BURUNDI— In an unprecedented step, the Burundi Ministry of Health has launched a national polio vaccination campaign targeting nearly 3 million children under seven years.

The vaccination campaign has been preceded by The Burundian Ministry of Health’s declaration of a polio epidemic on March 17, the first in 30 years.

This follows the confirmation from the Global Polio Laboratory Network (GPLN) of three cases of the circulant variant poliovirus type 2 (cVDPV2) in March 2023.

The cases included a four-year-old boy in the Isale district in western Burundi who had never been vaccinated against polio and two other children who were his contacts.

Currently, 13 cases of cVDPV2 have been reported so far in 2023 as well as the presence of the virus was confirmed in five samples of wastewater from environmental surveillance.

The campaign is receiving support from the World Health Organization (WHO) and other Global Polio Eradication Initiative (GPEI) partners.

The ministry reports that the country has prepared more than 3.7 million doses of the nOPV2 vaccine for administration over four days.

Dr. Sylvie Nzeyimana, Burundi’s Minister of Health said, “The detection of the virus continues to constitute a national public health emergency, and subsequent vaccination rounds can be expected to follow in the coming months in order to protect Burundi’s children.”

In anticipation of the upcoming vaccination campaign in Burundi, the WHO regional office in Africa, WHO-AFRO, has supported the training of more than 12,000 vaccinators and conducted over 700 sessions for the training of trainers at all levels, from community to national level.

Dr. Désiré Nolna, Burundi’s country coordinator for the Global Polio Eradication Initiative, stressed the need to implement quality campaigns in a timely manner, while fully operationalizing a consistent environmental surveillance system to enable early detection and adequate sample collection.

Further epidemiological investigations are ongoing, including risk assessments to determine the extent of the outbreak.

WHO experts in the field are also supporting Burundi with additional sample collection to further bolster polio surveillance while assessing the possibility of opening new environmental surveillance sites for early detection of silently circulating poliovirus.

Circulating poliovirus type 2 is the most prevalent form of polio in Africa, accounting for most of the polio outbreaks in the region, with more than 400 cases reported in 14 countries in 2022.

cVDPV2 can occur when the weakened strain of the virus contained in the oral polio vaccine circulates among under-immunized populations for long periods.

Challenging epidemic management in border areas

Enock Ngendakumana, the general secretary of the Group of Community Health Agents (GASC) in Gatumba, says that awareness-raising operations were strengthened following the declaration of this outbreak.

He explains that although the COVID-19 pandemic has had a negative impact on the fight against polio, vaccination campaigns were disrupted.

Nevertheless, the fight against COVID-19 has instead made it possible to strengthen the fight against polio virus disease as well as other diseases related to the lack of hygiene.

Ngendakumana admits that this area is at risk as it is located on the border with the Democratic Republic of the Congo.

 “Burundians go to DRC to earn a living by working there, and Congolese also come, all without health checks. It’s hard to manage,” he said.

Hussein Ntahetwa, the chief of the Gatumba area, says that in all the meetings in which he takes part, there is an emphasis on raising awareness of the routine vaccination schedule.

According to a GPEI report, all reported isolates stem from two separate and new emergences of cVDPV2 linked with nOPV2 that originated in Tanganyika and South Kivu provinces in DRC.

Consequently, complex humanitarian challenges in the country, including insecurity, have created longstanding barriers to reaching every child with the polio vaccine.

This has contributed to the continued spread of variant poliovirus within DRC and its exportation to nearby countries.

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