Poliomyelitis in Nigeria: Impact of Vaccination Services and Polio Intervention and Eradication Efforts.

Background

Polio is an infectious viral disease that can cause paralytic complications and death. Despite global efforts to eradicate wild poliovirus, there are ongoing outbreaks globally and the mutated form of paralytic polio, i.e., circulating vaccine-derived poliovirus, is present in Nigeria. Low vaccination uptake and poor sanitation are responsible for outbreaks in countries where polio had previously been eliminated. This review identifies policies, strategies and interventions for polio eradication and assesses their impact on polio vaccine uptake and eradication efforts in Nigeria.

Methods

A systematic literature review was conducted and guided by the Population, Intervention, Comparator and Outcome (PICO) framework and Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) flowchart, with identified articles appraised using the Critical Appraisal Skills Program appraisal tool.

Results

A total of 393 articles were identified, of which 26 articles were included. Key findings indicate polio intervention services, policies and mass campaigns have had a significant impact on eradicating WPV in Nigeria. However, there are gaps in variant polio eradication efforts, with low vaccination uptake, poor surveillance, vaccine hesitancy, lack of community engagement, weaknesses in the healthcare system and other challenges in Nigeria regionally and nationally, posing a risk to public health that threatens the eradication of all forms of polio in Nigeria.

Conclusions

Recommendations are suggested for changes to practice and policy to improve polio vaccination uptake in Nigeria and globally in the short-term (1-2 years), mid-term (3-4 years) and long-term (5+ years). Collaborative targeted polio vaccination programs and funding of public health infrastructure are imperative globally alongside national strategic policy intervention frameworks to strengthen the World Health Organization Global Polio Eradication Initiative and improve vaccine uptake and monitoring of vaccine hesitancy. Simultaneous health-literate community engagement is needed to achieve and maintain polio eradication efforts, which must be integrated into national health frameworks and coordinated across the African continent.