Review of XXXX in the Dominican Republic: 1940-1981.

@entity1 @entity3328 @entity9925 @entity3082 @entity204
In the Dominican Republic, national surveillance of the number of cases of @entity3328 began in 1940. During the 1940-58 period, sporadic cases were reported to the Ministry of Health, with annual incidences ranging from 0 to 0.68/100,000 population, with a mean incidence of 0.16 case. The 1st major @entity3082 was reported in 1959 and ivolved 315 cases (10.71 cases/100,000 population). Since 1959, epidemics have occurred in cycles of 2-5 years with the most recent epidemics occurring in 1975, 1978, and 1980-81. In May 1980 the Division of Epidemiology of the Ministry of Health in Santo Domingo received the 1st reports of probable @entity3082 activity of @entity3328 among residents of Azua in health region 1. In June 1980 cases were reported from Santo Domingo (health region 0). Cases continued to occur through April 1981. During the January 1980-April 1981 period, there were reports of 181 cases, including 7 @entity204 . Of 30 stool specimens tested, 13 were poitive for @entity9925 . ECHO virrus was isolated from 9; 2 virruses which could not be typed were isolated; and no viruses were isolated form 6 specimens. 7 of the 12 @entity9925 type 1 isolates wer tedted for antigenic characterization; all were nonvaccinelike by either the modified Wecker on Van Wezel antigenic characterization methods. The male to female ratio of cases was 1.3: 1. Cases ranged in age from 2 months to 6.5 years, with a mean age of 15.0 months and a median age of 12 months. While 88.4% of the cases occurred in @entity1 less than 2 years of age, the highest attack rate was seen among @entity1 6-11 months of age. Immunization histories were known for 176 (97.2%) cases: 81 (44.8%) had never received any doses of polio vaccine; 68 (37.6%) had received 1 dose; 18 (9.9%) had received 2 doses; and 9 (5.0%) had received 3 doses. In 1979 a decision was made to change the immunization program strategy to primarily house-to-house vaccination rounds every 3 months. By April 1980, 3 health regions had implemented the house-to-house strategy, and by July 1980 all health regions were conducting house-to-house rounds. A table shows the annual coverage of the less-than-1-year-old population with polio vaccine, by number of doses received, from 1978 to 1981. During this period, the coverage of the less-than-1-year-old population with 3 doses of polio vaccine has doubled. The dropout rate has decreased by 40%.
