title: Characteristics of districts in Pakistan with persistent transmission of wild poliovirus, 2000-2001.
abstract: We sought to identify factors associated with being a reservoir district for wild poliovirus in Pakistan. Differences between reservoir and non-reservoir districts were identified using acute flaccid paralysis surveillance data, population census statistics and data from a survey of district health officials (DHOs). Of the 11 poliovirus reservoir districts identified, population density was significantly higher (median 550 persons/km2) than the non-reservoirs (median 175 persons/km2). DHOs from reservoir districts more often reported that planning was affected by refugees and they had more frequent DHO transfers compared with non-reservoir districts. Multivariate analysis confirmed that reservoirs more often had high population density and frequent DHO transfers. Assessment of district-level and management characteristics can supplement surveillance methods to further improve health programmes.
authors.affiliation: World Health Organization, Polio Eradication Initiative, Islamabad, Pakistan.
authors.forename: S A
authors.initials: SA
authors.lastname: Lowther
authors.forename: T
authors.initials: T
authors.lastname: Mir
authors.forename: M K
authors.initials: MK
authors.lastname: Bile
authors.forename: R
authors.initials: R
authors.lastname: Abdul Hafiz
authors.forename: A W
authors.initials: AW
authors.lastname: Mounts
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D004197:Disease Reservoirs / Q000706:statistics & numerical data / Q000821:virology; D019353:Endemic Diseases / Q000517:prevention & control / Q000706:statistics & numerical data; D006285:Health Planning; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020380:Needs Assessment; D010154:Pakistan / Q000453:epidemiology; D010563:Personnel Turnover / Q000706:statistics & numerical data; D010820:Physicians / Q000458:organization & administration / Q000523:psychology; D011051:Poliomyelitis / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission / Q000821:virology; D017955:Poliovirus / Q000145:classification / Q000472:pathogenicity; D011156:Population Density; D011159:Population Surveillance; D012036:Refugees; D018570:Risk Assessment; D012307:Risk Factors; D012621:Seasons; D011795:Surveys and Questionnaires