vaccination coverage among nomadic pastoralists in northeastern Kenya for polio eradication. V. Gammino. US Centers for Disease Control and Prevention,.
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Abstracts / International Journal of Infectious Diseases 53S (2016) 4–163
06.002 The impact of climate change and population mobility on neglected tropical disease elimination J.J. Amon Neglected Tropical Diseases at Helen Keller International, New York, NY/US The WHO has established targets for the global or regional eradication or elimination of 11 neglected tropical diseases (NTDs) diseases by 2020. Other NTDs, such as soil transmitted helminths (STH), are the focus of intensified control efforts in specific countries. Two key strategies are being implemented to achieve these goals: preventive chemotherapy through repeated community-based mass drug administration (MDA) and intensified disease management. This presentation will present an update on NTD elimination efforts in sub-Saharan Africa, examining in particular the challenges posed by climate change and migration on MDA campaigns, including for lymphatic filariasis, onchocerciasis, schistosomiasis, STH and trachoma. While increasingly researchers are identifying (and predicting) health impacts from climate change (notably, how changes in temperature, precipitation and vegetation phenology impact malaria and certain arbovirus vectors), relatively less attention has been paid to the impact of climate change on NTDs in particular, or the challenges climate change related migration, which may also be associated with conflict or shifting labor migration, may pose to NTD elimination efforts. In addition to challenges in achieving high coverage rates for MDA, migration can complicate the assessment of transmission interruption and post-MDA disease surveillance, putting in doubt the verification of elimination. Achieving high coverage rates of mobile populations, whether for surveillance or MDA efforts, is a broader concern than for NTD programs. In the context of increasing health impacts of climate change, and in support of sustainable development goals and the push for universal health coverage, more emphasis should be put on the development of effective strategies to reach mobile populations across various public health, outbreak response, disease control and elimination programs and on documenting and sharing lessons learned. http://dx.doi.org/10.1016/j.ijid.2016.11.034 06.003 Interdisciplinary approaches to evaluate vaccination coverage among nomadic pastoralists in northeastern Kenya for polio eradication V. Gammino US Centers for Disease Control and Prevention, Global Immunization Division, Atlanta, GA/US Background: As polio eradication draws near, immunization and surveillance of remote and itinerant populations who are potential virus reservoirs become increasingly important. In 2013 and 2014, wild poliovirus imported from an endemic country in West Africa caused outbreaks in Somalia, Ethiopia and Kenya. Some cases were found among nomadic pastoralists, traditionally characterized as having limited access to health care including vaccination. We aimed to measure vaccination coverage and characterize its geospatial and socio-economic determinants among both settled and nomadic pastoralists in northeastern Kenya. Methods/ Materials: Utilizing a mixed-methods approach and remote sensing to create a more robust sampling frame, we
surveyed 12 households (HH) in each of 25 permanent (“settled”) and temporary (“nomadic”) pastoralist clusters. We utilized bi-lingual interviewers and a combination of tablet-based data collection tools to complete the survey; quality assurance checks were conducted onsite and using remote sensing methods. Results: We surveyed mothers in 235 settled and 263 nomadic pastoralist HHs. HHs were located, on average, 2 and 19 km from the closest clinic and/or co-located market for settled and nomadic HHs respectively. We obtained vaccination coverage data for 353 settled and 405 nomadic children < 5 respectively. Oral poliovirus vaccine (OPV3) coverage in settled pastoralist children < 5 was 85%; in nomadic children, coverage was 28% in children 1-4, and 10% among infants 100 outreach sessions targeting potential participants, community members, and health leaders and trained >350 Sierra Leone staff. The study design evolved in response to the changing epidemiologic situation. A stepped wedge design (sequential vaccination after full enrollment) was
