title: Outreach to underserved communities in northern Nigeria, 2012-2013.
abstract: BACKGROUND
  Persistent wild poliovirus transmission in Nigeria constitutes a major obstacle to global polio eradication. In August 2012, the Nigerian national polio program implemented a strategy to conduct outreach to underserved communities within the context of the country's polio emergency action plans.
  
  
  METHODS
  A standard operating procedure (SOP) for outreach to underserved communities was developed and included in the national guidelines for management of supplemental immunization activities (SIAs). The SOP included the following key elements: (1) community engagement meetings, (2) training of field teams, (3) field work, and (4) acute flaccid paralysis surveillance.
  
  
  RESULTS
  Of the 46,437 settlements visited and enumerated during the outreach activities, 8607 (19%) reported that vaccination teams did not visit their settlements during prior SIAs, and 5112 (11.0%) reported never having been visited by polio vaccination teams. Fifty-two percent of enumerated settlements (23,944) were not found in the existing microplan used for the immediate past SIAs.
  
  
  CONCLUSIONS
  During a year of outreach to >45,000 scattered, nomadic, and border settlements, approximately 1 in 5 identified were missed in the immediately preceding SIAs. These missed settlements housed a large number of previously unvaccinated children and potentially served as reservoirs for persistent wild poliovirus transmission in Nigeria.
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme.
authors.forename: Saheed O
authors.initials: SO
authors.lastname: Gidado
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme.
authors.forename: Chima
authors.initials: C
authors.lastname: Ohuabunwo
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme.
authors.forename: Patrick M
authors.initials: PM
authors.lastname: Nguku
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Ikechukwu U
authors.initials: IU
authors.lastname: Ogbuanu
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme.
authors.forename: Ndadilnasiya E
authors.initials: NE
authors.lastname: Waziri
authors.affiliation: Nigeria Field Epidemiology and Laboratory Training Programme.
authors.forename: Oladayo
authors.initials: O
authors.lastname: Biya
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Eric S
authors.initials: ES
authors.lastname: Wiesen
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Adamma
authors.initials: A
authors.lastname: Mba-Jonas
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: John
authors.initials: J
authors.lastname: Vertefeuille
authors.affiliation: Federal Ministry of Health Nigeria.
authors.forename: Akin
authors.initials: A
authors.lastname: Oyemakinde
authors.affiliation: CDC Nigeria.
authors.forename: Okey
authors.initials: O
authors.lastname: Nwanyanwu
authors.affiliation: Nigeria National Primary Health Care Development Agency.
authors.forename: Namadi
authors.initials: N
authors.lastname: Lawal
authors.affiliation: Nigeria National Primary Health Care Development Agency.
authors.forename: Mustapha
authors.initials: M
authors.lastname: Mahmud
authors.affiliation: Nigeria Center for Disease Control, Abuja, Nigeria.
authors.forename: Abdulsalami
authors.initials: A
authors.lastname: Nasidi
authors.affiliation: Global Immunization Division, Center for Global Health, Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
authors.forename: Frank J
authors.initials: FJ
authors.lastname: Mahoney
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003159:Community-Institutional Relations; D018562:Disease Transmission, Infectious / Q000517:prevention & control*; D005260:Female; D006291:Health Policy; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D009549:Nigeria / Q000453:epidemiology; D011051:Poliomyelitis / Q000453:epidemiology* / Q000517:prevention & control* / Q000635:transmission; D023321:Poliovirus Vaccines / Q000008:administration & dosage*
chemical_list: D023321:Poliovirus Vaccines
keywords: eradication; nomad; polio; settlement; underserved populations; wild poliovirus