|Year : 1997 | Volume
| Issue : 12 | Page : 455-458
Poliomyelitis in western Uttar Pradesh
SK Garg, JV Singh, M Bhatnagar, H Chopra
Department of S.P.M., Medical College, Meerut, India
S K Garg
Department of S.P.M., Medical College, Meerut
|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
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|| |
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  and 15% of the population being under-five. Vaccine efficacy was calculated by the formula recommended under National Child Survival and Safe Motherhood programme. 
| ¤ Result|| |
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|| |
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  ) 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  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.  The proportion of fully immunized cases of poliomyelitis (6.2%) in the present study has declined from 100% in 1991 in Meerut  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|| |
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|| |
Authors are grateful to UNICEF, Lucknow for providing support for the extended coverage evaluation surveys through which this study could be accomplished.
| ¤ References|| |
|1.||Park K. Text book of preventive and social medicine 14th Edition. Banarsidas Bhanot, Jabalpur, 1994: 142. |
|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. |
|3.||UNICEF : The progress of nations 1995, UNICEF ;House, New York, USA, 1096;2-5. |
|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. |
|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. |
[Table 1], [Table 2]