POLIOMYELITIS

ITS STATUS IN SOUTHERN PUNJAB (PAKISTAN) DURING 2003

Abstract

Introduction: To study the risk factors of polio in Southern Punjab.
Material and methods: The data of Acute Fluid Paralysis (AFP) cases of year 2003 from the districts of South Punjab
notified to the National Surveillance Cell, Islamabad was collected and analyzed. Results: Group A consisted of
Bahawalnagar, Khanewal, Lodhran, Multan, Muzaffargarh, Pakpattan, Sahiwal and Vehari districts with polio cases
while group B consisted of Bahawalpur, Dera Ghazi Khan, Layyah, Rahimyar khan and Rajanpur districts which were
polio free. Total 397 AFP cases with age range of 1-180 months were recorded. Total 17 polio cases (12 confirmed
and 5 compatible) were reported with age range of 4-42 months. Total 36 (9.07%) deaths were recorded. Cases
recorded with two stool specimens not collected within 14 days of onset of paralysis (24 hours apart) were 19(4.79%).
Children who received routine polio doses < 3 or unknown were 193(48.61%) while 150(37.78%) children received <
7 or unknown additional polio doses. Two stool specimens were collected in 380(95.72%) cases. The non-polio
enterovirus was isolated from the stool specimens of 92(23.17%) cases while polio vaccine virus was isolated in
15(3.78%) cases. There were significantly greater chances of late notification responsible in the non-collection of two
stool specimens within 14 days of onset of paralysis (p <0.006) and under vaccination during routine immunization (p
<0.0053) in polio cases. Significantly greater number of polio cases received additional polio doses <7 or unknown (p
< 0.0001). The difference in deaths rate in polio and non-polio AFP cases was insignificant (p=0.6597). Conclusion:
Children remain at risk for polio unless routine immunization is strengthened or additional supplementary immunization
is provided as well as timely collection of stool specimens.