy and Non-polio Acute Flaccid Paralysis (AFP) rates of the World Health Organisation (WHO) verified AFP cases, in order to estimate and establish concordance for both surveillance core indicators in Lafia and Nasarawa Egon LGAs in Nasarawa State.Introduction: Nigeria is the only polio endemic country in Africa. Four (4) WPV1 cases were confirmed in 2013 after two years of silence. Nigeria has a strong polio programme characterized by innovative and forward driven strategies, despite several challenges of which surveillance is one of the driving forces. Near perfect surveillance core indicators reported over the past twelve (12) months across certain states and Local Government Areas (LGAs) were issues of concern, given security challenges among others. In August, 2017, we conducted a peer review evaluation of the reported high stool adequacy and Non-polio Acute Flaccid Paralysis (AFP) rates of the World Health Organisation (WHO) verified AFP cases, in order to estimate and establish concordance for both surveillance core indicators in Lafia and Nasarawa Egon LGAs in Nasarawa State.Methods: The LGAs to be visited and AFP cases reported within ninety (90) days and verified to be true and adequate prior to peer review were selected. Any person with strong surveillance knowledge and skill, working in Nigeria with the government or partner agencies and involved in surveillance was identified as a peer reviewer, trained and deployed to the LGAs. Reviewers were not deployed to their geo-political zones where they work under routine conditions. Data was collected by visiting the residence of the respective AFP cases and eliciting responses, using a structured interviewer -administered peer review checklist. Data was collated, analysed using Microsoft Excel 2010 and interpreted accordingly. The causes of incoherence were identified and presented to the LGA Disease Surveillance and Notification Officers (DSNOs) and State authority. An improvement plan which would be monitored and evaluated was elaborated. The AFP surveillance data base for discordant AFP cases was updated with the data generated from the peer review.Results: Of the nineteen (19) AFP cases reviewed, 63.2% (12/19) were females. The mean Age of the total AFP case patients was 3 years (SD 3.4). In Lafia LGA, eight (8) AFP cases were verified and all were true AFP cases and adequate. In Nasarawa Egon LGA, eleven (11) cases were verified, 54.5% (6/11) were true AFP cases and 90.9% (10/11) were found to be adequate. The major causes of the gaps identified include mothers/caregivers dividing collected stool specimen sample to make for two (2) stool samples meant to be collected 24 hours apart for case investigation. This was due to failure on the part of the LGA DSNOs to either inform the mothers/caregivers or underscore the importance of appropriate stool collection. The inability of the surveillance focal officers to adequately identify/differentiate other disease conditions that mimic AFP and persistence of residual paralysis (in Non-polio AFP cases) in 5 (45.5%) cases were also identified in Nasarawa Egon LGA. This was as a result of the lack of referral to the next level for physiotherapy care.Conclusions: In Nasarawa Egon LGA, they were discordances in the reported AFP performance core indicators. They include inadequate stool sample, wrong classification of AFP cases and persistence of residual paralysis in Non-polio AFP cases. We therefore, recommend that the WHO State team should re-orient the LGA DSNOs on proper stool specimen collection for case investigation. Also, the LGA DSNOs should sensitize parents/caregivers on appropriate protocol of stool specimen collection and advise them on referral to the next level of care.

scholarly journals Outbreak of poliomyelitis in Tajikistan in 2010: risk for importation and impact on polio surveillance in Europe?

2010 ◽  
Vol 15 (17) ◽  
Author(s):  
collective World Health Organization Country Office Tajikistan ◽  
Collective WHO Regional Office for Europe ◽  
European Centre for Disease Prevention and Control
Keyword(s):  
High Risk ◽  
Acute Flaccid Paralysis ◽  
Uttar Pradesh ◽  
World Health Organisation ◽  
Flaccid Paralysis ◽  
World Health ◽  
Wild Poliovirus ◽  
The World ◽  
Serotype 1

On 23 April 2010, the World Health Organisation announced the confirmation of wild poliovirus serotype 1 (WPV1) in seven samples from children with Acute Flaccid Paralysis in Tajikistan, in the context of a multi-district cluster starting in December 2009. As of 28 April, 32 of 171 reported cases were laboratory-confirmed and most closely related to virus from Uttar Pradesh, India. This outbreak demonstrates the high risk that still exists for importation of wild poliovirus into polio-free regions.

scholarly journals Performance of Acute Flaccid Paralysis surveillance in Bauchi State, Nigeria, 2016

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Luka M. Ibrahim ◽  
Adamu Ningi ◽  
Jalal-Eddeen Saleh
Keyword(s):  
Stool Specimen ◽  
Acute Flaccid Paralysis ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
World Health ◽  
Polio Virus ◽  
Specimen Collection ◽  
Afp Surveillance ◽  
Stool Samples ◽  
Definition Of

ObjectiveTo identify and address gaps in acute flaccid surveillance for polioeradication in Buchi stateIntroductionPoliomyelitis a disease targeted for eradication since 19881still pose public health challenge. The Eastern Mediterranean andAfrican Regions out of the six World Health Organization (WHO)Regions are yet to be certified polio free2. The certification of theWHO Africa region is largely dependent on Nigeria, while the WHOEastern Mediterranean is dependent on Pakistan and Afghanistan.Surveillance for acute flaccid paralysis (AFP) is one of the criticalelements of the polio eradication initiative. It provides the neededinformation to alert health managers and clinician to timely initiateactions to interrupt transmission of the polio disease and evidence forthe absence of the wild polio virus.3,4One of the core assignments ofthe certification committee in all regions is to review documentationto verify the absence of wild poliovirus.5Good and completedocumentation is the proxy indication of the quality of the systemwhile poor documentation translates to possibilities of missing wildpoliovirus in the past. We evaluated the performance of the AFPsurveillance system in Bauchi, which is among the 11 high risks statesfor wild polio virus in Nigeria to identify and address gaps in thesurveillance system.MethodsWe conducted a cross-sectional study in Bauchi State. We assessedthe material and documentations on AFP surveillance in eighteen of thetwenty Local Government Areas (LGAs). We assessed the knowledgeof the clinician at focal and non-focal sites on case definition of AFP,the number and method of stool specimen collection to investigate acase and types of training received for AFP surveillance. We verifiedAFP case investigations for the last three years: The caregivers(mothers) were interviewed to authenticate the reported informationof AFP cases, the method used for stool specimen collection andfeedbacks. Community leaders’ knowledge on AFP surveillance wasalso assessed. Data was entered and analyzed in excel spread sheet.ResultsReview of the expected deliverables of 18 out of the 20 LGAdisease surveillance and notification officers (DSNO) revealed thatonly 2(11%), 5(28%), 6(33%) and 7(39%) had evidence of poliooutbreak investigation, supervisory reports, minutes of meeting andsurveillance work plan respectively. Of the 31 AFP cases investigated,correct and complete information was 39% for birth day, 26% forbirth month of the child, 23% for date of onset of paralysis and 23%for date of investigation. Contacts of informants, AFP 001-3 weredeficient in the focal and non-focal sites. The non-focal also lackedguidelines for integrated disease surveillance and response (IDSR)and terms of reference for surveillance focal person.Knowledge of case definition of AFP was 71% and 30% amongclinician at the focal and non-focal sites, respectively and 88% and55% for method of stool collection among clinician at focal and non-focal sites. Among the 38 care givers (mothers) interviewed 16 (42%)did not remember the day or month the investigation for the AFPwas conducted, 36(95%) gave the correct number of stool samples,15(40%) mentioned that the stool samples were collected 24 hoursapart and only 12 (32%) received feedbacks. Majority (79%) of thecommunity leaders interviewed were aware of AFP and knew thatstool was the specimen for investigation of the AFP but 21% did notknow whom to report a case of AFP in their communityConclusionsOur study revealed knowledge and documentations gaps in AFPsurveillance for certification of polio-free in Nigeria. The stateministry of health and the WHO consultants in the polio eradicationunit should update the knowledge of the health care workers at theoperational levels on AFP surveillance. The state ministry of healthand the WHO consultants should also provide all essential documentsrequired for quality AFP surveillance and ensure their judicious use.

scholarly journals Genotyping of non-polio enteroviruses associated with acute flaccid paralysis in Thailand in 2013 and 2014

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Napa Onvimala ◽  
Nathamon Kosoltanapiwat ◽  
Pornpan Pumirat ◽  
Muthita Vanaporn ◽  
Suchitra Nimmanitya ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
World Health ◽  
Reference Laboratory ◽  
Mouth Diseases ◽  
Circulation Patterns ◽  
The World ◽  
Afp Surveillance ◽  
Health Organization ◽  
First Time

Abstract Background Acute flaccid paralysis (AFP) surveillance was conducted as part of the World Health Organization’s strategy for completely eradicating poliomyelitis and leaving non-polio enteroviruses NPEVs as one of the main potential causes of AFP. We aimed to detect NPEV in association with AFP. Methods We used 459 isolates reported to be Negative Polio and some NPEVs by the World Health Organization Polio Regional Reference Laboratory (Thailand), which had been obtained during polio surveillance programmes conducted in Thailand in 2013–2014. Of 459 isolates, 35 belonged to the genus Enterovirus by RT-PCR and genotyping by DNA sequencing. Results This study found 17 NPEV genotypes, with 3, 13 and 1 belonging to enterovirus (EV) species A (EV-A), EV-B, and EV-C, respectively. The EV-A types identified included coxsackievirus A2 (CA2), CA4, and EV71, typically associated with hand, foot and mouth diseases. EV-B is the most prevalent cause of AFP in Thailand, while CA21 was the only type of EV-C detected. The EV-B species (13/35; 76.5%) constituted the largest proportion of isolates, followed by EV-A (3/35; 17.6%) and EV-C (1/35; 5.9%). For the EV-B species, Echovirus (E) 30 and CVB were the most frequent isolates. E30, CVB, E14, and E6 were considered endemic strains. Conclusion NPEVs, e.g. CA4, are reported for the first time in Thailand. Despite some limitations to this study, this is the first report on the circulation patterns of NPEVs associated with AFP in Thailand. AFP surveillance has unearthed many unknown NPEVs and, the cases of death due to AFP occur annually. Therefore, it is important to study NPEVs in the wake of the eradication of poliovirus in the context of the continued incidence of paralysis.

scholarly journals Gonotyping of non-polio enteroviruses associated with acute flaccid paralysis in Thailand in 2013 and 2014

2021 ◽  
Author(s):  
Napa Onvimala ◽  
Nathamon Kosoltanapiwat ◽  
Pornpan Pumirat ◽  
Muthita Vanaporn ◽  
Suchitra Nimmanitya ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
World Health ◽  
Reference Laboratory ◽  
Mouth Diseases ◽  
Circulation Patterns ◽  
The World ◽  
Afp Surveillance ◽  
Health Organization ◽  
First Time

Abstract Background Acute flaccid paralysis (AFP) surveillance was conducted as part of the World Health Organization’s strategy for completely eradicating poliomyelitis and leaving non-polio enteroviruses NPEVs as one of the main potential causes of AFP. We aimed to detect NPEV in association with AFP.Methods We used 459 isolates reported to be Negative Polio and some NPEVs by the World Health Organization Polio Regional Reference Laboratory (Thailand), which had been obtained during polio surveillance programmes conducted in Thailand in 2013–2014. Of 459 isolates, 35 belonged to the genus Enterovirus by RT-PCR and genotyping by DNA sequencing.Results This study found 17 NPEV genotypes, with 3, 13 and 1 belonging to enterovirus (EV) species A (EV-A), EV-B, and EV-C, respectively. The EV-A types identified included coxsackievirus A2 (CA2), CA4, and EV71, typically associated with hand, foot and mouth diseases. EV-B is the most prevalent cause of AFP in Thailand, while CA21 was the only type of EV-C detected. The EV-B species (13/35; 76.5%) constituted the largest proportion of isolates, followed by EV-A (3/35; 17.6%) and EV-C (1/35; 5.9%). For the EV-B species, Echovirus (E) 30 and CVB were the most frequent isolates. E30, CVB, E14, and E6 were considered endemic strains.Conclusion NPEVs, e.g. CA4, are reported for the first time in Thailand. Despite some limitations to this study, this is the first report on the circulation patterns of NPEVs associated with AFP in Thailand. AFP surveillance has unearthed many unknown NPEVs and, the cases of death due to AFP occur annually. Therefore, it is important to study NPEVs in the wake of the eradication of poliovirus in the context of the continued incidence of paralysis.

scholarly journals Environmental Surveillance Complements Case-Based Surveillance of Acute Flaccid Paralysis in Polio Endgame Strategy 2019–2023

2020 ◽  
Vol 86 (15) ◽  
Author(s):  
Peng Chen ◽  
Yao Liu ◽  
Haiyan Wang ◽  
Guifang Liu ◽  
Xiaojuan Lin ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
World Health ◽  
Paralytic Poliomyelitis ◽  
Environmental Surveillance ◽  
Wild Poliovirus ◽  
The World ◽  
Afp Surveillance ◽  
Case Based

ABSTRACT The Polio Endgame Strategy 2019–2023 has been developed. However, more effective and efficient surveillance activities should be conducted with the preparedness of emergence for vaccine-derived poliovirus (VDPV) or wild poliovirus (WPV). We reviewed the impact of the case-based acute flaccid paralysis (AFP) surveillance (1991 to 2018) and environmental surveillance (2011 to 2018) in polio eradication in Shandong province of China. Clinical characteristics of AFP cases and enterovirus (EV) investigation of research samples were assessed. During the period, 10,224 AFP cases were investigated, and 352 sewage samples were collected. The nonpolio AFP rate sustained at over 2.0/100,000 since 1997. Of 10,224 cases, males and young children experienced a higher risk of severe diseases, and 68.5% suffered lower limb paralysis. We collected 1,707 EVs from AFP cases, including 763 polioviruses and 944 nonpolio enteroviruses (NPEVs). No WPV was isolated since 1992. The AFP surveillance showed high sensitivity in detecting 143 vaccine-associated paralytic poliomyelitis (VAPP) cases and 6 VDPVs. For environmental surveillance, 217 (61.6%) samples were positive for poliovirus, and altogether, 838 polioviruses and 2,988 NPEVs were isolated. No WPV was isolated in environmental surveillance, although one VDPV2 was identified. Phylogenetic analysis revealed environmental surveillance had the capacity to detect a large scope of NPEVs. The case-based AFP surveillance will be indispensable for detecting VAPP cases and VDPV circulation in countries using oral polio vaccine. Environmental surveillance is advantageous in identifying EV circulation and responding to ongoing circulating VDPV outbreaks and should be expanded to complement the AFP surveillance. IMPORTANCE Interrupting wild poliovirus transmission and stopping circulating vaccine-derived poliovirus (cVDPV) outbreaks have been proposed as two global goals by the World Health Organization in the Global Polio Eradication Initiative (GPEI). This analysis, based on the 28-year acute flaccid paralysis (AFP) surveillance and 8-year environmental surveillance, provides continued high-quality surveillance performance in achieving the GPEI and detecting the circulation of enterovirus. Given the ongoing cVDPV outbreaks in the world, we present the surveillance capacity of environmental surveillance in capturing enterovirus circulation. The final poliovirus (especially VDPV) elimination has become increasingly complex, and the case-based AFP surveillance alone will lead to difficulties in early detecting dynamics of poliovirus transmission and monitoring the extent of environmental circulation. This study goes beyond previous work to provide a detailed comprehensive evaluation of the enterovirus surveillance and can be used to formulate a set of implementation plan and performance indicators for environmental surveillance.

A Collaborative Study to Establish the Second International Standard for Streptokinase

1990 ◽  
Vol 64 (02) ◽  
pp. 267-269 ◽  
Author(s):  
A B Heath ◽  
P J Gaffney
Keyword(s):  
High Purity ◽  
Collaborative Study ◽  
World Health Organisation ◽  
World Health ◽  
Clot Lysis ◽  
Current Standard ◽  
International Standard ◽  
Accelerated Degradation ◽  
The World ◽  
International Collaborative Study

SummaryAn International Standard for Streptokinase - Streptodomase (62/7) has been used to calibrate high purity clinical batches of SK since 1965. An international collaborative study, involving six laboratories, was undertaken to replace this standard with a high purity standard for SK. Two candidate preparations (88/826 and 88/824) were compared by a clot lysis assay with the current standard (62/7). Potencies of 671 i.u. and 461 i.u. were established for preparations A (88/826) and B (88/824), respectively.Either preparation appeared suitable to serve as a standard for SK. However, each ampoule of preparation A (88/826) contains a more appropriate amount of SK activity for potency testing, and is therefore preferred. Accelerated degradation tests indicate that preparation A (88/826) is very stable.The high purity streptokinase preparation, coded 88/826, has been established by the World Health Organisation as the 2nd International Standard for Streptokinase, with an assigned potency of 700 i.u. per ampoule.

Comparative docking of SARS-CoV-2 receptors antagonists from repurposing drugs

2020 ◽  
Author(s):  
Micael Davi Lima de Oliveira ◽  
Kelson Mota Teixeira de Oliveira
Keyword(s):  
World Health Organisation ◽  
World Health ◽  
Lung Cells ◽  
The Novel ◽  
High Modulation ◽  
Main Protease ◽  
The World ◽  
Novel Coronavirus ◽  
Viral Receptors ◽  
Theoretical Results

According to the World Health Organisation, until 16 June, 2020, the number of confirmed and notified cases of COVID-19 has already exceeded 7.9 million with approximately 434 thousand deaths worldwide. This research aimed to find repurposing antagonists, that may inhibit the activity of the main protease (Mpro) of the SARS-CoV-2 virus, as well as partially modulate the ACE2 receptors largely found in lung cells, and reduce viral replication by inhibiting Nsp12 RNA polymerase. Docking molecular simulations were performed among a total of 60 structures, most of all, published in the literature against the novel coronavirus. The theoretical results indicated that, in comparative terms, paritaprevir, ivermectin, ledipasvir, and simeprevir, are among the most theoretical promising drugs in remission of symptoms from the disease. Furthermore, also corroborate indinavir to the high modulation in viral receptors. The second group of promising drugs includes remdesivir and azithromycin. The repurposing drugs HCQ and chloroquine were not effective in comparative terms to other drugs, as monotherapies, against SARS-CoV-2 infection.

Use of Phosphatidylcholine in the Treatment of Localized Fat Deposits. Results and expectations

2017 ◽  
Vol 68 (7) ◽  
pp. 1438-1441 ◽  
Author(s):  
Sorin Berbece ◽  
Dan Iliescu ◽  
Valeriu Ardeleanu ◽  
Alexandru Nicolau ◽  
Radu Cristian Jecan
Keyword(s):  
World Health Organisation ◽  
Normal Weight ◽  
World Health ◽  
Basic Substance ◽  
Physical Exercises ◽  
Fat Deposits ◽  
The World ◽  
The Common ◽  
Global Health Problem ◽  
Over Time

Obesity represents a global health problem. According to the latest studies released by the World Health Organisation (WHO), 1.7 billion currently in excess of normal weight individuals, of which approx. 75% are overweight (body mass index - BMI 25 to 30). The common form of excess adipose tissue manifestation in overweight individuals is localized fat deposits with high (abdominal) or low (buttocks and thighs) disposition. Although the overweight can be corrected relatively easy by changing behavioral habits or food, a constant physical exercises program or following a diet food are not accessible to all through the efforts of will, financial and time involved. Several methods have been studied and tested over time to eliminate more or less invasive fat deposits with varying efficacy and adverse effects. Chemical lipolysis using phosphatidylcholine as the basic substance was initially used in hypercholesterolemia and its complications and was rapidly adopted in mesotherapy techniques for the treatment of fat deposits. This study reveals the results obtained using Dermastabilon on a sample of 16 patients, the time allocated to treatment and discomfort being minimal, and rapid and notable results. There were no side effects.

The Undiscovered Potential of Essential Oils for Treating SARS-CoV-2 (COVID-19)

2020 ◽  
Vol 26 (41) ◽  
pp. 5261-5277
Author(s):  
Peter J. Wilkin ◽  
Minnatallah Al-Yozbaki ◽  
Alex George ◽  
Girish K. Gupta ◽  
Cornelia M. Wilson
Keyword(s):  
Essential Oils ◽  
Clinical Symptoms ◽  
Synergistic Effects ◽  
World Health Organisation ◽  
Diagnostic Techniques ◽  
World Health ◽  
Clinical Aspects ◽  
Traditional Use ◽  
In Silico Studies ◽  
The World

On 11th March 2020, the World Health Organisation (WHO) announced a pandemic caused by a novel beta-coronavirus SARS-CoV-2, designated COVID-19. The virus emerged in December 2019 in Wuhan, China, has spread across the world as a global pandemic. The traditional use of medicines from plants can be traced back to 60,000 years. Global interest in the development of drugs from natural products has increased greatly during the last few decades. Essential oils (EOs) have been studied through the centuries and are known to possess various pharmaceutical properties. In the present review, we have highlighted the current biology, epidemiology, various clinical aspects, different diagnostic techniques, clinical symptoms, and management of COVID-19. An overview of the antiviral action of EOs, along with their proposed mechanism of action and in silico studies conducted, is described. The reported studies of EOs' antiviral activity highlight the baseline data about the additive and/or synergistic effects among primary or secondary phytoconstituents found in individual oils, combinations or blends of oils and between EOs and antiviral drugs. It is hoped that further research will provide better insights into EOs' potential to limit viral infection and aid in providing solutions through natural, therapeutically active agents.

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