PARALYTIC POLIOMYELITIS IN CHILDREN UNDER 6 YEARS IN PONDICHERRY - A COMMUNITY SURVEY

Study objectives-To assess the amount of poliomyelitis and its epidemi ological features including risk factors. Design-This was a retrospect ive study of cases of paralytic poliomyelitis among children 0-6 years of age. Setting-Pondicherry, India, 1983-89. Subjects-A total of 47 9 60 children aged less than 6 years. Measurements and main results-In 1 989, 469 field workers undertook a door to door survey of children 0-6 years old to identify those with limb paralysis. This was followed by clinical examination to establish the cause, supplemented by case not es held by the Child Development Services. Altogether 203 cases of lim b paralysis were identified, 188 of which were judged a result of para lytic poliomyelitis. The prevalance of poliomyelitis in 1989 was 3.9/1 000 among children below 6 years of age. There was a male preponderanc e with a male:female ratio of 1.4:1. The prevalence was least in infan ts (1/1000) and highest in children aged 2 to 3 years (6-4/1000). The age at onset was less than 12 months in 42% of cases and less than 3 y ears in 98%. The median age at onset was 13.4 months. Time series anal ysis showed a high occurrence of cases from May to September between 1 983 and 1989. The legs were affected in 97%. About 41% of children had received three doses of oral polio vaccine. There was a history of in tramuscular injection, possibly provoking a paralytic attack, in 54% o f cases.Conclusion-This retrospective community study involving the st aff of the Integrated Child Development Services provided valid data a bout poliomyelitis with little additional cost and minimum training. B ecause the study covered a whole population of children under 6 years, rather than a sample, the data will help in monitoring and surveillan ce of poliomyelitis and also in planning strategies for effective cont rol.