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- Title
Assessment of immunity to polio among Rohingya children in Cox's Bazar, Bangladesh, 2018: A cross-sectional survey.
- Authors
Estivariz, Concepcion F.; Bennett, Sarah D.; Lickness, Jacquelyn S.; Feldstein, Leora R.; Weldon, William C.; Leidman, Eva; Ehlman, Daniel C.; Khan, Muhammad F. H.; Adhikari, Jucy M.; Hasan, Mainul; Billah, Mallick M.; Oberste, M. Steven; Alamgir, A. S. M.; Flora, Meerjady D.
- Abstract
<bold>Background: </bold>We performed a cross-sectional survey in April-May 2018 among Rohingya in Cox's Bazar, Bangladesh, to assess polio immunity and inform vaccination strategies.<bold>Methods and Findings: </bold>Rohingya children aged 1-6 years (younger group) and 7-14 years (older group) were selected using multi-stage cluster sampling in makeshift settlements and simple random sampling in Nayapara registered camp. Surveyors asked parents/caregivers if the child received any oral poliovirus vaccine (OPV) in Myanmar and, for younger children, if the child received vaccine in any of the 5 campaigns delivering bivalent OPV (serotypes 1 and 3) conducted during September 2017-April 2018 in Cox's Bazar. Dried blood spot (DBS) specimens were tested for neutralizing antibodies to poliovirus types 1, 2, and 3 in 580 younger and 297 older children. Titers ≥ 1:8 were considered protective. Among 632 children (335 aged 1-6 years, 297 aged 7-14 years) enrolled in the study in makeshift settlements, 51% were male and 89% had arrived after August 9, 2017. Among 245 children (all aged 1-6 years) enrolled in the study in Nayapara, 54% were male and 10% had arrived after August 9, 2017. Among younger children, 74% in makeshift settlements and 92% in Nayapara received >3 bivalent OPV doses in campaigns. Type 1 seroprevalence was 85% (95% CI 80%-89%) among younger children and 91% (95% CI 86%-95%) among older children in makeshift settlements, and 92% (88%-95%) among younger children in Nayapara. Type 2 seroprevalence was lower among younger children than older children in makeshift settlements (74% [95% CI 68%-79%] versus 97% [95% CI 94%-99%], p < 0.001), and was 69% (95% CI 63%-74%) among younger children in Nayapara. Type 3 seroprevalence was below 75% for both age groups and areas. The limitations of this study are unknown routine immunization history and poor retention of vaccination cards.<bold>Conclusions: </bold>Younger Rohingya children had immunity gaps to all 3 polio serotypes and should be targeted by future campaigns and catch-up routine immunization. DBS collection can enhance the reliability of assessments of outbreak risk and vaccination strategy impact in emergency settings.
- Subjects
BANGLADESH; MYANMAR; POLIO; BLOOD collection; POLIOMYELITIS vaccines; EPIDEMICS; ORAL vaccines; POLIO prevention; RESEARCH; IMMUNIZATION; CROSS-sectional method; RESEARCH methodology; EVALUATION research; MEDICAL cooperation; COMPARATIVE studies; REFUGEES; DISEASE prevalence; RESEARCH funding; EPIDEMIOLOGICAL research
- Publication
PLoS Medicine, 2020, Vol 17, Issue 3, p1
- ISSN
1549-1277
- Publication type
journal article
- DOI
10.1371/journal.pmed.1003070