Phase 1a containment activities were carried out based on WHO guidelines.
Creation of National Task Force (NTF) and work plan
Phase 1a containment activities commenced with the institution of the NTF in January 2015 by the Government. Six consultant virologists (one per geopolitical zone) were engaged from June–November 2015 for this activity. Both NTF and the consultants had a capacity building workshop in May 2015 (before the commencement of survey). The NTF elaborated a 6 months’ work plan (June–November 2015).
National stakeholder’s sensitization
Apart from building the capacity of the NTF and consultants, a broad spectrum of stakeholders were sensitized in May 2015 on the concept and logistics of the national survey and inventory. Participants to the forum were drawn from several ministerial departments and government agencies amongst which were the National Agency for Food and Drug Administration and Control (NAFDAC) and the Medical Laboratory Council of Nigeria. Introductory letters on containment requirements were provided to stakeholders and copies were sent to various biomedical facilities for compliance with the process.
Establishment of a preliminary list of biomedical facilities
At the commencement of survey in June 2015, a list of existing biomedical facilities in the country was provided by the Medical Laboratory Council of Nigeria, the Nigeria Medical Association, the Federal Ministries of Health, Defense and Agriculture.
Pre-testing of survey questionnaire
The WHO generic questionnaire for poliovirus containment was adopted and pre-tested in one state of each of the six geo-political zones in May 2015 before the commencement of the survey in June 2015.
Administration of questionnaires
The questionnaires were physically taken to all biomedical facilities in the country by the six consultants and supported by personnel working on the polio eradication activities. NTF members also conducted a survey of low-risk facilities during supervisory field visits.
Questionnaires were completed on site by the laboratory heads in the presence of the consultants. In rare occasions, the consultants had to come back some other time to collect the completed forms. An onsite inventory was carried out for facilities found with poliovirus infectious or potentially infectious materials.
These questionnaires were directed towards the identification of sample types, their sources, quantification, storage conditions including temperature, date of collection and methods of destruction once not more needed in the laboratory.
Completed questionnaires for both survey and inventory were transmitted to WHO, and all the data were entered into an MS Access computer database for analysis and sharing with government and partners every week. All data generated from the study were checked manually for errors in filling responses, in some cases more information was requested, or the consultants returned to the facility for onsite review. Descriptive statistics such as mean, frequency, standard deviation, percentages and graphs were used to analyze the results. The data were analyzed using Epi Info version 3.5.3 (US Centers for Disease Control and Prevention) and the Statistical Program for the Social Sciences (SPSS 21) computer software packages.
Supervision and coordination of containment process
Physical visits were made by the NTF members to supervise the containment process. They visited all laboratories in tertiary institutions as well as other laboratories identified with poliovirus or potentially infectious materials. Each NTF field visit was followed by meetings with the consultants to propose solutions to identified difficulties to the process.
The national inventory of laboratories having poliovirus infectious or potentially infectious materials was compiled indicating name of the laboratory, organization or ministerial department. The type of material identified, the quantity of material in store, storage temperature, the level of risk of the laboratory and the contact information of head of the facility was recorded.
Destruction of poliovirus infectious or potentially infectious materials
The identified poliovirus or potentially infectious materials in all biomedical facilities were destroyed using the best standard practices of autoclaving and incineration. The destruction was implemented through a directive from the Federal Government of Nigeria to all heads of the identified laboratories. The destruction process was supervised and monitored by NTF members.
Report of phase 1a activities
A report on the processes and findings of laboratory containment activities was written and forwarded to the Africa Regional Commission for the Certification of Poliomyelitis Eradication on 31st December 2015 through WHO country office as was required.
Post-phase 1a laboratory containment activities
An enlarged stakeholder meeting (comprising mostly heads of the laboratories with an inventory of materials) was organized by the government. The meeting served as feedback on phase one containment activities as well as to train them on standard operating procedures (SOPs) for safe handling and destruction of subsequent polioviruses or potentially infectious materials in the laboratories henceforth. The forum was also charged to update the list of laboratories annually to be coordinated by the Medical Laboratory Council of Nigeria for which the NTF was to regularly visit and ensure compliance with biosafety particularly the immediate destruction of polioviruses or potentially infectious materials.
Destruction of type 2 poliovirus after the trivalent Oral polio vaccine to bivalent Oral polio vaccine (tOPV to bOPV) switch
From 5th Feb 2016 to 5th July 2016, all type 2 poliovirus in both national polio laboratories in Ibadan and Maiduguri were destroyed through autoclaving and incineration.