INTEGRATED DISEASE-CONTROL INITIATIVES - POLIO ERADICATION AND NEONATAL TETANUS ELIMINATION IN EGYPT

Accelerated disease control initiatives, such as polio eradication by the year 2000, may substantially benefit public health programs in gen eral. In Egypt, the control of other vaccine-preventable diseases, mos t noticeably neonatal tetanus (NT), has been facilitated by the polio eradication initiative. Linking NT reporting with the acute flaccid pa ralysis (AFP) surveillance system, which had been established for poli o eradication, markedly improved the capacity to identify NT high-risk areas and target supplementary immunization activities appropriately. While the close integration of surveillance activities was to the ben efit of both programs, mass immunization activities were not conducted simultaneously because of differences in the objectives, target popul ations, and operational aspects of oral polio vaccine and tetanus toro id campaigns. In addition to substantial progress toward polio eradica tion in Egypt since 1988, there has been an 80% reduction in annual NT cases, in part due to the integration of appropriate aspects of these two disease control initiatives.