title: Polio outbreak among nomads in Chad: outbreak response and lessons learned.
abstract: BACKGROUND
  In response to the 2011 and 2012 polio epidemic in Chad, Chad's Ministry of Public Health, with support from Global Polio Eradication Initiative partners, took steps to increase vaccination coverage of nomadic children with targeted polio campaigns. This article describes the strategies we used to vaccinate nomads in 3 districts of Chad.
  
  
  METHODS
  Our targeted interventions involved using mobile vaccination teams, recruiting local nomads to identify settlements, using social mobilization, and offering vaccinations to children, women, and animals.
  
  
  RESULTS
  Vaccination coverage of nomadic children 0-59 months of age increased, particularly among those never before vaccinated against polio. These increases occurred mostly in the intervention districts of Dourbali, from 2956 to 8164 vaccinated children, and Kyabe, from 7319 to 15 868. The number of first-time vaccinated nomadic children also increased the most in these districts, from 60 to 131 in Dourbali and from 1302 to 2973 in Kyabe. Coverage in the Massaguet district was only 37.7%.
  
  
  CONCLUSIONS
  Our success was probably due to (1) appointment of staff to oversee implementation, (2) engagement of the national government and its partners, (3) participation of nomadic community leaders, (4) intersectoral collaboration between human and animal health services, and (5) flexibility and capacity of vaccinators to vaccinate when and where nomads were available.
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Serigne M
authors.initials: SM
authors.lastname: Ndiaye
authors.affiliation: Centre de Support en Santé International.
authors.forename: Mahamat Abdoulaye
authors.initials: MA
authors.lastname: Ahmed
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Melinda
authors.initials: M
authors.lastname: Denson
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Allen S
authors.initials: AS
authors.lastname: Craig
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Katrina
authors.initials: K
authors.lastname: Kretsinger
authors.affiliation: Programme Elargie ide Vaccination, Ministere de la Santé Publique.
authors.forename: Baharadine
authors.initials: B
authors.lastname: Cherif
authors.affiliation: World Health Organization, N'Djamena, Chad.
authors.forename: Pierre
authors.initials: P
authors.lastname: Kandolo
authors.affiliation: Centre de Support en Santé International.
authors.forename: Daugla Doumagoum
authors.initials: DD
authors.lastname: Moto
authors.affiliation: World Health Organization, N'Djamena, Chad.
authors.forename: Ayangma
authors.initials: A
authors.lastname: Richelot
authors.affiliation: Global Immunization Division, Centers for Disease Control and Prevention, Atlanta, Georgia.
authors.forename: Jude
authors.initials: J
authors.lastname: Tuma
mesh_terms: D000328:Adult; D000818:Animals; D002596:Chad / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D003140:Communicable Disease Control / Q000458:organization & administration; D004196:Disease Outbreaks; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011051:Poliomyelitis / Q000453:epidemiology* / Q000517:prevention & control*; D023321:Poliovirus Vaccines / Q000008:administration & dosage*; D011247:Pregnancy; D014171:Transients and Migrants
chemical_list: D023321:Poliovirus Vaccines
keywords: nomad health; polio vaccination; vaccination outreach strategies; vaccinations of mobile populations