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ORIGINAL CONTRIBUTION
Year : 1997  |  Volume : 51  |  Issue : 12  |  Page : 455-458
 

Poliomyelitis in western Uttar Pradesh


Department of S.P.M., Medical College, Meerut, India

Correspondence Address:
S K Garg
Department of S.P.M., Medical College, Meerut
India
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PMID: 9715544

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How to cite this article:
Garg S K, Singh J V, Bhatnagar M, Chopra H. Poliomyelitis in western Uttar Pradesh. Indian J Med Sci 1997;51:455-8

How to cite this URL:
Garg S K, Singh J V, Bhatnagar M, Chopra H. Poliomyelitis in western Uttar Pradesh. Indian J Med Sci [serial online] 1997 [cited 2014 Jul 28];51:455-8. Available from: http://www.indianjmedsci.org/text.asp?1997/51/12/455/11486


W.H.O. has aimed the global eradication of poliomyelitis by 2000 AD, which can only be accom­plished by vaccination of susceptible populations by an effective oral polio vaccine (OPV) and active surveillance for poliomyelitis in the community. Surveys based on lameness due to poliomyelitis in children have been found to pro­vide the simplest procedure for estimating the magnitude of pro­blem. The present study was aim­ed to assess the magnitude of polio­myelitis problem and the impact of immunization coverage on the problem.


 ¤ Material and Methods Top


Lameness survey among under­five children supplemented with immunization coverage among children was conducted in Ghazia­bad, Saharanpur, Muzaffarnagar and Meerut Districts of Western Uttar Pradesh during 1994-95 em­ploying WHO's standard 30 cluster sampling technique, covering at­least 10,000 children (0-59 months) for lameness and atleast 210 child­ren (12 to 23 months) for assess­ing the immunization coverage in each district. The prevalence and incidence of poliomyelitis was esti­mated by taking multiplication fac­tor of 1.25 and 1.33 for cases not involving lower extremity and un­detected cases (Death, complete recovery, migration) respectively [1] and 15% of the population being under-five. Vaccine efficacy was calculated by the formula recom­mended under National Child Sur­vival and Safe Motherhood pro­gramme. [2]


 ¤ Result Top


In all 229 cases (4.6/1000 child­ren) of lameness were detected out of whom 193 were due to poliomyelitis giving an overall polio­prevalence rate of 6.47/1000 child­ren, and an annual incidence of 19.3 cases per 1,00,000 of popu­lation. The district wise break up of prevalence and incidence of poliomyelitis has been shown in [Table 1]. The average age of onset of poliomyelitis was 17.2 months being minimum (14.4 months) in Meerut followed by 15.8 months in Ghaziabad, 18.0 months in Muza­farnagar and 22.7 months in Saha­ranpur District. The overall cove­rage of children (12 to 23 months) by three doses of OPV was 53.2% varying from 38.9% in Meerut to 65.3% in Muzaffarnagar [Table 2]. Taking into consideration, the im­munization coverage of children and proportion of fully immunized poliomyelitis cases, the overall vaccine efficacy of OPV was found as 94.2% with minor inter-district variations [Table 2]. The incidence of poliomyelitis was found to be negatively correlated to immuniza­tion coverage among the children (r = -.93) e.g. Meerut district having the lowest immunization coverage (38.9%) had the highest incidence of poliomyelitis (37.3/ Lac population).


 ¤ Discussion Top


The number of polio victims world wide is down by 75% in 10 years and confidence is running high that polio will be eradicated by the target date of the year 2000 A.D. But it cannot be eradicated anywhere unless it is eradicated everywhere. A significant wild polio virus transmission is still occurring in India (UNICEF [3] ) which is well documented by the high incidence in the present study. However, the incidence of poliomyelitis has declined by 21.3% in Meerut district from 47.4/Lac population in Nov. 1991 [4] to 37.3/ lac population in November 1994. The average age of onset of polio­myelitis was 17.2 months in the present study which is higher than 15.6 months in Jaipur City. [5] The proportion of fully immunized cases of poliomyelitis (6.2%) in the pre­sent study has declined from 100% in 1991 in Meerut [4] which could have been possible by a high vaccine efficacy. A strong inverse relation­ship of poliomyelitis incidence with the immunization coverage level strongly suggest the achieve­ment of high level of routine im­munization as first step for eradi­cation of poliomyelitis and when the case load is at negligible level national immunization days can then push the virus to the edge of extinction as suggested.


 ¤ Summary Top


The studies on prevalence of lameness in Western Uttar Pradesh revealed the overall poliomyelitis prevalence rate of 6.47/1000 child­ren and an annual incidence rate of 19.3 per lac population with an average age of onset at 17.2 months. The overall OPV cove­rage was 53.2% with a vaccine efficacy of 94.2%. The incidence of poliomyelitis was negatively cor­related to OPV immunization strongly suggesting the need­ of achieving high level of OPV cove­rage as a first step for eradication of poliomyelitis.


 ¤ Acknowledgement Top


Authors are grateful to UNICEF, Lucknow for providing support for the extended coverage evaluation surveys through which this study could be accomplished.

 
 ¤ References Top

1.Park K. Text book of preventive and social medicine 14th Edition. Banarsidas Bhanot, Jabalpur, 1994: 142.  Back to cited text no. 1      
2.Govt. of India : Surveillance Na­tional Child Survival and Safe Motherhood Programme MCH Divi­sion, Ministry of Health and Family Welfare, New Delhi-1994: 40-41.  Back to cited text no. 2      
3.UNICEF : The progress of nations 1995, UNICEF ;House, New York, USA, 1096;2-5.  Back to cited text no. 3      
4.Garg SK, Mishra VN, Bhatnagar M, Singh JV, Singh RB, Chopra H. Lameness among under five child­ren in Meerut District. The Med and Surg 1993:32:10-11.  Back to cited text no. 4      
5.Shah KC, Bansal RK, Gupta SD, Tomar VNS. Prevalence and in­cidence of Poliomyelitis in Child­ren in Jaipur city Ind Comm. Med 1990;15:67-69.  Back to cited text no. 5      



 
 
    Tables

  [Table 1], [Table 2]



 

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