CROSS- Border Wild Polio VIRUS Transmission in CORE Group Polio Project Areas in Ethiopia

Background: Ethiopia interrupted indigenous polio transmission in April 2008. However, it remains at risk of re-infection because of importation of polio virus from bordering countries.

 Objectives: Assess polio immunization activities and risk of wild polio virus (WPV) importation in CORE Group Polio Project (CGPP) international border areas of Ethiopia.

 Methods: The study employed key informant interviews of community volunteers (CV), health extension workers (HEWs), program coordinators, managers and other stakeholders, as well as focus group discussions (FGDs) with community and religious leaders in six border districts (woredas) located in three regions of the country. It was conducted in March and April 2012.

 Results: Thirty-three key informant interviews and six FGDs were conducted. Immunization coverage was reported to be low and misconceptions about causes and transmission of polio were abundant. There was extensive cross-border movement of people for various reasons and mechanisms for prevention of cross-border polio transmission were generally absent. AFP case detection and reporting was generally low.

Conclusion and recommendations:  Cross-border transmission of polio can occur from several frontiers.  Suggestions to control cross-border polio transmission included establishing and/or strengthening cross-border collaboration with responsible counterparts in neighboring countries by using existing cross-border forums and structures to create community awareness, share  information and resources, design and implement strategies for identification of children who are eligible for vaccination or who are suspected AFP cases. In addition districts should coordinate supplemental immunization activities to coincide with when adjacent districts in neighboring countries are carrying out similar actions.