scholarly journals The Acute Flaccid Paralysis (AFP) Surveillance System in Yemen, 2010-2015: Descriptive Study Based on Secondary Data Analysis (Preprint)

2019 ◽  
Author(s):  
Khaled Abdullah Almoayed ◽  
Ali Bin Break ◽  
Mutahar Al-Qassimi ◽  
Ali Assabri ◽  
Yousef Khader
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Descriptive Study ◽  
Flaccid Paralysis ◽  
World Health ◽  
Reference Laboratory ◽  
Sample Collection ◽  
Afp Surveillance ◽  
Stool Specimens ◽  
Central Level

BACKGROUND Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus eradication. OBJECTIVE This study aimed to evaluate the performance of the AFP surveillance system in Yemen from 2010 to 2015, identify components that require strengthening, and compare the indicators by year and governorates. METHODS This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The World Health Organization (WHO) minimum performance standards were used to evaluate the performance of the AFP surveillance system. RESULTS A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for the nonpolio AFP rate of cases per 100,000 members of the population younger than 15 years of age, proportion of AFP cases reported within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which nonpolio enterovirus was isolated. However, the proportion of specimens that arrived at the central level within 3 days of the first sample collection and the proportion of stool specimens with results sent from the reference laboratory within 28 days of receipt did not reach targets in 2011 and 2015, respectively. CONCLUSIONS The AFP surveillance system in Yemen has met most of the WHO indicator levels. Nevertheless, the evaluation showed areas of weakness regarding the arrival of specimens at the central level within 3 days of the first sample collection and delays in processing of the results and submitting feedback by the laboratory. Therefore, there is a need to strengthen the follow-up of specimens submitted to the laboratory.

scholarly journals The Acute Flaccid Paralysis (AFP) Surveillance System in Yemen, 2010-2015: Descriptive Study Based on Secondary Data Analysis

10.2196/14413 ◽  
2019 ◽  
Vol 5 (4) ◽  
pp. e14413
Author(s):  
Khaled Abdullah Almoayed ◽  
Ali Bin Break ◽  
Mutahar Al-Qassimi ◽  
Ali Assabri ◽  
Yousef Khader
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Descriptive Study ◽  
Flaccid Paralysis ◽  
World Health ◽  
Reference Laboratory ◽  
Sample Collection ◽  
Afp Surveillance ◽  
Stool Specimens ◽  
Central Level

Background Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus eradication. Objective This study aimed to evaluate the performance of the AFP surveillance system in Yemen from 2010 to 2015, identify components that require strengthening, and compare the indicators by year and governorates. Methods This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The World Health Organization (WHO) minimum performance standards were used to evaluate the performance of the AFP surveillance system. Results A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for the nonpolio AFP rate of cases per 100,000 members of the population younger than 15 years of age, proportion of AFP cases reported within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which nonpolio enterovirus was isolated. However, the proportion of specimens that arrived at the central level within 3 days of the first sample collection and the proportion of stool specimens with results sent from the reference laboratory within 28 days of receipt did not reach targets in 2011 and 2015, respectively. Conclusions The AFP surveillance system in Yemen has met most of the WHO indicator levels. Nevertheless, the evaluation showed areas of weakness regarding the arrival of specimens at the central level within 3 days of the first sample collection and delays in processing of the results and submitting feedback by the laboratory. Therefore, there is a need to strengthen the follow-up of specimens submitted to the laboratory.

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 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 Evaluation of the acute flaccid paralysis (AFP) surveillance system in Mwenezi district, Masvingo, 2018: a descriptive study

2018 ◽  
Vol 11 (1) ◽  
Author(s):  
Morgen Muzondo ◽  
Amadeus Shamu ◽  
Gerald Shambira ◽  
Notion Tafara Gombe ◽  
Tsitsi Patience Juru ◽  
...  
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Descriptive Study ◽  
Flaccid Paralysis ◽  
Afp Surveillance

scholarly journals Using Nonpolio Enterovirus Detection to Assess the Integrity of Stool Specimens Collected From Acute Flaccid Paralysis Cases in Somalia During 2014–2017

2020 ◽  
Vol 7 (5) ◽  
Author(s):  
Amen Ben Hamida ◽  
Kamil Mohamed Ali ◽  
Rennatus Mdodo ◽  
Abdinoor Mohamed ◽  
Kumlachew Mengistu ◽  
...  
Keyword(s):  
Odds Ratio ◽  
Surveillance System ◽  
Virus Isolation ◽  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
System Quality ◽  
Multivariable Model ◽  
Afp Surveillance ◽  
Stool Specimens ◽  
Key Indicators

Abstract Background Despite insecurity challenges in Somalia, key indicators for acute flaccid paralysis (AFP) surveillance have met recommended targets. However, recent outbreaks of vaccine-derived polioviruses have raised concerns about possible gaps. We analyzed nonpolio enterovirus (NPEV) and Sabin poliovirus isolation rates to investigate whether comparing these rates can inform about the integrity of stool specimens from inaccessible areas and the likelihood of detecting circulating polioviruses. Methods Using logistic regression, we analyzed case-based AFP surveillance data for 1348 cases with onset during 2014−2017. We assessed the adjusted impacts of variables including age, accessibility, and Sabin-like virus isolation on NPEV detection. Results NPEVs were more likely to be isolated from AFP case patients reported from inaccessible areas than accessible areas (23% vs 15%; P = .01). In a multivariable model, inaccessibility and detection of Sabin-like virus were positively associated with NPEV detection (adjusted odds ratio [AOR], 1.75; 95% confidence interval [CI], 1.14–2.65; and AOR, 1.79; 95% CI, 1.07–2.90; respectively), while being aged ≥5 years was negatively associated (AOR, 0.42; 95% CI, 0.20–0.85). Conclusions Rates of NPEV and Sabin poliovirus detection in inaccessible areas suggest that the integrity of fecal specimens tested for AFP surveillance in Somalia can generate useful AFP data, but uncertainties remain about surveillance system quality.

scholarly journals Genotyping of non-polio enteroviruses associated with acute flaccid paralysis in Thailand in 2013 and 2014

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Napa Onvimala ◽  
Nathamon Kosoltanapiwat ◽  
Pornpan Pumirat ◽  
Muthita Vanaporn ◽  
Suchitra Nimmanitya ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
World Health ◽  
Reference Laboratory ◽  
Mouth Diseases ◽  
Circulation Patterns ◽  
The World ◽  
Afp Surveillance ◽  
Health Organization ◽  
First Time

Abstract Background Acute flaccid paralysis (AFP) surveillance was conducted as part of the World Health Organization’s strategy for completely eradicating poliomyelitis and leaving non-polio enteroviruses NPEVs as one of the main potential causes of AFP. We aimed to detect NPEV in association with AFP. Methods We used 459 isolates reported to be Negative Polio and some NPEVs by the World Health Organization Polio Regional Reference Laboratory (Thailand), which had been obtained during polio surveillance programmes conducted in Thailand in 2013–2014. Of 459 isolates, 35 belonged to the genus Enterovirus by RT-PCR and genotyping by DNA sequencing. Results This study found 17 NPEV genotypes, with 3, 13 and 1 belonging to enterovirus (EV) species A (EV-A), EV-B, and EV-C, respectively. The EV-A types identified included coxsackievirus A2 (CA2), CA4, and EV71, typically associated with hand, foot and mouth diseases. EV-B is the most prevalent cause of AFP in Thailand, while CA21 was the only type of EV-C detected. The EV-B species (13/35; 76.5%) constituted the largest proportion of isolates, followed by EV-A (3/35; 17.6%) and EV-C (1/35; 5.9%). For the EV-B species, Echovirus (E) 30 and CVB were the most frequent isolates. E30, CVB, E14, and E6 were considered endemic strains. Conclusion NPEVs, e.g. CA4, are reported for the first time in Thailand. Despite some limitations to this study, this is the first report on the circulation patterns of NPEVs associated with AFP in Thailand. AFP surveillance has unearthed many unknown NPEVs and, the cases of death due to AFP occur annually. Therefore, it is important to study NPEVs in the wake of the eradication of poliovirus in the context of the continued incidence of paralysis.

scholarly journals Gonotyping of non-polio enteroviruses associated with acute flaccid paralysis in Thailand in 2013 and 2014

2021 ◽  
Author(s):  
Napa Onvimala ◽  
Nathamon Kosoltanapiwat ◽  
Pornpan Pumirat ◽  
Muthita Vanaporn ◽  
Suchitra Nimmanitya ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
World Health ◽  
Reference Laboratory ◽  
Mouth Diseases ◽  
Circulation Patterns ◽  
The World ◽  
Afp Surveillance ◽  
Health Organization ◽  
First Time

Abstract Background Acute flaccid paralysis (AFP) surveillance was conducted as part of the World Health Organization’s strategy for completely eradicating poliomyelitis and leaving non-polio enteroviruses NPEVs as one of the main potential causes of AFP. We aimed to detect NPEV in association with AFP.Methods We used 459 isolates reported to be Negative Polio and some NPEVs by the World Health Organization Polio Regional Reference Laboratory (Thailand), which had been obtained during polio surveillance programmes conducted in Thailand in 2013–2014. Of 459 isolates, 35 belonged to the genus Enterovirus by RT-PCR and genotyping by DNA sequencing.Results This study found 17 NPEV genotypes, with 3, 13 and 1 belonging to enterovirus (EV) species A (EV-A), EV-B, and EV-C, respectively. The EV-A types identified included coxsackievirus A2 (CA2), CA4, and EV71, typically associated with hand, foot and mouth diseases. EV-B is the most prevalent cause of AFP in Thailand, while CA21 was the only type of EV-C detected. The EV-B species (13/35; 76.5%) constituted the largest proportion of isolates, followed by EV-A (3/35; 17.6%) and EV-C (1/35; 5.9%). For the EV-B species, Echovirus (E) 30 and CVB were the most frequent isolates. E30, CVB, E14, and E6 were considered endemic strains.Conclusion NPEVs, e.g. CA4, are reported for the first time in Thailand. Despite some limitations to this study, this is the first report on the circulation patterns of NPEVs associated with AFP in Thailand. AFP surveillance has unearthed many unknown NPEVs and, the cases of death due to AFP occur annually. Therefore, it is important to study NPEVs in the wake of the eradication of poliovirus in the context of the continued incidence of paralysis.

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.

scholarly journals Investigation Report of cVDPV2 Outbreak in Bokh Woreda of Dollo Zone, Somali Regional State, Ethiopia

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Diriba Sufa ◽  
Urge Gerema
Keyword(s):  
Acute Flaccid Paralysis ◽  
Addis Ababa ◽  
Flaccid Paralysis ◽  
World Health ◽  
Reference Laboratory ◽  
Health Extension Worker ◽  
High Grade ◽  
High Grade Fever ◽  
Regional State ◽  
Investigation Report

Background. Poliovirus isolates detected in persons or in the environment can fall into three major categories: wild, Sabin and Sabin-like, or vaccine-derived. Detection of wild or vaccine-derived poliovirus may constitute an emergency, which can be categorized as an event that can lead to an outbreak, depending on characteristics of the isolate and the context in which it appears. The aim of the study was investigation report of cVDPV2 outbreak in Bokh woreda of Dollo Zone, Somali regional state, Ethiopia. Methods. A team of experts drawn from different organizations was deployed to Bokh woreda to make detailed field investigation from May 25 to June 17, 2019. By using standard World Health Organization polio outbreak investigation checklist, document review of surveillance, immunization, and clinical data related to the case was made. Key informant’s interview was made to health professionals, managers, parents of case, woreda and kebele leaders, religious leaders, and HEWs related to acute flaccid paralysis outbreak. Result. The notified AFP case was a 39-month-old female from Angalo kebele of Bokh woreda, Dollo Zone. On 19th May 2019, the patient developed high grade fever and was taken to Angalo Health Post on 20th May 2019. As per the examination by a health extension worker, the child had high grade fever and neck stiffness with preliminary diagnosis of meningitis for which ceftriaxone injection was prescribed. Contact sample was taken from three children on 28th May 2019 and 29th May 2019 and was sent to Addis Ababa National Polio Laboratory. All contact stool samples were found to be positive for poliovirus type 2 and referred for sequencing in National Institute of Communicable Diseases (NICD), South Africa, the Regional Polio Reference Laboratory. Conclusion and Recommendation. The clinical presentation of the cases is compatible with poliovirus infection, improving the quality and coverage of supplementary polio immunization activities through proper planning; strict supervision and follow-up can reduce the occurrence of acute flaccid paralysis.

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