scholarly journals The critical role of acute flaccid paralysis surveillance in the Global Polio Eradication Initiative

2017 ◽  
Vol 9 (3) ◽  
pp. 156-163 ◽  
Author(s):  
Rudolf H. Tangermann ◽  
Christine Lamoureux ◽  
Graham Tallis ◽  
Ajay Goel
Keyword(s):  
Acute Flaccid Paralysis ◽  
Critical Role ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Acute Flaccid Paralysis Surveillance ◽  
Global Polio Eradication Initiative

scholarly journals Acute Flaccid Paralysis surveillance in Polio Eradication and Beyond: Learning from Bangladesh

2021 ◽  
Author(s):  
Humayra Binte Anwar ◽  
Yameen Mazumder ◽  
Sanjana Nujhat ◽  
Bushra Zarin Islam ◽  
Anna Kalbarczyk ◽  
...  
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Technical Assistance ◽  
Acute Flaccid Paralysis ◽  
Grey Literature ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Depth Information ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance

Abstract IntroductionGlobal Polio Eradication Initiative, GPEI led by the World Health Organization (WHO), helped to develop standard acute flaccid paralysis surveillance (AFP) system worldwide, including Bangladesh, which comprises infrastructure, knowledge, expertise, funding, technical assistance, and trained personnel. AFP surveillance can complement any disease surveillance systems, and many countries are now utilizing these polio surveillance assets for monitoring other vaccine-preventable diseases. This paper outlines how AFP surveillance has evolved in Bangladesh over time, its success and challenging factors, and its potential to accomplish other health goals.MethodologyThis mixed-method study includes a grey literature review, a survey for quantitative and qualitative information on barriers and facilitators, and Key Informant Interviews (KIIs) to gather relevant in-depth information on AFP surveillance in Bangladesh. Grey literature was collected online and paper documentation from different stakeholders. Online and in-person surveys were conducted in six divisions of Bangladesh, including Dhaka, Rajshahi, Rangpur, Chittagong, Sylhet, and Khulna, to map tacit knowledge ideas, approaches, and experiences. KIIs were conducted at global, national, and sub-national levels. Data were then combined on focused emerging themes, including history, challenges, and successes of the AFP surveillance system in Bangladesh.ResultsAFP surveillance in Bangladesh was first introduced in 1990 at the district and Upazila level major hospitals. High population growth, low performance, hard-to-reach areas, and groups of people residing in risky zones were major challenges to implementing this surveillance system. Surveillance was gradually enriched by establishing certification standards and community-based AFP surveillance and improved Surveillance Immunization Medical Officer (SIMO) network activities, laboratory activities, and proper monitoring and evaluation. In Bangladesh, a national disease surveillance system and a laboratory are now being used for multiple diseases, including polio, measles, Japanese Encephalitis, Neonatal Tetanus etc.ConclusionIn Bangladesh, it is evident that the AFP surveillance system is supporting the health system more broadly by building knowledge, experience, and assets and forming a strong platform for other health programs. In addition, its strengths can be leveraged for combating new and emerging diseases like COVID-19. However, the sustainability of the AFP surveillance in Bangladesh still needs collaborative support from partners, mainly technical assistance.

scholarly journals Surveillance during an era of rapidly changing poliovirus epidemiology in India: the role of one vs. two stool specimens in poliovirus detection, 2000–2010

2013 ◽  
Vol 142 (1) ◽  
pp. 163-171 ◽  
Author(s):  
C. V. CARDEMIL ◽  
M. RATHEE ◽  
H. GARY ◽  
K. WANNEMUEHLER ◽  
A. ANAND ◽  
...  
Keyword(s):  
Maximum Likelihood ◽  
Maximum Likelihood Estimation ◽  
Stool Specimen ◽  
Acute Flaccid Paralysis ◽  
Likelihood Estimation ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Stool Specimens

SUMMARYSince 2004, efforts to improve poliovirus detection have significantly increased the volume of specimen testing from acute flaccid paralysis (AFP) patients in India. One option to decrease collection and testing burden would be collecting only a single stool specimen instead of two. We investigated stool specimen sensitivity for poliovirus detection in India to estimate the contribution of the second specimen. We reviewed poliovirus isolation data for 303984 children aged <15 years with AFP during 2000–2010. Using maximum-likelihood estimation, we determined specimen sensitivity of each stool specimen, combined sensitivity of both specimens, and sensitivity added by the second specimen. Of 5184 AFP patients with poliovirus isolates, 382 (7·4%) were identified only by the second specimen. Sensitivity was 91·4% for the first specimen and 84·5% for the second specimen; the second specimen added 7·3% sensitivity, giving a combined sensitivity of 98·7%. Combined sensitivity declined, and added sensitivity increased, as the time from paralysis onset to stool collection increased (P = 0·032). The sensitivity added by the second specimen is important to detect the last chains of poliovirus transmission and to achieve certification of polio eradication. For sensitive surveillance, two stool specimens should continue to be collected from each AFP patient in India.

scholarly journals Polio eradication in Nigeria: evaluation of the quality of acute flaccid paralysis surveillance documentation in Bauchi state, 2016

2018 ◽  
Vol 18 (S4) ◽  
Author(s):  
Adamu Ibrahim Ningi ◽  
Faisal Shuaib ◽  
Luka Mangveep Ibrahim ◽  
Jalal-Eddeen Abubakar Saleh ◽  
Khalid Abdelrahim ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Acute Flaccid Paralysis Surveillance

scholarly journals Two-Source Capture-Recapture Method to Estimate the Incidence of Acute Flaccid Paralysis in the Marches Region (Italy)

2020 ◽  
Vol 17 (24) ◽  
pp. 9400
Author(s):  
Pamela Barbadoro ◽  
Aurora Luciani ◽  
Matteo Ciotti ◽  
Marcello D’Errico ◽  
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Critical Role ◽  
Age Groups ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Incidence Estimate ◽  
Common Diagnosis ◽  
Significant Difference ◽  
Capture Recapture

A combination of high infant immunization coverage and surveillance of acute flaccid paralysis (AFP) cases, plays a critical role in polio eradication. This study aimed to estimate the incidence of AFP, to evaluate the completeness of AFP ascertainment during the years, age groups and gender, and to define the main associated diagnosis among children aged under 15 in the Marches region of Italy. Analysis was performed on data from the active AFP surveillance system and the hospital discharge records in the 2006–2014 period. The two-source capture-recapture method was applied. After cross-validation, 30 AFP compatible conditions as defined by the WHO were identified, with an incidence estimate of 1.91 cases of AFP per 100,000 children under 15 years (95% CI = 1.4–2.6/100,000). Guillain–Barrè syndrome was the most common diagnosis. A significant difference (p < 0.05) has been registered in the estimated probability of case ascertainment in females. The reasons for the lower reporting of cases in females are unknown. Specific research and the implementation of a more sensitive surveillance system are essential in verifying potential inequalities and to succeed in the polio eradication initiative.

scholarly journals Cases of Acute Flaccid Paralysis Associated with Coxsackievirus A2: Findings of a 20-Year Surveillance in the Russian Federation

2022 ◽  
Vol 10 (1) ◽  
pp. 112
Author(s):  
Olga E. Ivanova ◽  
Armen K. Shakaryan ◽  
Nadezhda S. Morozova ◽  
Yulia A. Vakulenko ◽  
Tatyana P. Eremeeva ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Laboratory Data ◽  
Foot And Mouth Disease ◽  
Polio Eradication ◽  
Vaccination Schedule ◽  
Flaccid Paralysis ◽  
Global Polio Eradication Initiative ◽  
Afp Surveillance ◽  
Stool Samples ◽  
The Russian Federation

Surveillance for acute flaccid paralysis syndrome (AFP) in children under 15 is the backbone of the Global Polio Eradication Initiative. Laboratory examination of stool samples from AFP cases allows the detection of, along with polioviruses, a variety of non-polio enteroviruses (NPEV). The etiological significance of these viruses in the occurrence of AFP cases has been definitively established only for enteroviruses A71 and D68. Enterovirus Coxsackie A2 (CVA2) is most often associated with vesicular pharyngitis and hand, foot and mouth disease. Among 7280 AFP cases registered in Russia over 20 years (2001–2020), CVA2 was isolated only from five cases. However, these included three children aged 3 to 4 years, without overt immune deficiency, immunized with 4–5 doses of poliovirus vaccine in accordance with the National Vaccination Schedule. The disease resulted in persistent residual paralysis. Clinical and laboratory data corresponded to poliomyelitis developing during poliovirus infection. These findings are compatible with CVA2 being the cause of AFP. Molecular analysis of CVA2 from these patients and a number of AFP cases in other countries did not reveal association with a specific phylogenetic group, suggesting that virus genetics is unlikely to explain the pathogenic profile. The overall results highlight the value of AFP surveillance not just for polio control but for studies of uncommon AFP agents.

scholarly journals Non-Polio Enteroviruses from Acute Flaccid Paralysis Surveillance in Korea, 2012–2019

Viruses ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 411
Author(s):  
Youngsil Yoon ◽  
Yong-Pyo Lee ◽  
Deog-Yong Lee ◽  
Hye-Jin Kim ◽  
June-Woo Lee ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Neurological Diseases ◽  
Acute Disseminated Encephalomyelitis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance ◽  
Polymerase Chain

The risk of polio importation and re-emergence persists since epidemic polio still occurs in some countries, and the resurgence of polio occurring almost 20 years after polio eradication was declared in Asia has been reported. We analyzed the results of acute flaccid paralysis (AFP) surveillance in Korea to assess the quality of AFP surveillance and understand the etiology of non-polio enterovirus (NPEV)-associated central nervous system diseases in a polio-free area. We investigated 637 AFP patients under 15 years of age whose cases were confirmed during 2012–2019 by virus isolation, real-time reverse transcription polymerase chain reaction, and VP1 gene sequencing. Among the 637 AFP cases, NPEV was detected in 213 (33.4%) patients, with the majority observed in EV-A71, with 54.9% of NPEV positives. EV-A71 has been shown to play a role as a major causative agent in most neurological diseases except for Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM), and meningitis. This study provides information on the AFP surveillance situation in Korea and highlights the polio eradication stage in the monitoring and characterization of NPEV against the outbreak of neurological infectious diseases such as polio.

scholarly journals Characterising the costs of the Global Polio Laboratory Network: a survey-based analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e023290 ◽  
Author(s):  
Radboud J Duintjer Tebbens ◽  
Ousmane M Diop ◽  
Mark A Pallansch ◽  
M Steven Oberste ◽  
Kimberly M Thompson
Keyword(s):  
Environmental Samples ◽  
Acute Flaccid Paralysis ◽  
Response Rates ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
Environmental Surveillance ◽  
Variable Response ◽  
Laboratory Network ◽  
Laboratory Component ◽  
Global Polio Eradication Initiative

ObjectiveTo characterise the costs, including for environmental surveillance (ES), of the Global Polio Laboratory Network (GPLN) that provides laboratory support to the Global Polio Eradication Initiative (GPEI).Design and participantsWe conducted a survey of the network across 92 countries of the 146 GPLN laboratories plus three non-GPLN laboratories that concentrate environmental samples to collect information about their activities, characteristics and costs during 2016. We estimate the total costs using regression of reported responses and complementing the findings with GPEI data.ResultsWe received responses from 132 (89%) of the 149 laboratories, with variable response rates for individual questions. We estimate that processing samples of patients with acute flaccid paralysis leads to total costs of approximately $28 million per year (2016 US$) based on extrapolation from reported costs of $16 million, of which 61% were supported by internal (national) funds. Fifty-nine (45%) of the 132 responding laboratories reported supporting ES and we estimate an additional $5.3 million of recurring costs for ES activities performed by the laboratories. The reported costs do not include an estimated additional $10 million of annual global and regional costs to coordinate and support the GPLN. On average, the staff supported by funding for polio in the responding laboratories spent 30% of their time on non-polio activities. We estimate total costs for laboratory support of approximately $43 million (note that this estimate does not include any field or other non-laboratory costs of polio surveillance).ConclusionsAlthough countries contribute significantly to the GPLN financing, many laboratories currently depend on GPEI funds, and these laboratories also support the laboratory component of surveillance activities for other diseases. Sustaining critical global surveillance for polioviruses and transitioning support for other disease programmes will require continued significant funding after polio certification.

scholarly journals Role of environmental poliovirus surveillance in global polio eradication and beyond

2011 ◽  
Vol 140 (1) ◽  
pp. 1-13 ◽  
Author(s):  
T. HOVI ◽  
L. M. SHULMAN ◽  
H. VAN DER AVOORT ◽  
J. DESHPANDE ◽  
M. ROIVAINEN ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
World Health ◽  
Human Populations ◽  
Disease Symptoms ◽  
Global Polio Eradication Initiative ◽  
Afp Surveillance ◽  
Health Organization ◽  
Better Than

SUMMARYEnvironmental poliovirus surveillance (ENV) means monitoring of poliovirus (PV) transmission in human populations by examining environmental specimens supposedly contaminated by human faeces. The rationale is based on the fact that PV-infected individuals, whether presenting with disease symptoms or not, shed large amounts of PV in the faeces for several weeks. As the morbidity:infection ratio of PV infection is very low, this fact contributes to the sensitivity of ENV which under optimal conditions can be better than that of the standard acute flaccid paralysis (AFP) surveillance. The World Health Organization has included ENV in the new Strategic Plan of the Global Polio Eradication Initiative for years 2010–2012 to be increasingly used in PV surveillance, supplementing AFP surveillance. In this paper we review the feasibility of using ENV to monitor wild PV and vaccine-derived PV circulation in human populations, based on global experiences in defined epidemiological situations.

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