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Providing monovalent oral polio vaccine type I to newborns: findings from a pilot birth-dose project in Moradabad district, India/ Delivrance du vaccin antipoliomyelitique oral monovalent type 1 aux nouveau-nes : [...], Problem Poliovirus transmission remained a public health challenge in western Uttar Pradesh, India in late 2005 and early 2006. In 2006, the India Expert Advisory Group for Polio Eradication concluded that, given the peak incidence of polio among children 6 to 12 months of age, a targeted birth dose of oral polio vaccine may be necessary to interrupt intense poliovirus transmission in high risk areas. Approach The Govemment of Uttar Pradesh, the National Polio Surveillance Project and the United Nations Children's Fund (UNICEF) implemented a pilot birth-dose project aimed at identifying and vaccinating all newborns with a dose of oral polio vaccine within 72 hours of birth in an effort to evaluate operational feasibility and potential impact on population immunity. Local setting The project was piloted in Moradabad district: zone 7 in Moradabad City (urban setting), Kunderki block (rural setting) and in select birthing hospitals. Relevant changes Between July 2006 and February 2007, 9740 newborns were identified, of which 6369 (65%) were vaccinated by project personnel within 72 hours of birth. Project coverage (for total newborns vaccinated) ranged from 39% (in zone 7) to 76% (in Kunderki block) of the estimated number of newborns vaccinated during previous supplemental immunization activities. Lessons learned Birth-dose coverage among newborns was lower than expected. Expansion costs were estimated to be high, with marginal impact. The project, however, provided opportunities to strengthen newborn tracking systems which have increased the number of newborns and young infants vaccinated during supplemental immunization activities and enrolled in routine programmes. Problematique La transmission du poliovirus restait un grand probleme de sante publique dans l'Ouest de l'Uttar Pradesh a la fin de l'annee 2005 et debut 2006. En 2006, le Groupe consultatif d'experts indien pour l'eradication de la polio avait conclu que, compte tenu du pic atteint par l'incidence de cette maladie chez les enfants entre 6 et 12 mois, l'administration ciblee a la naissance d'une dose de vaccin antipoliomyelitique oral pouvait etre necessaire pour interrompre la transmission intense du poliovirus dans les zones a haut risque. Demarche Le Gouvernement de l'Uttar Pradesh, le Projet national de surveillance de la polio et le Fonds des Nations Unies pour l'enfance (UNICEF) ont mis en oeuvre un projet pilote d'administration du vaccin a la naissance, visant a identifier et a vacciner tous les nouveau-nes avec une dose de vaccin antipoliomyelitique oral dans les 72 heures suivant la naissance, dans le cadre d'un effort pour evaluer la faisabilite operationnelle de cette intervention et son impact eventuel sur l'immunite de la population. Contexte local Le projet a ete mene dans le district de Moradabad : zone 7 de la ville de Moradabad (contexte urbain), agglomeration de Kunderki (contexte rural) et dans certaines maternites. Modifications pertinentes Entre juillet 2006 et fevrier 2007, 9740 nouveau-nes ont ete identifies, parmi lesquels 6369 (65 %) ont ete vaccines par des personnes travaillant pour le projet dans les 72 h suivant la naissance. La couverture par le projet (pour l'ensemble des nouveau-nes vaccines) se situait entre 39 % (zone 7) et 76 % (quartier de Kunderki) du nombre estime de nouveaunes vaccines pendant les activites de vaccination supplementaires menees anterieurement. Enseignements tires La couverture par une dose a la naissance des nouveau-nes etait plus faible qu'attendu. Les couts d'elargissement de cette couverture ont ete evalues comme eleves, avec un impact correspondant marginal. Le projet a neanmoins fourni la possibilite de renforcer les systemes permettant de retrouver les nouveau-nes, d'ou une progression de nombre de nouveau-nes et de jeunes nourrissons vaccines dans le cadre des activites de vaccination supplementaires et soumis aux programmes de vaccination systematique. Problema A finales de 2005 y principios de 2006 la transmision del poliovirus seguia planteando un problema de salud publica en Uttar Pradesh occidental, India. En 2006, el Grupo Consultivo de Expertos para la Erradicacion de la Poliomielitis de la India llego a la conclusion de que, a la vista de la incidencia maxima de poliomielitis entre Ios ninos de 6 a 12 meses, probablemente se requeria una dosis neonatal focalizada de vacuna antipoliomielitica oral para interrumpir la intensa transmision del poliovirus observada en las zonas de alto riesgo. Enfoque El Gobierno de Uttar Pradesh, el Proyecto Nacional de Vigilancia de la Poliomielitis y el Fondo de las Naciones Unidas para la Infancia (UNICEF) pusieron en marcha un proyecto piloto de administracion de una dosis al nacer basado en localizar y vacunar a todos los recien nacidos con una dosis de vacuna antipoliomielitica oral en las primeras 72 horas de vida, con la finalidad de evaluar la viabilidad operacional y el impacto potencial de esa medida en la inmunidad de la poblacion. Contexto local El proyecto piloto tuvo como escenario el distrito de Moradabad: la zona 7 de la ciudad de Moradabad (entorno urbano), la aglomeracion de Kunderki (entorno rural) y varios hospitales de maternidad. Cambios destacables Entre julio de 2006 y febrero de 2007 se registraron 9740 recien nacidos, 6369 de los cuales (65%) fueron vacunados por personal del proyecto en las 72 horas siguientes al nacimiento. La cobertura del proyecto (numero total de recien nacidos vacunados) se situo entre el 39% (zona 7) y el 76% (Kunderki) del numero estimado de neonatos vacunados en las actividades suplementarias de inmunizacion anteriores. Ensenanzas extraidas La cobertura de administracion de una dosis a los neonatos al poco de nacer fue inferior a la prevista. Se estima que el costo de la expansion fue elevado y su impacto, insignificante. El proyecto, sin embargo, brindo oportunidades para reforzar unos sistemas de seguimiento de los recien nacidos que han permitido aumentar el numero de neonatos y lactantes de corta edad vacunados en las actividades suplementarias de inmunizacion e incluidos en los programas de vacunacion sistematica. [TEXT NOT REPRODUCIBLE IN ASCII.]

The root hairs of plants are tubular projections of root epidermal cells and are suitable for investigating the control of cellular morphogenesis. In wild-type Arabidopsis thaliana (L.) Heynh, growing root hairs were found to exhibit cellular expansion limited to the apical end of the cell, a polarized distribution of organelles in the cytoplasm, and vesicles of several types located near the growing tip. The rhd3 mutant produces short and wavy root hairs with an average volume less than one-third of the wild-type hairs, indicating abnormal cell expansion. The mutant hairs display a striking reduction in vacuole size and a corresponding increase in the relative proportion of cytoplasm throughout hair development. Bead-labeling experiments and ultrastructural analyses indicate that the wavy-hair phenotype of the mutant is caused by asymmetric tip growth, possibly due to abnormally distributed vesicles in cortical areas flanking the hair tips. It is suggested that a major effect of the rhd3 mutation is to inhibit vacuole enlargement which normally accompanies root hair cell expansion. [ABSTRACT FROM AUTHOR]

Eradication Initiative, in which communication interventions have played a consistently central role. Mass media and information dissemination approaches used in immunization efforts worldwide have contributed to this success. However, reaching the hardest-to-reach, the poorest, the most marginalized and those without access to health services has been challenging. In the last push to eradicate polio, Polio Eradication Initiative communication strategies have become increasingly research-driven and innovative, particularly through the introduction of sustained interpersonal communication and social mobilization approaches to reach unreached populations. This review examines polio communication efforts in India and Pakistan between the years 2000 and 2007. It shows how epidemiological, social and behavioural data guide communication strategies that have contributed to increased levels of polio immunity, particularly among underserved and hard-to-reach populations. It illustrates how evidence-based and planned communication strategies - such as sustained media campaigns, intensive community and social mobilization, interpersonal communication and political and national advocacy combined - have contributed to reducing polio incidence in these countries. Findings show that communication strategies have contributed on several levels by: mobilizing social networks and leaders; creating political will; increasing knowledge; ensuring individual and community-level demand; overcoming gender barriers and resistance to vaccination; and reaching out to the poorest and marginalized populations. The review concludes with observations about the added value of communication strategies in polio eradication efforts and implications for global and local public health communication interventions. Copyright © 2009 World Health Organization [ABSTRACT FROM AUTHOR]

Background: As we move toward a polio-free world, the challenge for the polio program is to create an unrelenting focus on smaller areas where the virus is still present, where children are being repeatedly missed, where immunity levels are low, and where surveillance is weak., Objective: This article aimed to describe a possible solution to address weak surveillance systems and document the outcomes of the deployment of the Auto-Visual Acute Flaccid Paralysis Detection and Reporting (AVADAR) project., Methods: This intervention was implemented in 99 targeted high-risk districts with concerns for silent polio circulation from eight countries in Africa between August 1, 2017, and July 31, 2018. A total of 6954 persons (5390 community informants and 1564 health workers) were trained and equipped with a smartphone on which the AVADAR app was configured to allow community informants to send alerts on suspected acute flaccid paralysis (AFP) and allow health worker to use electronic checklists for investigation of such alerts. The AVADAR and Open Data Kit ONA servers were at the center of the entire process. A dashboard system and coordination teams for monitoring and supervision were put in place at all levels., Results: Overall, 96.44% (24,142/25,032) of potential AFP case alerts were investigated by surveillance personnel, yielding 1414 true AFP cases. This number (n=1414) reported through AVADAR was higher than the 238 AFP cases expected during the study period in the AVADAR districts and the 491 true AFP cases reported by the traditional surveillance system. A total of 203 out of the 1414 true AFP cases reported were from special population settings, such as refugee camps and insecure areas. There was an improvement in reporting in silent health areas in all the countries using the AVADAR system. Finally, there were 23,473 reports for other diseases, such as measles, diarrhea, and cerebrospinal meningitis, using the AVADAR platform., Conclusions: This article demonstrates the added value of AVADAR to rapidly improve surveillance sensitivity. AVADAR is capable of supporting countries to improve surveillance sensitivity within a short interval before and beyond polio-free certification., (©Johnson Muluh Ticha, Godwin Ubong Akpan, Lara MF Paige, Kamel Senouci, Andrew Stein, Patrick Briand, Jude Tuma, Daniel Rasheed Oyaole, Reuben Ngofa, Sylvester Maleghemi, Kebba Touray, Abdullahi Ahmed Salihu, Mamadou Diallo, Sisay Gashu Tegegne, Isah Mohammed Bello, Umar Kabo Idris, Omosivie Maduka, Casimir Manengu, Faisal Shuaib, Michael Galway, Pascal Mkanda. Originally published in JMIR Public Health and Surveillance (http://publichealth.jmir.org), 02.12.2020.)

Objective: To evaluate a project that integrated essential primary health-care services into the oral polio vaccine programme in hard-to-reach, underserved communities in northern Nigeria., Methods: In 2013, Nigeria's polio emergency operation centre adopted a new approach to rapidly raise polio immunity and reduce newborn, child and maternal morbidity and mortality. We identified, trained and equipped eighty-four mobile health teams to provide free vaccination and primary-care services in 3176 hard-to-reach settlements. We conducted cross-sectional surveys of women of childbearing age in households with children younger than 5 years, in 317 randomly selected settlements, pre- and post-intervention (March 2014 and November 2015, respectively)., Findings: From June 2014 to September 2015 mobile health teams delivered 2 979 408 doses of oral polio vaccine and dewormed 1 562 640 children younger than 5 years old; performed 676 678 antenatal consultations and treated 1 682 671 illnesses in women and children, including pneumonia, diarrhoea and malaria. The baseline survey found that 758 (19.6%) of 3872 children younger than 5 years had routine immunization cards and 690/3872 (17.8%) were fully immunized for their age. The endline survey found 1757/3575 children (49.1%) with routine immunization cards and 1750 (49.0%) fully immunized. Children vaccinated with 3 or more doses of oral polio vaccine increased from 2133 (55.1%) to 2666 (74.6%). Households' use of mobile health services in the previous 6 months increased from 509/1472 (34.6%) to 2060/2426(84.9%)., Conclusion: Integrating routine primary-care services into polio eradication activities in Nigeria resulted in increased coverage for supplemental oral polio vaccine doses and essential maternal, newborn and child health interventions.

Background: Eradication of polio requires that the acute flaccid paralysis (AFP) surveillance system is sensitive enough to detect all cases of AFP, and that such cases are promptly reported and investigated by disease surveillance personnel. When individuals, particularly community informants, are unaware of how to properly detect AFP cases or of the appropriate reporting process, they are unable to provide important feedback to the surveillance network within a country., Methods: We tested a new SMS-based smartphone application (App) that enhances the detection and reporting of AFP cases to improve the quality of AFP surveillance. Nicknamed Auto-Visual AFP Detection and Reporting (AVADAR), the App creates a scenario where the AFP surveillance network is not dependent on a limited number of priority reporting sites. Being installed on the smartphones of multiple health workers (HWs) and community health informants (CHIs) makes the App an integral part of the detection and reporting system., Results: Results from two phases of tests conducted in Nigeria point to the effectiveness of the App in the surveillance of AFP., Conclusion: We posit that appropriate use of the App can soon bring about a worldwide eradication of poliomyelitis.

The legacy of polio in Africa goes far beyond the tragedies of millions of children with permanent paralysis. It has a positive side, which includes the many well-trained polio staff who have vaccinated children, conducted surveillance, tested stool specimens in the laboratories, engaged with communities, and taken care of polio patients. This legacy also includes support for routine immunization services and vaccine introductions and campaigns for other diseases. As polio funding declines, it is time to take stock of the resources made available with polio funding in Africa and begin to find ways to keep some of the talented staff, infrastructure, and systems in place to work on new public health challenges. The partnerships that helped support polio eradication will need to consider funding to maintain and to strengthen routine immunization services and other maternal, neonatal, and child health programs in Africa that have benefitted from the polio eradication infrastructure., (© The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.)

The use of Inactivated Polio Vaccine (IPV) in routine immunization to replace Oral Polio Vaccine (OPV) is crucial in eradicating polio. In June 2014, Nigeria launched an IPV campaign in the conflict-affected states of Borno and Yobe, the largest ever implemented in Africa. We present the initiatives and lessons learned. The 8-day event involved two parallel campaigns. OPV target age was 0-59 months, while IPV targeted all children aged 14 weeks to 59 months. The Borno state primary health care agency set up temporary health camps for the exercise and treated minor ailments for all. The target population for the OPV campaign was 685,674 children in Borno and 113,774 in Yobe. The IPV target population for Borno was 608,964 and for Yobe 111,570. OPV coverage was 105.1 per cent for Borno and 103.3 per cent for Yobe. IPV coverage was 102.9 per cent for Borno and 99.1 per cent for Yobe. (Where we describe coverage as greater than 100 per cent, this reflects original underestimates of the target populations.) A successful campaign and IPV immunization is viable in conflict areas.

The control of cell fate was investigated in the root epidermis of Arabidopsis thaliana. Two distinct types of differentiated epidermal cells are normally present: root-hair-bearing cells and hairless cells. In wild-type Arabidopsis roots, epidermal cell fate was found to be correlated with cell position, with root-hair cells located over radial walls between cortical cells, and with hairless cells located directly over cortical cells. This normal positional relationship was absent in ttg (transparent testa glabrous) mutants (lacking trichomes, anthocyanins, and seed coat mucilage); epidermal cells in all positions differentiate into root-hair cells. The opposite condition was generated in roots of transgenic Arabidopsis expressing the maize R (R-Lc) gene product (a putative TTG homologue) under the control of a strong promoter (CaMV35S), which produced hairless epidermal cells in all positions. In both the ttg and R-expressing roots, epidermal cell differentiation was affected at an early stage, prior to the onset of cell elongation or root-hair formation. The ttg mutations were also associated with abnormalities in the morphology and organization of cells within and surrounding the root apical meristem. The results indicate that alterations in TTG activity cause developing epidermal cells to misinterpret their position and differentiate into inappropriate cell types. This suggests that, in wild-type roots, TTG provides, or responds to, positional signals to cause differentiating epidermal cells that lie over cortical cells to adopt a hairless cell fate.