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 ACUTE FLACCID PARALYSIS SURVEILLANCE SYSTEM: CURRENT STATUS IN AZAD JAMMU & KASHMIR- 2018

2019 ◽  
Vol 9 (2) ◽  
pp. 54-56
Author(s):  
Syed Nadeem-ur-Rehman ◽  
Uzma Hafeez ◽  
Mumtaz Ahmad Khan ◽  
Masood Ahmad Bukhari
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Acute Flaccid Paralysis ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Current Status ◽  
Adjacent Area ◽  
Surveillance Systems ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance

Background: The State of Azad Jammu & Kashmir (AJ&K) is polio free since October 2000.The objectives of our study is to review of existing Acute Flaccid Paralysis Surveillance System in Azad Jammu &Kashmir, identify the strong & weak points of the existing system and suggest course of action for efficient performance of the existing system. Methods: This qualitative & quantitative evaluation was conducted at Provincial Disease Surveillance &Response Unit (PDSRU) Muzaffarabad Azad Jammu & Kashmir during March -April 2019. The database of AFP cases during 2018 was reviewed and relevant stakeholder's interviews were conducted consulting guidelines formulated by the Centre for Disease Control & prevention(CDC) in 2001 for Evaluating Public Health Surveillance Systems. Results: In 2018, a total of 265 AFP cases were registered. The mean age was 65 months (range 01 - 180 months). 59 % (n=157) were male children. 58% of cases were under 05 year's age. Standardized case definition and data format with simple information flow was found. System was flexible enough to incorporate measles and neonatal tetanus cases since 2009. Data quality was excellent (100% zero and monthly reports). A close coordination was observed amongst all relevant stakeholders. Sensitivity was 200%. No polio case was identified and therefore, PPV was zero. Majority of cases were reported by public sector (93%).Sufficient financial as well as skilled human resources were available and hence system found stable. Timeliness of reporting found 90%. Conclusion: The performance of AFP surveillance system in AJ&K is up to the mark. However, there is constant threat of reintroduction of polio virus from adjacent area of Punjab & Khyber Pakhtunkhwa provinces. Highly vigilant AFP surveillance system with capacity of rapid response is the solution. Furthermore, it is vital to sustain the AFP Surveillance till the goal of global polio eradication is achieved.

scholarly journals Acute Flaccid Paralysis Surveillance system Evaluation, Oyo state, Nigeria; 2008-2014

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Maureen Anyanwu
Keyword(s):  
Surveillance System ◽  
Disease Surveillance ◽  
Acute Flaccid Paralysis ◽  
Case Definition ◽  
Operating Conditions ◽  
Flaccid Paralysis ◽  
Cold Chain ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance ◽  
The Mean

ObjectiveWe evaluated the AFP surveillance system in Oyo State to assessits attributes and determine if it was meeting its set objectives.IntroductionIn September, 2015, Nigeria was delisted from the list of polioendemic countries globally. To be certified polio free, the countrymust attain and maintain certification standard Acute Flaccid Paralysis(AFP) surveillance for additional two-years. In Oyo State, no case ofWild Polio Virus (WPV) has been reported since February, 2009.MethodsWe used the Centre for Disease Control and Prevention updatedguidelines for evaluating public health surveillance system.We conducted a retrospective review of AFP surveillance databetween 1stJanuary, 2008 and 31stDecember, 2014. We conductedin-depth interviews with identified stakeholders. Semi-structuredquestionnaires were administered to Disease Surveillance andNotification Officers (DSNOs) and AFP focal persons. Univariateanalysis was performed by calculating frequencies, means andproportions using Microsoft Excel 2010.ResultsThe case definition of AFP and the tools for reporting are simple.Of the 897 AFP cases detected during the period under review(2008-2014), 20 (2.2%) were laboratory confirmed WPV. Thesensitivity of the system between 2008 and 2014 measured by theAnnualized Non-Polio AFP (NPAFP) rate was consistently abovethe target. of≥2/100,000 population(Mean=3.96, Standard deviation(SD): 0.48). The mean NPAFP rate for underperforming LGAs duringthe review period was 1.6, SD: 0.31. The mean Stool adequacy andTimeliness were 91.43% (SD: 18.3) and 91.3% (SD: 20.3) abovethe target of≥80% respectively. The mean Data quality was 90%(target is≥90; SD: 3.8). Positive Predictive Value (PVP) was 2%(2008 -2009), and 0% in 2010-2014.ConclusionsThe Oyo State AFP surveillance system is simple, flexible,sensitive and meeting its set objectives. However, PVP was low andthe system’s operating conditions are not stable. All the LGAs, at onepoint during the period under review did not meet the NPAFP andNPENT rates. We recommended that more logistic support shouldbe provided for non-performing LGAs to improve case reporting,investigation, and response. DSNOs should be re -sensitized onreverse cold chain, so as to improve the NPENT rate

scholarly journals Impact of the protracted war on performance of Acute Flaccid Paralysis Surveillance System Indicators, Yemen: 2014-2017 (Preprint)

2021 ◽  
Author(s):  
Riham Al-Dubaiee ◽  
Mutaher AL Qassimi ◽  
Ahmed Al-Dar ◽  
Abdulwahed Al Serouri ◽  
Yousef Khader
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
National Level ◽  
Good Condition ◽  
Flaccid Paralysis ◽  
Reference Laboratory ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance ◽  
Stool Specimens ◽  
The Impact

BACKGROUND Highly sensitive acute flaccid paralysis surveillance (AFP), which include immediate case investigation, and specimen collection are critical for reaching polio global eradication. In Yemen, the Acute Flaccid Paralysis Surveillance System (AFPSS) was launched in 1998 to achieve the polio eradication target. Although Yemen was certified as polio free country in 2009, the protracted war since 2015 put the country at risk for polio re-emergence OBJECTIVE to evaluate the performance of the Yemen AFPSS at both national and governorate levels and to assess the impact of the ongoing war on the performance METHODS Retrospective descriptive analysis was conducted on Yemen secondary AFP surveillance data for the years 2014 (before the war) and 2015-2017 (during the war). Data consisting of all children <15years reported as AFP. AFP surveillance performance was evaluated using WHO-specified AFP surveillance indicators RESULTS At the national level, all indicators were met before and after the war except for the “Lab results received ≤ 28 days” that was unmet since the war erupted. Furthermore, the “Stool specimens arriving at central level ≤3 days” was unmet after the war but only in 2017. At the governorate level, although the “Adequacy” and "Stool specimens arriving at laboratory in good condition” indicators were met before the war in all governorates, the first indicator was unmet in 9 (41%) governorates since the war erupted and the second was unmet in 9 governorates (41%) but only in 2017 CONCLUSIONS Findings showed that some of the AFP indicators was negatively impacted by eruption of the war due to closure of the Sana'a capital airport and postponement of samples during shipment to the reference laboratory under poor storage condition. To ensure rapid detection of any polio cases, improving specimens’ collection, storage, and transportation together with proper and timely specimens' shipment to the reference laboratory should be considered

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 Hospital discharges-based search of acute flaccid paralysis cases 2007–2016 in Italy and comparison with the National Surveillance System for monitoring the risk of polio reintroduction

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Paola Stefanelli ◽  
◽  
Stefania Bellino ◽  
Stefano Fiore ◽  
Stefano Fontana ◽  
...  
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Flaccid Paralysis ◽  
National Surveillance ◽  
Hospital Discharges ◽  
Diagnostic Codes ◽  
Northern Regions ◽  
Afp Surveillance ◽  
National Surveillance System

Abstract Background Acute flaccid paralysis (AFP) surveillance has been adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Hereby, to evaluate the completeness of the ascertainment of AFP cases in Italy, a hospital-discharges based search was carried out. Methods AFP cases occurring between 2007 and 2016 among children under 15 years of age were searched in the Italian Hospital Discharge Records (HDR) database using specific ICD-9-CM diagnostic codes. AFP cases identified between 2015 and 2016 were then compared with those notified to the National Surveillance System (NSS). Results Over a 10-year period, 4163 hospital discharges with diagnosis of AFP were reported in Italy. Among these, 956 (23.0%) were acute infective polyneuritis, 1803 (43.3%) myopathy, and 1408 (33.8%) encephalitis, myelitis and encephalomyelitis. During the study period, a decreasing trend was observed for all diagnoses and overall the annual incidence rate (IR) declined from 5.5 to 4.5 per 100,000 children. Comparing NSS with HDR data in 2015–2016, we found a remarkable underreporting, being AFP cases from NSS only 14% of those recorded in HDR. In particular, the acute infective polyneuritis cases reported to NSS accounted for 42.6% of those detected in HDR, while only 0.9% of myopathy cases and 13.1% of encephalitis/myelitis/encephalomyelitis cases have been notified to NSS. The highest AFP IRs per 100,000 children calculated on HDR data were identified in Liguria (17.4), Sicily (5.7), and Veneto (5.1) Regions; regarding the AFP notified to the NSS, 11 out of 21 Regions failed to reach the number of expected cases (based on 1/100,000 rate), and the highest discrepancies were observed in the Northern Regions. Overall, the national AFP rate was equal to 0.6, therefore did not reach the target value. Conclusions AFP surveillance data are the final measure of a country’s progress towards polio eradication. The historical data obtained by the HDR have been useful to assess the completeness of the notification data and to identify the Regions with a low AFP ascertainment rate in order to improve the national surveillance system.

scholarly journals Evaluation of the Acute Flaccid Paralysis Surveillance System in Polio-Free Jordan, 2012-2016: Retrospective Secondary Analysis (Preprint)

2019 ◽  
Author(s):  
Fatima Zerriouh ◽  
Yousef Khader ◽  
Nabil Qasem ◽  
Kamel Abusal ◽  
Ibrahim Iblan ◽  
...  
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Secondary Analysis ◽  
Flaccid Paralysis ◽  
Cold Chain ◽  
World Health ◽  
Eradication Strategy ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance ◽  
Stool Specimens

BACKGROUND As part of the polio-eradication strategy, the World Health Organization (WHO) has established a global acute flaccid paralysis (AFP) surveillance system. AFP surveillance has successfully helped Jordan achieve polio-free certification. However, there is a substantial risk of polio importation from neighboring countries including Syria and Iraq. OBJECTIVE This study aimed to evaluate the AFP surveillance in Jordan and identify areas that need improvement. METHODS This retrospective study is a secondary analysis of data that were routinely collected between 2012 and 2016 by Jordan’s Expanded Program on Immunization. The WHO’s minimum performance indicators were used to evaluate the AFP surveillance. RESULTS Cumulatively, 328 AFP cases had been reported. Almost half (n=168, 51.3%) of the patients were aged 1-5 years, and 55.8% (n=183) were male. All cases were discarded (classified as a nonpolio case). The most common cause of AFP was Guillain-Barre Syndrome (n=115, 35.1%). The annualized nonpolio AFP rate increased from 1.4/100,000 children below 15 years of age in 2012 to 4.3 in 2016. National and subnational sensitivities were not met in 2012 and 2013. Adequacy of stool specimens and timeliness of specimens arriving at and processed in the laboratory were constantly above the minimum target. Timeliness of the investigation met the expected target but with a decreasing trend. The nonpolio enterovirus isolation rate was below the target, except in 2016. CONCLUSIONS The AFP surveillance system in Jordan is performing well; however, additional efforts are needed to strengthen the subnational sensitivity. The cold chain from sample collection to laboratory testing has to be maintained to ensure the reliability of stool specimens required for isolation of the nonpolio enterovirus.

scholarly journals Evaluation of the Acute Flaccid Paralysis Surveillance System in Polio-Free Jordan, 2012-2016: Retrospective Secondary Analysis

10.2196/14217 ◽  
2019 ◽  
Vol 5 (3) ◽  
pp. e14217
Author(s):  
Fatima Zerriouh ◽  
Yousef Khader ◽  
Nabil Qasem ◽  
Kamel Abusal ◽  
Ibrahim Iblan ◽  
...  
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Secondary Analysis ◽  
Flaccid Paralysis ◽  
Cold Chain ◽  
World Health ◽  
Eradication Strategy ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance ◽  
Stool Specimens

Background As part of the polio-eradication strategy, the World Health Organization (WHO) has established a global acute flaccid paralysis (AFP) surveillance system. AFP surveillance has successfully helped Jordan achieve polio-free certification. However, there is a substantial risk of polio importation from neighboring countries including Syria and Iraq. Objective This study aimed to evaluate the AFP surveillance in Jordan and identify areas that need improvement. Methods This retrospective study is a secondary analysis of data that were routinely collected between 2012 and 2016 by Jordan’s Expanded Program on Immunization. The WHO’s minimum performance indicators were used to evaluate the AFP surveillance. Results Cumulatively, 328 AFP cases had been reported. Almost half (n=168, 51.3%) of the patients were aged 1-5 years, and 55.8% (n=183) were male. All cases were discarded (classified as a nonpolio case). The most common cause of AFP was Guillain-Barre Syndrome (n=115, 35.1%). The annualized nonpolio AFP rate increased from 1.4/100,000 children below 15 years of age in 2012 to 4.3 in 2016. National and subnational sensitivities were not met in 2012 and 2013. Adequacy of stool specimens and timeliness of specimens arriving at and processed in the laboratory were constantly above the minimum target. Timeliness of the investigation met the expected target but with a decreasing trend. The nonpolio enterovirus isolation rate was below the target, except in 2016. Conclusions The AFP surveillance system in Jordan is performing well; however, additional efforts are needed to strengthen the subnational sensitivity. The cold chain from sample collection to laboratory testing has to be maintained to ensure the reliability of stool specimens required for isolation of the nonpolio enterovirus.

scholarly journals Sensitivity of the acute flaccid paralysis surveillance system for poliovirus in South Africa, 2016–2019

2021 ◽  
Vol 70 (10) ◽  
Author(s):  
Wayne Howard ◽  
Shelina Moonsamy ◽  
Lerato Seakamela ◽  
Sabelle Jallow ◽  
Faith Modiko ◽  
...  
Keyword(s):  
South Africa ◽  
Surveillance System ◽  
Environmental Samples ◽  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
World Health ◽  
Surveillance Programme ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance ◽  
Type 3

Introduction. Global poliovirus eradication is a public health emergency of international concern. The acute flaccid paralysis (AFP) surveillance programme in South Africa has been instrumental in eliminating polioviruses and keeping the country poliovirus free. Gap statement. The sensitivity of surveillance for polioviruses by every African country is of global interest in the effort to ensure global health security from poliovirus re-emergence. Aim. To describe the epidemiology of polioviruses from AFP cases and environmental samples in South Africa and to report the performance of the AFP surveillance system for the years 2016–2019 against targets established by the World Health Organization (WHO). Methods. Stool specimens from AFP or suspected AFP cases were received and tested as per WHO guidelines. Environmental samples were gathered from sites across the Gauteng province using the grab collection method. Concentration was effected by the two-phase polyethylene glycol method approved by the WHO. Suspected polioviruses were isolated in RD and/or L20B cell cultures through identification of typical cytopathic effects. The presence of polioviruses was confirmed by intratypic differentiation PCR. All polioviruses were sequenced using the Sanger method, and their VP1 gene analysed for mutations. Results. Data from 4597 samples (2385 cases) were analysed from the years 2016–2019. Two cases of immunodeficiency-associated vaccine-derived poliovirus (iVDPV) type 3 were detected in 2017 and 2018. A further 24 Sabin type 1 or type 3 polioviruses were detected for the 4 years. The national surveillance programme detected an average of 3.1 cases of AFP/100 000 individuals under 15 years old (2.8/100 000–3.5/100 000). The stool adequacy of the samples received was 53.0 % (47.0–55.0%), well below the WHO target of 80 % adequacy. More than 90 % of results were released from the laboratory within the turnaround time (96.6 %) and non-polio enteroviruses were detected in 11.6 % of all samples. Environmental surveillance detected non-polio enterovirus in 87.5 % of sewage samples and Sabin polioviruses in 12.5 % of samples. Conclusion. The AFP surveillance programme in South Africa is sensitive to detect polioviruses in South Africa and provided no evidence of wild poliovirus or VDPV circulation in the country.

Evaluation of Acute Flaccid Paralysis Surveillance System in Polio-Free Jordan, 2012

2018 ◽  
Author(s):  
Fatima Zerriouh ◽  
M Abdallat ◽  
L Ghaffari ◽  
I Iblan ◽  
K Abusal ◽  
...  
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
Acute Flaccid Paralysis Surveillance

Detection of non-polio and polio enteroviruses in Acute Flaccid Paralysis surveillance in Turkey

2021 ◽  
Author(s):  
Gulay Korukluoglu ◽  
Umit Ozdemirer ◽  
Fatma Bayrakdar ◽  
Zehra Unal ◽  
Yasemin Cosgun ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
Sequencing Analysis ◽  
National Data ◽  
Polio Virus ◽  
Vaccination Rates ◽  
Acute Flaccid Paralysis Surveillance ◽  
Polio Vaccination ◽  
Afp Surveillance ◽  
Comprehensive Study

AbstractPoliomyelitis was a disease feared worldwide, striking suddenly and paralysing mainly children for life. Monitoring of suspected cases of poliomyelitis is carried out with Acute Flaccid Paralysis (AFP) surveillance in Turkey. This study examines national data of AFP surveillance and the epidemiology of enteroviruses (EV) in Turkey from 2000 to 2019 and gives an overview of the detected serotypes of EVs. A total of 13,640 samples collected from patients with 5216 AFP pre-diagnosed cases (2 samples from each patient) and 3,208 contacts, during a 20-year period (2000–2019) were investigated. All isolated polioviruses were tested for their wild or vaccine origin according to the WHO recommended protocol by PCR and sequencing analysis were performed. Enterovirus positivity was detected in a total of 915 cases, which were identified as 204 Sabin-like polio virus (SLPV) and 711 non-polio enterovirus (NPEV). Of the 204 SLPV, 141 (69.1%) AFP were detected in patients and 63 (30.9%) were detected in samples taken from their contacts. Of the 711 NPEVs, 516 (72.5%) were from AFP cases and 195 (27.5%) were detected in samples taken from their contacts. It is concluded that the reason for the higher detection rate of NPEV in samples from AFP pre-diagnosed cases is attributed to the polio vaccination rates reaching 97% between 2008 and 2019 in Turkey. The most frequently detected NPEV serotypes were Coxackie A24, B3, and Echo 30. This retrospective study is the first comprehensive study in Turkey to evaluate the results of the AFP surveillance in the last 20 years.

Sign in / Sign up

Export Citation Format

Share Document