TABLE 1.
Key risk indicators for countries of the “wild poliovirus (WPV) importation belt,” by risk for transmission after an importation of WPV — World Health Organization (WHO) African Region, 2012–2013
| Population immunity indicators | Surveillance quality indicators | Other risk factors | |||||||
|---|---|---|---|---|---|---|---|---|---|
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| Country | National coverage with OPV3 (goal 90%)* | % districts that have ≥80% OPV3 coverage (goal 100%)† | Risk tier vaccine history ≥3 doses in children with NPAFP (Low, ≥90%; Moderate, 80%–90%; High, <80%) | Risk tier vaccine history zero doses in children with NPAFP (Low, <5%; Moderate, 5%–10%; High, >10%) | Risk tier for % provinces with NPAFP cases ≥2 per 100,000 (Low, >80%; Moderate, 51%–80%; High, ≤50%)§ | Risk tier for % provinces with ≥80% of AFP cases with adequate specimens¶ | Border a country with endemic or reestablished WPV transmission in 2012 (Nigeria, Chad) | No. of years with at least one importation event (2003–2012) | Areas of insecurity |
| High-risk countries ** | |||||||||
| Benin | 85% | 95% | High | High | High | Low | Yes | 4 | No |
| Cameroon | 85% | 75% | High | High | High | Moderate | Yes | 5 | Yes |
| CAR | 47% | 13% | Moderate | Low | High | Low | Yes | 5 | Yes |
| Chad | 56% | 52% | High | High | High | Moderate | Yes | 10 | Yes |
| Côte d’ Ivoire | 94% | NA | High | Moderate | High | Low | No | 5 | No |
| Ethiopia | 70% | 54% | High | Moderate | High | Moderate | No | 4 | Yes |
| Guinea-Bissau | 78% | 91% | High | Low | High | High | No | 0 | No |
| Mali | 74% | 73% | Low | Moderate | Low | Low | No | 6 | Yes |
| Niger | 78% | 98% | Low | Moderate | Moderate | Moderate | Yes | 10 | Yes |
| Uganda | 82% | 42% | High | Moderate | Moderate | Low | No | 2 | No |
| Moderate-risk countries | |||||||||
| Burkina Faso | 90% | 100% | Moderate | Moderate | High | Low | No | 4 | No |
| Guinea | 57% | 97% | Moderate | Low | Moderate | Low | No | 3 | No |
| Kenya | 82% | NA | Low | Moderate | Moderate | Low | No | 3 | No |
| Liberia | 77% | 93% | Moderate | Low | Low | Low | No | 2 | No |
| Mauritania | 80% | 40% | Moderate | Moderate | Moderate | Low | No | 2 | Yes |
| Senegal | 89% | NA | Moderate | Moderate | Moderate | Low | No | 1 | No |
| Togo | 84% | 89% | Moderate | Low | High | Low | No | 3 | No |
| Low-risk countries | |||||||||
| Eritrea | 99% | 48% | Low | Low | Low | Low | No | 1 | No |
| Gambia | 98% | 100% | Low | Low | Low | Low | No | 0 | No |
| Ghana | 91% | 80% | Low | Low | Low | Low | No | 2 | No |
| Sierra Leone | 81% | 100% | Low | Low | Low | Low | No | 2 | No |
Abbreviations: OPV3 = ≥3 doses of oral poliovirus vaccine; NPAFP = nonpolio acute flaccid paralysis; AFP = acute flaccid paralysis; CAR = Central African Republic; NA = not available.
WHO-United Nations Children’s Fund estimate (2012).
Administrative data reported using a WHO-UNICEF Joint Reporting Form (2012).
The data for this indicator contain a substantial number of NPAFP cases with missing vaccination history. For 10 (46%) of 21 countries, ≥10% of the children with NPAFP had unknown vaccination histories.
Standard WHO target is adequate stool specimen collection from ≥80% of AFP cases, in which two specimens are collected ≥24 hours apart, and within 14 days of paralysis onset, and arriving in good condition (received by reverse cold chain and without leakage or desiccation) in a WHO-accredited laboratory.
Countries were assessed to be at high risk for outbreaks during 2012–2013 based on proximity to countries with WPV-endemic or reestablished transmission in 2012, current or recent civil unrest, or with any population immunity indicator in a high-risk tier. Countries were assessed to be at moderate risk based on any of the population immunity risk criteria suggesting vulnerability.