Objectives: The purpose of this study is to advance the understanding of secondary conditions experienced by persons aging with the long-term disabilities of polio and rheumatoid arthritis and the consequences of these declines in health and function on disability bed days. Additionally, it explores the effects of the timing and severity of onset of disability characteristics on the frequency and consequences of secondary conditions. A life course conceptual framework with the Institute of Medicine’s model of disablement is used to frame and anchor disability and life events. Methods: In-depth structured in-home interviews were conducted on 216 individuals with polio and 186 individuals with rheumatoid arthritis. They consisted of objective and subjective self-reports of current status and prior condition. The survey was a regional crosssectional, group comparison design with a cross-sequential sampling and data analytic framework. Scale development for data reduction was utilized to obtain parsimonious measures for the models. Linear regression was then performed to test the models for three outcome variables (number of chronic secondary conditions, increases in functional limitations and number of disability bed days in six months) in a theorized order for the polio and RA samples individually. Results: There was partial support for within-sample hypotheses for both polio and rheumatoid arthritis regarding interrelationships and disability bed days in past six months. No significant differences were found across subsamples for the effects of timing and severity of onset of disability characteristics, predicting chronic secondary conditions, predicting increase in functional limitations, and the number of disability bed days in six months. Similarities were found between the two samples when examining subgroup predictors on the three outcomes above. Chronic secondary conditions predicted (p<.05 for both subsamples) increase in functional limitations and increase in mobility was a significant predictor (p<.001 for both subsamples) of increase in functional limitations. Discussion: There were limited findings for these data. Judgment must be withheld with respect to the hypotheses. The analyses did not yield enough predictive strength to make comparisons possible across subsamples. Likewise, in examining similarities, only general, descriptive statements could be made. The subjective nature of disability is an immense challenge in cross disability research for comparability within disabilities and across disabilities.

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Thesis (Ph. D.)--University of Texas at Austin, 2004. / Supervisor: Alexa Stuifbergen. Vita. Includes bibliographical references. Also available from UMI.

This thesis offers a detailed account of early polio epidemics (between 1918 and 1945) in Johannesburg, where the disease was particularly severe. At this time, little was known about the poliovirus, and such limited understanding affected the public health and medical initiatives taken during this period. These actions are highlighted in the thesis, along with the responses of the media and lay public to the disease. The effect of war on the management of the disease is also examined, as it siphoned off vital medical personnel and jeopardised disease control. It also lent an emotional overlay to the way the disease was perceived, as `battle' rhetoric became the parlance used against polio, which was personified as the `enemy' of innocent children who were disabled at the whim of the virus. The epidemic of 1944-1945 was the first to be systematically investigated, by Dr James Gear as part of his groundbreaking polio research; he later became part of an international team of researchers who contributed to the development of a prophylactic vaccine within a decade of this epidemic. / History / M.A. (History)

Polioviruses have been around for a long time in man's history. Before the development of killed and live virus vaccines in the 1960's, poliomyelitis was a serious problem in public health. Since then paralytic poliomyelitis remains a threat in certain underdeveloped countries but has been considered a conquered disease in the developed world. The molecular epidemiology of wild-type 1 polioviruses (WPV1) isolated in Angola in 2005, the Democratic Republic of the Congo (DRC) in 2006-2008 and Namibia in 2006 were investigated by sequence analysis of the complete VP1 gene of all isolates. All outbreak viruses clustered with the Indian type 1 genotype (SOAS) which was unique to India circulating endemically in the Uttar Pradesh (UP) and Bihar provinces in Northern India. Epidemiological and virological analyses suggested that the Namibia outbreak virus had been circulating without detection for at least one year in Angola. Four cases of acute flaccid paralysis (AFP) occurred in children in Madagascar in 2005. Molecular analysis confirmed cVDPV type 2 and 3 in affected patients. The first case, occurred in Toliara II district, on 09 April 2005. The last two cases were in the Toliara I and Beloha districts and paralysis onset on 26 June and 13 July 2005 respectively. Partial genomic sequencing of the poliovirus isolates revealed considerable divergence from the prototype Sabin strain in all cases. This is the second time that type 2 cVDPV is associated with an outbreak of AFP in Madagascar, and to our knowledge the first time that a type 3 cVDPV is identified in Madagascar. A total of fifty-six children with AFP were found to excrete VDPVs of serotype 2 in the DRC between 2005 and 2010. These viruses represent at least three emergences and at least two outbreaks. Partial genomic sequencing of the poliovirus isolates revealed considerable nucleotide sequence divergence of between 1.1% to 2o/o from the prototype Sabin strain in the VP1 region of the viral genome. This was the first time that a type 2 cVDPV outbreak was detected in the DRC. In total, 89 viral isolates obtained from Ethiopia during 2007 to 2010 and partial sequencing analysis confirmed that 13 isolates were VDPV's. Seven AFP cases were type 3, 4 AFP cases were type 2 and 2 contacts for type 3. Partial genomic sequencing of the poliovirus isolates revealed considerable divergence from the prototype Sabin strain in all cases. Finally, cases of AFP where only Sabin-like viruses were identified were investigated in South Africa with 11 possible VAPP cases identified with recombinant events in the 30 region and also revealing a mutation that restore the original stem-loop structure in the internal ribosomal entry site (IRES) in the 5' Non-Translated Region (NTR). In this study, the molecular epidemiology of poliovirus outbreaks that occurred in Angola, Namibia, and the DRC is described that were associated with wild polio 1 and 3. Investigation of Sabin-like vaccine strains in the DRC, Madagascar and Ethiopia identified vaccine-derived polioviruses in AFP cases as well as possible vaccineassociated paralytic poliovirus in South Africa. Copyright / Thesis (PhD)--University of Pretoria, 2012. / Medical Virology / Unrestricted

No description available.

Poliomyelitis is a foremost cause of paralysis among preventable diseases among children and adolescents globally. It is caused by persistent infection with poliovirus (PV). The PV infection does not always cause paralysis. A lack of immunization always increases the risk of paralytic polio. Genetic factors also been shown to affect the risk of developing the disease. The aim of this thesis is to investigate whether there are any genetic associations to paralytic poliomyelitis. This is based on a model for understanding its nature as a complex disease, where many genes are involved in contributing to the disease state. This is a population-based case-control study to identify genetic loci that influence disease risk. The study examined the association of genetic variation in single nucleotide polymorphisms (SNPs) across the genome with paralytic poliomyelitis susceptibility in the United States and Canadian survivors of poliomyelitis population, using a genome-wide association study (GWAS) approach. No association was observed. Loci that have been previously implicated were not found to affect the susceptibility to poliomyelitis in this study. The thesis consists of four chapters. Chapter 1 describes the epidemiology, pathogenesis and management of poliomyelitis. Chapter 2 gives an overview of the genomics of infectious diseases in general. Chapter 3 introduces the study population and presents the genome-wide analysis and associations with logistic regression to identify loci explore genes that might be associated with paralytic poliomyelitis and presents results. Chapter 4 discusses the implications of the results and explains future directions. / Thesis / Master of Science (MSc)

Diss. Umeå : Univ., 2004.

In den 1950er-Jahren stellte das epidemische Auftreten der spinalen Kinderlähmung (Poliomyelitis) die Gesundheitssysteme weltweit vor große Herausforderungen. Da eine kausale Therapie der Viruserkrankung nicht existierte, kam der Expositionsprophylaxe eine besondere Bedeutung zu. Letztlich gelang es erst durch die Entwicklung von Impfstoffen, die spinale Kinderlähmung nachhaltig zurückzudrängen. In der Deutschen Demokratischen Republik (DDR) wurde 1960 erstmals in Deutschland die Schluckimpfung nach Sabin-Tschumakow verabreicht, mit der binnen eines Jahres die nahezu vollständige Eradikation der spinalen Kinderlähmung in der DDR gelang. Der Artikel zeichnet anhand von unveröffentlichtem Archivmaterial die systematisch angelegte Impfaktion am Beispiel der damaligen Bezirkshauptstadt Halle (Saale) nach. Allein dort wurden im Mai 1960 innerhalb von 3 Tagen 63.328 Kinder und Jugendliche immunisiert. Bei 78.085 im Vorfeld erfassten Impflingen entsprach dies einer Quote innerhalb der poliovulnerablen Bevölkerungsgruppe von rund 81 %. Die Quellen zeigen, dass die staatliche Struktur des Gesundheitswesens der DDR und das Prinzip der aufsuchenden Impfung zum Erfolg der Impfaktion beitrugen. / In the 1950s, the epidemic occurrence of infantile paralysis (poliomyelitis) posed major challenges to health systems worldwide. Since there was no causal therapy for the viral disease, exposure prophylaxis was of particular importance. Ultimately, it was only through the development of vaccines that infantile paralysis could be permanently reduced. In 1960, the Sabin–Tschumakow oral vaccine was administered in the former German Democratic Republic GDR for the first time in Germany. Within one year, this vaccine succeeded in almost completely eradicating polio in the GDR. The article uses unpublished archival material to trace the systematic vaccination campaign using the example of the then district capital Halle (Saale). There alone, 63,328 children and adolescents were immunized within three days in May 1960. With 78,085 vaccinees recorded in advance, this corresponded to a rate within the polio-vulnerable population group of around 81%. The sources show that the GDR’s government healthcare system and the principle of outreach vaccination contributed to the success of the vaccination campaign.

L’objectif de cette thèse était d’identifier les freins et les leviers aux stratégies d’éradication de la poliomyélite dans les pays en développement puis d’analyser au travers d’un questionnaire les connaissances, attitudes et pratiques vis-à-vis de la vaccination contre la poliomyélite des parents des enfants âgés de 0 à 5 ans au Tchad. Une revue de la littérature a été effectuée en interrogeant la base de données PubMed avec des mots clés et une limitation des articles publiés entre 2010-2015 en anglais et en français pour identifier les freins et les leviers à la vaccination poliomyélite et ensuite une enquête a été mené apures des parents dans ménages de la ville d’Abéché. Les freins le plus cités étaient le refus de la vaccination, l’insécurité et les conflits armés rendant l’accès difficile aux enfants et favorisant la circulation du poliovirus. Beaucoup de pays ont pris de mesures pour améliorer la couverture vaccinale. L’enquête auprès de 210 parents a révélé qu’aucune famille ne possédait de carnet de vaccination de leurs enfants. Cependant, 97% ont déclaré avoir des enfants ayant participé aux campagnes de vaccination de masse. Près de 97 % connaissaient la poliomyélite et 98 % avaient entendu parler des campagnes de vaccination. Ce travail a permis d’identifier plusieurs freins et leviers à l’éradication de la poliomyélite. Au Tchad, les connaissances sur la maladie et le vaccin sont bonnes malgré l’existence de rumeurs concernant notamment les effets secondaires des vaccins. Néanmoins, l’absence de carnet de vaccination a limité l’analyse des résultats de l’enquête, uniquement déclarative avec un taux de vaccination très élevé déclaré. / The aim of this thesis was to identify the brakes and levers for poliomyelitis eradication strategies in developing countries and then to analyze through a questionnaire the knowledge, attitudes and practices vis-à-vis poliomyelitis vaccination for parents of children aged 0-5 in Chad. A review of the literature was conducted by cross-referencing the PubMed database with keywords and a limitation of articles published between 2010-2015 in English and French to identify the barriers and levers to polio vaccination and then a survey to was conducted to relatives in the town of Abeche. The most cited barriers were the refusal of vaccination, insecurity and armed conflict, making access difficult for children and promoting the circulation of poliovirus. Many countries have taken steps to improve immunization coverage. The survey of 210 parents revealed that no family had a vaccination record of their children. However, 97% reported having children who participated in mass vaccination campaigns. Nearly 97% knew about polio and 98% had heard about vaccination campaigns. This work has identified several brakes and levers for the eradication of poliomyelitis. In Chad, knowledge of the disease and the vaccine is good despite rumors about the side effects of vaccines. Nevertheless, the lack of vaccination cards limited the analysis of the results of the survey, only declarative with a very high vaccination rate reported.