Top 5 Takeaways

1. Significant Decrease in WPV1 Cases: The number of wild poliovirus type 1 (WPV1) cases in Afghanistan decreased by 93% from 2020 to 2021.
2. Reduction in Positive Sewage Samples: Positive sewage samples for WPV1 decreased by 97% during the same period.
3. Increased Inaccessibility of Children: The number of children inaccessible to vaccination increased significantly in 2021, peaking at 40% during certain national immunization days.
4. Resumption of Vaccination Campaigns: After the new government took control in August 2021, nationwide oral poliovirus vaccine (OPV) campaigns resumed, potentially reaching 2.5 million previously inaccessible children.
5. Environmental Surveillance Success: Environmental surveillance detected only one WPV1-positive sample in 2021, a significant decrease from 34 in 2020.

Original Article Author and Citation

Corresponding Author

Katrin S. Sadigh, ksadigh@cdc.gov

Suggested Citation

Sadigh KS, Akbar IE, Wadood MZ, et al. Progress Toward Poliomyelitis Eradication ― Afghanistan, January 2020–November 2021. MMWR Morb Mortal Wkly Rep 2022;71:85–89. DOI: http://dx.doi.org/10.15585/mmwr.mm7103a3

Summary

This report highlights the progress made towards the eradication of poliomyelitis in Afghanistan from January 2020 to November 2021. Despite significant challenges, including increased inaccessibility of children, disruption due to the COVID-19 pandemic, and political instability, the number of WPV1 cases and positive sewage samples decreased markedly. The resumption of vaccination campaigns by the new government in August 2021 offers hope for further progress in 2022–2023.

Methods

The study utilized data from immunization activities, acute flaccid paralysis (AFP) surveillance, and environmental surveillance (ES) to monitor the presence and spread of WPV1 and circulating vaccine-derived poliovirus type 2 (cVDPV2). Immunization data were collected through national and subnational immunization days, case-response campaigns, and fixed-site campaigns. AFP surveillance involved a network of health facilities and community volunteers, while ES involved systematic sampling and virologic testing of sewage.

Discussion

The report discusses the challenges faced in polio eradication efforts, including the increased number of inaccessible children and the impact of the COVID-19 pandemic on vaccination activities. Despite these challenges, the significant decrease in WPV1 cases and positive sewage samples indicates progress. The resumption of vaccination campaigns by the new government and the involvement of female frontline workers are positive steps towards further reducing WPV1 transmission.

Conclusion

While challenges remain, the substantial decrease in WPV1 cases and positive sewage samples, along with the resumption of vaccination campaigns, provide hope for significant progress towards polio eradication in Afghanistan during 2022–2023. Continued robust and sustained efforts are essential to achieve this goal.

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