DRC - Polio 2022 - 2023

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 43: 23 October - 29 October 2023
Data as reported by: 17:00; 29 October 2023
...

Democratic Republic of
the Congo

Polio (cVDPV1 and cVDPV2)

186 Cases
0 Deaths
0.0% CFR

EVENT DESCRIPTION

The Democratic Republic of the Congo (DRC) was
certified “wild Polio-free country” by WHO since
November 2015 following zero case of wild Polio
reported in the country since December 2011. However,
regarding vaccine derived polio outbreak, the country
is the most affected in the WHO AFRO region reporting
both circulating vaccine-derived polioviruses (cVDPV1
and cVDPV2 cases).

Since 2017, the country has experienced 23 outbreaks
of vaccine derived Polio, reported in 181 health zones
across 24 provinces. Of the 23 reported outbreaks, 14
(61.0%) ended and nine (39.0%) are still ongoing, with
most cases reported in the southeastern part of the
country, over the last two years (2022 and 2023).

During epidemiological week 41 (ending 15 October
2023), two new cases of cVDPV1 were reported from
two newly affected health zones: Kiambi in Tanganyika
province and Mufunga-Sampwe in Haut Katanga
province. Furthermore, 33 environmental samples
collected in the provincial sites of Kinshasa, Equateur,
Haut Katanga, and Lualaba tested positive for cVDPV2,
of which 85.0% (n=25) were from Kinshasa province.

From epidemiological week 1 to week 41, a total of
186 confirmed circulating vaccine-derived poliovirus
(cVDPV) including 79 (42.5 %) cVDPV1 and 107
(57.5%) cVDPV2 have been reported. Haut Katanga and
Tanganyika provinces were the most affected, with 44
cases (33 cVDPV1 and 11 cVDPV2) and 41 cases (36
cVDPV1 and 5 cVDPV2) respectively.

From 1 January to 19 October 2023, a cumulative total of
3 630 AFP cases have been reported in 98.0% (n=509)
of the 519 health districts, with an estimated no polio AFP
rate of 7.2 per 100 000 population of less than 15 years
old (country target: ≥ 3/100 000). Nearly 60.0% (n=2 083)
of the AFP cases were notified by healthcare providers
(n= 2 083), followed by community health workers
(36.0%, n=1 310), relatives (3.1%, n=113), traditional
healers (0.5%, n=21) and non-government organizations
(0.4%, n=16).

The percentage of AFP cases notified within 7 days of
the onset of paralysis was 67.1% (target: ≥ 80 %), and
only 9.1% (target: ≥ 80%) of the collected samples
reached the laboratory for investigation within 3 days
or less; the remaining samples arrived late.

Since 2017 and as of 20 October 2023, there have
been a cumulative total of 23 648 AFP cases, with 938
(4.0%) confirmed polio cases including 722 (77.0%)
cVDPV2 and 216 (23.0%) cVDPV1. The highest
number of cases was reported in 2022 with a total
of 520 (55.4%) confirmed cVDPV cases, including
377 cVDPV2 and 143 cVDPV1. Haut Lomami and
Tanganyika provinces reported most cases with 185
cases (103 cVDPV1 and 82 cVDPV2) and 163 cases
(103 cVDPV1 and 82 cVDPV2) respectively.

From 20 October 2022 to 19 October 2023, of the
3 644 reported AFP cases, 46% (n=1 676) of those
aged between 6- 59 months, received more than four
Polio vaccine doses, while 16.0% (n=583) had an
unknown vaccination status, and 10.0% (n=365) had
zero Polio vaccine dose.

PUBLIC HEALTH ACTIONS

The Ministry of health is coordinating the
preparation and implementation of polio
vaccination campaigns in the affected provinces
and health zones with support from WHO and
other implementing partners.

WHO continues to support the training of national,
provincial and health zones surveillance officers
on electronic surveillance

Active Polio case search, case investigation and
supportive integrated supervisions in the affected
health zones are ongoing.

Annual review of environmental surveillance sites
is ongoing, and investigations of polioviruses
isolated from environmental samples are
underway.

SITUATION INTERPRETATION

Vaccine derived Polio disease remains a public health
concern in DRC. While efforts have been made to fulfill
two key indicators, namely AFP case investigation
within 48 hours, and stool sample collection adequacy,
there still a need to strengthen cases notification within
7 days of the onset of paralysis and ensure that samples are
shipped to the laboratory within 3 days or less. It’s worth noting
a significant community involvement in reporting AFP
cases, with nearly 36% of AFP cases reported.
The Government along with its partners should
enhance and maintain quality routine polio vaccination
activities, as well as targeted response
efforts in hard-to-reach areas to achieve the
national and global polio eradication objectives.

https://www.afro.who.int/countries/m...-october-2023\[]

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Translation Google

Tanganyika: significant drop in poliomyelitis cases, EPI raises the need to continue vaccination

Wednesday November 22, 2023 - 10:31 p.m.

In the province of Tanganyika, the number of confirmed cases of poliomyelitis has decreased significantly since the start of the current year, announces the provincial medical coordinator of the expanded immunization program (EPI), Dr Jean-Pierre Kitenge Mikenza.

According to him, the number of polio cases has fallen by 75% and the number of patients has fallen from nearly 147 to 41 across the 11 health zones in the province since the beginning of the year; and of these 41 cases, more than 36 cases are caused by type 1 polio, and the remaining 5 are type 2. Despite these figures, Dr. Mikenza points out the low vaccination coverage in Tanganyika, which surrounded by courses of water and varying relief.

“Many areas are bordered by several watercourses. This may pose difficulties regarding the accessibility of the vaccine in these areas. Tanganyika also has mountains which make it difficult to administer general health care, including vaccination. This is one of the weaknesses of the province's vaccination system. And this could explain the comeback of the type 1 polio variant which had disappeared for a while,” he reports.

A vaccination campaign against Poliomyelitis took place in the province of Tanganyika from November 17 to 20.

During a workshop held in Kinshasa on the analysis of the vaccination situation in the DRC, with a view to planning the future financing of the EPI for the period from 2025 to 2029, the experts recognized that Tanganyika was among the 3 provinces which maintain regular vaccination coverage, with Haut-Lomani and Lualaba. Recent strikes by vaccination workers had slowed down vaccination in this part of the country.

Jean Marie Makuma

https://actualite.cd/2023/11/22/tanganyika-baisse-significative-des-cas-de-poliomyelite-pev-evoque-la-necessite-de

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Translation Google

Tanganyika: two cases of polio recorded in the Kalemie health zone in 10 months

Published on Sun, 26/11/2023 - 23:36 | Modified on Sun, 26/11/2023 - 23:42

Two confirmed cases of polio and 47 others of acute flaccid paralysis have been recorded since last January in the Kalemie health zone (Tanganyika).

The chief medical officer of this health zone, Dr Yvan Mwamba reported these figures in an interview with the media.

“ Thus, this year 2023, the Kalemie health zone recorded only two confirmed cases of polio while 47 cases of acute flaccid paralysis whose samples were sent to the INRB in Kinshasa for analysis” he said . he declares.

This doctor director of the Kalemie General Reference Hospital (Tanganyika) attributed this improvement to the implementation of the strategy called “owl”.

This consists of vaccinators going into households and vaccinating children at night under the supervision of either their mothers or fathers.

According to this doctor director of the Kalemie General Reference Hospital (Tanganyika), this “owl” strategy supports others used in the fight against poliomyelitis and other diseases.

“ Regarding polio vaccination, we use the door-to-door strategy, and the second strategy we use is the owl strategy, where the nurses (IT) and health area coordinators go to the households and vaccinate the children at night under the supervision of either the mother or the father. Under the pretext that we cannot score, because the dad does not agree with vaccination and the mom agrees, so it is done at night when the dad is absent,” underlined Dr. Yvan Mwamba.

Another vaccination strategy “consists of the involvement of indigenous peoples (the pygmies) in vaccination activities as community relays in order to bring the population together.

“ These refractory groups easily agree to be vaccinated if they find that a community relay is from their community ,” added this doctor.

A third strategy is recovery through routine vaccination:

“There are information sheets that the community relays use and each time we identify a child receiving vaccination, the community relays direct the child with a token to the respective health area to go and take the vaccine. There are vaccination activities that IT organizes on site, in health areas and advanced activities, IT travel from one village to another to vaccinate.”

These vaccination strategies and in particular the owl strategy have paid off.

He also recommended that the Congolese state help health zones in “planning vaccination activities.

“ This good planning helps us at the provincial level to properly coordinate our activities and achieve the objective and properly cover the target population that we are supporting ,” continued Dr. Yvan Mwamba.

Finally, the head doctor of the Kalemie health zone mentioned cases of resistance to vaccination. These cases are often due to the religious beliefs of certain sects such as Watch Taywer, Red Kimbanguism, etc.

The town of Kalemie has two health zones: Nyemba and Kalemie. The Kalemie health zone includes 27 health areas including 8 in the town of Kalemie and 19 in the outskirts of the town.

https://www.radiookapi.net/2023/11/26/actualite/sante/tanganyika-deux-cas-de-polio-recenses-dans-la-zone-de-sante-de-kalemie-en