TABLE 1.

Key risk indicators for 25 countries with wild poliovirus (WPV) cases during 2009–2014 and eight selected neighboring countries, by risk for transmission after an importation of WPV — Africa, 2014

	Childhood immunity indicators			Routine immunization indicators		Surveillance quality indicators			Other factors
Risk level/Country	Risk tier: routine immunization with OPV3 national coverage*†	Risk tier: vaccine history ≥3 doses in children with NPAFP*,§	Risk tier: vaccine history zero doses in children with NPAFP¶	OPV3 national coverage (%)	% districts with ≥80% OPV3 coverage**	Risk tier for % provinces with ≥2 AFP cases per 100,000 children aged <15 yrs††	Risk tier for % of provinces with 80% of AFP stool specimen collection within 2 wks††	% of population residing in a province that meets both criteria	Areas of insecurity in the country that disrupt vaccine delivery§§	No. of WPV importations 2009–2013	Outbreak response countries (OR) and other priority countries (PC)	Borders with a country with WPV case in the last 12 months¶¶
High risk
Benin	High	High	High	69	84	Mod	Low	59	No	0	PC	Yes
Cameroon	Mod	High	High	89	78	Low	High	36	Yes	3	OR	Yes
CAR	High	Low	Low	23	4	High	Low	35	Yes	2	PC	Yes
Chad	High	Mod	Low	48	60	Low	Mod	73	Yes	4	PC	Yes
Congo	High	High	High	69	73	Low	Mod	79	No	1	PC	Yes
Djibouti	Mod	High	Low	82	50	Low	Low	100	No	0		Yes
Equatorial Guinea	High	High	Low	3	6	High	High	0	No	0	OR	Yes
Ethiopia	High	High	Mod	72	50	Low	High	21	No	1	OR	Yes
Gabon	High	Low	Low	79	33	Low	High	0	No	1	PC	Yes
Guinea	High	High	Low	63	92	Low	Mod	38	No	2		No
Kenya	High	Low	Low	76	45	Low	Low	91	No	3		Yes
Niger	High	Low	Low	70	90	High	High	0	Yes	11	PC	Yes
Somalia	High	High	High	42	6	Low	Low	99	Yes	1	OR	Yes
South Sudan	High	Low	Low	45	23	High	Low	19	Yes	0		Yes
Uganda	High	High	Mod	78	83	Mod	Mod	46	No	0		No
Moderate-to-high risk
Angola	Low	High	Low	93	66	Mod	Low	46	No	1	PC	No
Cote d’Ivoire	Mod	High	Low	88	99	Low	Mod	16	No	2	PC	No
DRC	High	Mod	Low	72	80	Low	Low	90	Yes	3	PC	No
Liberia	Mod	High	Low	89	87	Mod	Low	23	No	2		No
Mali	High	Low	Low	74	77	Low	Low	96	Yes	6	PC	No
Moderate risk
Burkina Faso	Mod	Low	Low	88	100	Low	Low	95	No	1		No
Eritrea	Low	Low	Low	94	40	Mod	Low	65	No	1		Yes
Guinea-Bissau	Mod	Low	Low	80	91	Low	High	0	No	0		No
Mauritania	Mod	Low	Low	80	42	Low	Mod	61	No	1		No
Senegal	Low	Mod	Mod	92	32	Mod	Mod	54	No	3		No
Sudan	Low	Low	Low	93	93	Low	Low	100	Yes	0		Yes
Togo	Mod	Low	Low	84	95	Low	Low	58	No	2		No
Low risk
Burundi	Low	Low	Low	96	93	High	Low	38	No	1		No
Gambia	Low	Low	Low	97	100	Low	Mod	67	No	0		No
Ghana	Low	Low	Low	90	75	High	Low	34	No	0		No
Rwanda	Low	Low	Low	98	100	Low	Low	100	No	0		No
Sierra Leone	Low	Low	Low	92	93	Mod	Low	79	No	1		No
Tanzania	Low	Low	Low	91	79	Mod	Low	66	No	0		No

Abbreviations: OPV3 = third dose of oral poliovirus vaccine; NPAFP = nonpolio acute flaccid paralysis; AFP = acute flaccid paralysis; CAR = Central African Republic; DRC = Democratic Republic of the Congo.

^*Countries were considered to be at low risk at ≥90%, moderate risk at 80%–89%, and high risk at <80%.

^†OPV3 coverage is based on World Health Organization (WHO)/United Nations Children’s Fund (UNICEF) estimates of the national vaccination coverage of the third dose of diphtheria-tetanus-pertussis (DTP3) for 2013.

^§Nonpolio acute flaccid paralysis database maintained by WHO.

^¶Countries were considered to be at low risk at <5%, moderate risk at 5%–10%, and high risk at >10%.

^**Routine immunization administrative data as reported via WHO-UNICEF Joint Reporting Form, 2013, are based on use of DTP3 as proxy for OPV3 that does not count OPV doses administered during supplementary immunization activities.

^††Countries were considered to be at low risk at ≥80%, moderate risk at 50%–79%, and high risk at <50%.

^§§Areas with limitations in access and/or threats to the physical security of vaccination staff members.

^¶¶Nigeria, Cameroon, Ethiopia, Somalia, and Equatorial Guinea.