Polio is a crippling and potentially fatal infectious disease. Critical to its detection, treatment and prevention is the availability of high grade functional laboratory. The donation of a modular by USAID that is expected to increase the workspace and pave way for improved diagnosis and subsequently promote better environmental surveillance in Nigeria, reports Sade Oguntola.
THE Global Polio Eradication Initiative was launched in 1988 by the international community and tremendous progress have been made to stop interruption of wild polio transmission in the country.
Little wonder, the stunning news of four cases of children struck by wild polio in the newly liberated communities in Borno State – the former stronghold of Boko Haram for two years in Northeast Nigeria created national and international crisis. The country was initially cruising to her certification of being declared wild polio free.
Experts estimate that for every case of polio that paralyses its victim, another 200 silent infections go undetected. The virus, which can cause irreversible paralysis within hours, spreads quickly among children, particularly those living in unhygienic conditions and war-torn regions, where healthcare is limited.
Although the recent polio cases in Nigeria have cast a shadow over global eradication, Nigerian government, developmental partners like USAID and WHO and dedicated health workers gathering at the commissioning of a Modular Polio Laboratory at the Department of Virology, University of Ibadan, are confident that the nation will be free of polio by next year.
The polio modular laboratory, a renewed boost to the fight against polio, was purchased with a grant from the United States Agency for International Aid, USAID, to support polio eradication activities in Nigeria.
The standard BSL2 laboratory would also support diagnosis of many viral infections like measles, rubella, rotavirus, yellow fever and dengue fever, among others at the Ibadan Polio laboratory.
Health Minister, Professor Isaac Adewole at the commissioning acknowledged the modular polio laboratory as an important asset to the effort to ensure that not only is Nigeria polio-free, but that Africa is polio-free by 2017.
Adewole, who noted that polio eradication was a health agenda of President Muhammadu Buhari, stated “The laboratory will strengthen our Polio surveillance effort in Nigeria.”
The gold standard for polio eradication programme is surveillance. This involves detection of cases of acute flaccid paralysis (AFP) and laboratory testing of stool specimens from suspected polio cases in a WHO accredited laboratory. At present, there are two of such laboratories at Ibadan and Maiduguri.
Currently the Ibadan polio laboratory, established in 1997 serves 26 states and the Federal Capital Territory (FCT). It is the only laboratory in the country processing environmental samples for polio virus isolation, thus paving way also for expansion of environmental surveillance in Nigeria.
Polio situation in Nigeria
The Minister, however, said it was not true that Nigeria had experienced a resurgence of wild polio virus in the security challenged Northeast States of Borno.
“We do not have resurgence of polio. Actually we shouldn’t have declared Nigeria polio free when we did. What we should have said scientifically is that the area of Nigeria that is free and accessible is polio-free”.
“So, what we have now is polio been detected in areas that we have no control over before. These were places where they had no access to medical care in the last five years. There was no way, we could have vaccinated children living there. So, it was not really a surprise that we picked polio among them.”
Surveillance on polio
Nonetheless, he said there have being heightened surveillance activities, including active case search for polio during and between the outbreak response campaigns which are on-going fortnightly.
For the sub-national campaigns, Professor Adewole stated that four outbreak response vaccination rounds on wild polio had been conducted by the Federal Government with support from partners.
“The first response which took place in the affected local governments resulted in 800,000 children being immunised. We have done three rounds of immunisation, covering 18 northern states of the federation, excluding Kwara and Kogi in each occasion.
“Specifically, the third round which ended in October resulted in 31,422,237 million children being immunised. We are currently compiling the result of the fourth round that was completed on 15 November, 2016.
“We are on track to commence the fifth round on 3rd December, 2016. Our ultimate goal is to reach over 41million children per round.”
Professor Adewole stated that the four wild polio cases was a setback for Nigeria, adding that it was also a wakeup call to government at all levels and people to play their roles to stop transmission of wild polio virus in Nigeria, and indeed Africa.
Moreover, he added, “this outbreak is not a failure of the polio eradication campaign. It is mainly due to the insurgency in the North east which resulted in limited access to children for immunisation and health services for several years.”
Adewole appreciated the military for their stride to recover territories from insurgency, provide protection for health workers and support movement of materials and personnel for immunisation services.
He appealed to state governors and Local government chairmen to complement Federal Government’s efforts by providing the needed counterpart funds and political oversight for polio immunisation activities and indeed primary health care programmes.
US Consul General, John Bray declared that health initiatives in Nigeria were US government’s priority, adding that over half of USAID’s budget in Nigeria is spent on health.
“Our government spends about 600million US Dollars a year in Nigeria on health,” he stated.
Bray stated that the 400,000 US Dollars modular polio laboratory Ibadan was US contribution to improve the health of Nigerians, adding “I see the Ibadan polio laboratory as a tangible way to make a difference in peoples’ lives and improve Nigerians health status.”
The US Consul General said that Nigeria needs to lead vigilance in the fight against polio until global certification, adding that the complex security environment and humanitarian emergency in northeast Nigeria demands innovative approaches in the widening traditional partnerships.
The new modular polio laboratory, he stated, was critical to enhance response to polio outbreaks by quickly detecting polio in samples as well as critical to providing convincing diagnostic evidence of the absence of wild poliovirus infections in humans and the environment.
While noting that diseases do not have borders, he urged countries to work together to stop public health threats.
Bray stated that Nigeria has an important regional leadership role in disease surveillance, and thus underscore the critical importance of Nigeria’s participation in the disease surveillance coordination platform.
WHO’s representative, Dr Fiona Braca in her remarks said that the two WHO accredited polio laboratories in Nigeria had been experiencing an increase in workload due to improvement in surveillance sensitivity nationwide, and thus the funding grant from USAID for a new modular laboratory.
Braca, then, pledged WHO’s continued support towards achieving polio free status and certification in the African region.
Vice Chancellor, University of Ibadan, Professor Idowu Olayinka, expressed confidence that the laboratory would further enhance the university’s contribution and relevance to diagnosis, management and policy control for viral diseases as well as building of capacity in research and training and prevention of diseases.
The Provost, College of Medicine, University of Ibadan, Professor Bunmi Olapade-Olaopa, who represented the vice chancellor, said that the donation will further enhance the strong collaboration between the university and the United State’s government through the USAID.