scholarly journals Performance of Acute Flaccid Paralysis surveillance in Bauchi State, Nigeria, 2016

2017 ◽  
Vol 9 (1) ◽  
Author(s):  
Luka M. Ibrahim ◽  
Adamu Ningi ◽  
Jalal-Eddeen Saleh
Keyword(s):  
Stool Specimen ◽  
Acute Flaccid Paralysis ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
World Health ◽  
Polio Virus ◽  
Specimen Collection ◽  
Afp Surveillance ◽  
Stool Samples ◽  
Definition Of

ObjectiveTo identify and address gaps in acute flaccid surveillance for polioeradication in Buchi stateIntroductionPoliomyelitis a disease targeted for eradication since 19881still pose public health challenge. The Eastern Mediterranean andAfrican Regions out of the six World Health Organization (WHO)Regions are yet to be certified polio free2. The certification of theWHO Africa region is largely dependent on Nigeria, while the WHOEastern Mediterranean is dependent on Pakistan and Afghanistan.Surveillance for acute flaccid paralysis (AFP) is one of the criticalelements of the polio eradication initiative. It provides the neededinformation to alert health managers and clinician to timely initiateactions to interrupt transmission of the polio disease and evidence forthe absence of the wild polio virus.3,4One of the core assignments ofthe certification committee in all regions is to review documentationto verify the absence of wild poliovirus.5Good and completedocumentation is the proxy indication of the quality of the systemwhile poor documentation translates to possibilities of missing wildpoliovirus in the past. We evaluated the performance of the AFPsurveillance system in Bauchi, which is among the 11 high risks statesfor wild polio virus in Nigeria to identify and address gaps in thesurveillance system.MethodsWe conducted a cross-sectional study in Bauchi State. We assessedthe material and documentations on AFP surveillance in eighteen of thetwenty Local Government Areas (LGAs). We assessed the knowledgeof the clinician at focal and non-focal sites on case definition of AFP,the number and method of stool specimen collection to investigate acase and types of training received for AFP surveillance. We verifiedAFP case investigations for the last three years: The caregivers(mothers) were interviewed to authenticate the reported informationof AFP cases, the method used for stool specimen collection andfeedbacks. Community leaders’ knowledge on AFP surveillance wasalso assessed. Data was entered and analyzed in excel spread sheet.ResultsReview of the expected deliverables of 18 out of the 20 LGAdisease surveillance and notification officers (DSNO) revealed thatonly 2(11%), 5(28%), 6(33%) and 7(39%) had evidence of poliooutbreak investigation, supervisory reports, minutes of meeting andsurveillance work plan respectively. Of the 31 AFP cases investigated,correct and complete information was 39% for birth day, 26% forbirth month of the child, 23% for date of onset of paralysis and 23%for date of investigation. Contacts of informants, AFP 001-3 weredeficient in the focal and non-focal sites. The non-focal also lackedguidelines for integrated disease surveillance and response (IDSR)and terms of reference for surveillance focal person.Knowledge of case definition of AFP was 71% and 30% amongclinician at the focal and non-focal sites, respectively and 88% and55% for method of stool collection among clinician at focal and non-focal sites. Among the 38 care givers (mothers) interviewed 16 (42%)did not remember the day or month the investigation for the AFPwas conducted, 36(95%) gave the correct number of stool samples,15(40%) mentioned that the stool samples were collected 24 hoursapart and only 12 (32%) received feedbacks. Majority (79%) of thecommunity leaders interviewed were aware of AFP and knew thatstool was the specimen for investigation of the AFP but 21% did notknow whom to report a case of AFP in their communityConclusionsOur study revealed knowledge and documentations gaps in AFPsurveillance for certification of polio-free in Nigeria. The stateministry of health and the WHO consultants in the polio eradicationunit should update the knowledge of the health care workers at theoperational levels on AFP surveillance. The state ministry of healthand the WHO consultants should also provide all essential documentsrequired for quality AFP surveillance and ensure their judicious use.

scholarly journals Evaluation of Acute Flaccid Paralysis Surveillance indicators in Sokoto State, Nigeria, 2012-2019: A secondary data analysis

2020 ◽  
Author(s):  
Ismail Abdullateef Raji ◽  
Auwal Abubakar Usman ◽  
Abdulrahman Ahmad ◽  
Saheed Gidado ◽  
Abdulhakeem Abayomi Olorukooba ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Secondary Data ◽  
High Sensitivity ◽  
Flaccid Paralysis ◽  
World Health ◽  
Surveillance Network ◽  
Polio Virus ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance ◽  
Health Organization

Abstract Background: Nigeria and indeed, entire Africa has been certified free of Wild Polio Virus (WPV) in 2020. However, the continent is still at risk of importation of WPV, especially in states like Sokoto in Nigeria, which has an international border. Furthermore, due to low immunity in some communities in Sokoto, outbreaks of the circulating Vaccine Derived Polio Virus (cVDPV) occur. Therefore, this paper evaluates the Acute Flaccid Paralysis (AFP) surveillance indicators in Sokoto state, Nigeria. Methods: This retrospective study was an analysis of routinely collected AFP surveillance data between 2012 and 2019 by the Sokoto state surveillance network. We assessed the Sokoto state AFP surveillance system using the AFP surveillance performance indicators. We performed all analyses using Microsoft Excel 2019.Results: Cumulatively, 3001 Acute Flaccid Paralysis (AFP) cases were reported over the evaluation period, out of which 1692 (56.4%) were males, and 2478 (82.4%) were below five years. More than half, 1773 (59.1%) had a fever at the beginning of the disease, and 1911 (63.7%) had asymmetric paralysis. The non-polio AFP rate (9.1 to 23.5%) and stool adequacy rate (92.5 to 100%) indicate high sensitivity. The proportion of cases that had stool samples collected early, timely transported to the laboratory and arrived at the laboratory in optimal condition were all above the World Health Organization (WHO) minimum standard of 80%. There was inadequate profile documentation of some suspected cases.Conclusions: Sokoto State has exceeded the WHO minimum standards in most of the AFP surveillance indicators. The performance of the system is sufficient enough to detect any reintroduction of WPV into the state. However, there is a need for improvement in data quality.

scholarly journals In-Country Acute Flaccid Paralysis Surveillance Review, Nasarawa State, Nigeria, 2017

2018 ◽  
Vol 10 (1) ◽  
Author(s):  
Maureen O Anyanwu ◽  
Ndubuisi Akpuh ◽  
Adewole Adefisoye
Keyword(s):  
Peer Review ◽  
Stool Specimen ◽  
Acute Flaccid Paralysis ◽  
World Health Organisation ◽  
Flaccid Paralysis ◽  
World Health ◽  
Residual Paralysis ◽  
Case Investigation ◽  
Specimen Collection ◽  
The World

Objective: In August, 2017, we conducted a peer review evaluation of the reported high stool adequacy and Non-polio Acute Flaccid Paralysis (AFP) rates of the World Health Organisation (WHO) verified AFP cases, in order to estimate and establish concordance for both surveillance core indicators in Lafia and Nasarawa Egon LGAs in Nasarawa State.Introduction: Nigeria is the only polio endemic country in Africa. Four (4) WPV1 cases were confirmed in 2013 after two years of silence. Nigeria has a strong polio programme characterized by innovative and forward driven strategies, despite several challenges of which surveillance is one of the driving forces. Near perfect surveillance core indicators reported over the past twelve (12) months across certain states and Local Government Areas (LGAs) were issues of concern, given security challenges among others. In August, 2017, we conducted a peer review evaluation of the reported high stool adequacy and Non-polio Acute Flaccid Paralysis (AFP) rates of the World Health Organisation (WHO) verified AFP cases, in order to estimate and establish concordance for both surveillance core indicators in Lafia and Nasarawa Egon LGAs in Nasarawa State.Methods: The LGAs to be visited and AFP cases reported within ninety (90) days and verified to be true and adequate prior to peer review were selected. Any person with strong surveillance knowledge and skill, working in Nigeria with the government or partner agencies and involved in surveillance was identified as a peer reviewer, trained and deployed to the LGAs. Reviewers were not deployed to their geo-political zones where they work under routine conditions. Data was collected by visiting the residence of the respective AFP cases and eliciting responses, using a structured interviewer -administered peer review checklist. Data was collated, analysed using Microsoft Excel 2010 and interpreted accordingly. The causes of incoherence were identified and presented to the LGA Disease Surveillance and Notification Officers (DSNOs) and State authority. An improvement plan which would be monitored and evaluated was elaborated. The AFP surveillance data base for discordant AFP cases was updated with the data generated from the peer review.Results: Of the nineteen (19) AFP cases reviewed, 63.2% (12/19) were females. The mean Age of the total AFP case patients was 3 years (SD 3.4). In Lafia LGA, eight (8) AFP cases were verified and all were true AFP cases and adequate. In Nasarawa Egon LGA, eleven (11) cases were verified, 54.5% (6/11) were true AFP cases and 90.9% (10/11) were found to be adequate. The major causes of the gaps identified include mothers/caregivers dividing collected stool specimen sample to make for two (2) stool samples meant to be collected 24 hours apart for case investigation. This was due to failure on the part of the LGA DSNOs to either inform the mothers/caregivers or underscore the importance of appropriate stool collection. The inability of the surveillance focal officers to adequately identify/differentiate other disease conditions that mimic AFP and persistence of residual paralysis (in Non-polio AFP cases) in 5 (45.5%) cases were also identified in Nasarawa Egon LGA. This was as a result of the lack of referral to the next level for physiotherapy care.Conclusions: In Nasarawa Egon LGA, they were discordances in the reported AFP performance core indicators. They include inadequate stool sample, wrong classification of AFP cases and persistence of residual paralysis in Non-polio AFP cases. We therefore, recommend that the WHO State team should re-orient the LGA DSNOs on proper stool specimen collection for case investigation. Also, the LGA DSNOs should sensitize parents/caregivers on appropriate protocol of stool specimen collection and advise them on referral to the next level of care.

scholarly journals Evaluation of acute flaccid paralysis surveillance indicators in Sokoto state, Nigeria, 2012–2019: a secondary data analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ismail Abdullateef Raji ◽  
Auwal Usman Abubakar ◽  
Abdulrahman Ahmad ◽  
Saheed Gidado ◽  
Abdulhakeem Abayomi Olorukooba ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Secondary Data ◽  
High Sensitivity ◽  
Flaccid Paralysis ◽  
World Health ◽  
African Region ◽  
Surveillance Network ◽  
Polio Virus ◽  
Acute Flaccid Paralysis Surveillance ◽  
Afp Surveillance

Abstract Background Nigeria, the last endemic country in the WHO African Region, was certified free of Wild Polio Virus (WPV) in 2020. However, due to low immunity in some communities in Sokoto, outbreaks of the circulating Vaccine Derived Polio Virus (cVDPV) occur. The aim of this study is to evaluate the Acute Flaccid Paralysis (AFP) surveillance indicators in Sokoto state, Nigeria. Methods This retrospective study was an analysis of routinely collected AFP surveillance data between 2012 and 2019 by the Sokoto state surveillance network. We assessed the Sokoto state AFP surveillance system using the AFP surveillance performance indicators. We performed all analyses using Microsoft Excel 2019. Results Cumulatively, 3001 Acute Flaccid Paralysis (AFP) cases were reported over the evaluation period, out of which 1692 (56.4%) were males, and 2478 (82.4%) were below five years. More than half, 1773 (59.1%), had a fever at the beginning of the disease, and 1911 (63.7%) had asymmetric paralysis. The non-polio AFP rate (9.1 to 23.5% per 100,000 children < 15 years old) and stool adequacy rate (92.5 to 100%) indicate high sensitivity. The proportion of cases that had stool samples collected early, timely transported to the laboratory and arrived at the laboratory in optimal condition were all above the World Health Organization (WHO) minimum standard of 80%. There was inadequate profile documentation of some suspected cases. Conclusions Sokoto State has exceeded the WHO minimum standards in most of the AFP surveillance indicators. The performance of the system is sufficient enough to detect any reintroduction of WPV into the state. However, there is a need for improvement in data quality.

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.

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 (AFP) surveillance: challenges and opportunities from 18 years’ experience, Spain, 1998 to 2015

2018 ◽  
Vol 23 (47) ◽  
Author(s):  
Josefa Masa-Calles ◽  
Nuria Torner ◽  
Noemí López-Perea ◽  
María de Viarce Torres de Mier ◽  
Beatriz Fernández-Martínez ◽  
...  
Keyword(s):  
Acute Flaccid Paralysis ◽  
Polio Eradication ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Notification Rate ◽  
Surveillance Network ◽  
Challenges And Opportunities ◽  
Afp Surveillance ◽  
The Mean ◽  
Annual Proportion

Acute flaccid paralysis (AFP) surveillance is key for global polio eradication. It allows detecting poliovirus (PV) reintroductions from endemic countries. This study describes AFP surveillance in Spain from 1998 to 2015. During this time, 678 AFP cases were reported to the Spanish National Surveillance Network. The mean notification rate was 0.58 AFP cases/100,000 population under 15 years old (range: 0.45/100,000–0.78/100,000). Two periods (P) are described: P1 (1998–2006) with the AFP notification rate ranging from 0.66/100,000 to 0.78/100,000, peaking in 2001 (0.84/100,000); and P2 (2007–2015) when the AFP rate ranged from 0.43/100,000 to 0.57/100,000, with the lowest rate in 2009 (0.31/100,000). No poliomyelitis cases were caused by wild PV infections, although two Sabin-like PVs and one imported vaccine-derived PV-2 were detected. Overall, 23 (3.4%) cases met the hot case definition. Most cases were clinically diagnosed with Guillain–Barré syndrome (76.9%; 504/655). The adequate stool collection rate ranged from 33.3% (7/21) to 72.5% (29/40). The annual proportion of AFP cases with non-polio enterovirus findings varied widely across the study period. AFP surveillance with laboratory testing for non-polio enteroviruses must be maintained and enhanced both to monitor polio eradication and to establish sensitive surveillance for prompt detection of other enteroviruses causing serious symptoms.

scholarly journals Preponderance of Enterovirus Species C in RD-L20B cell culture negative stool samples from children diagnosed with Acute Flaccid Paralysis in Nigeria

2017 ◽  
Author(s):  
J.A. Adeniji ◽  
A.O. Oragwa ◽  
U.E. George ◽  
U.I. Ibok ◽  
T.O.C. Faleye ◽  
...  
Keyword(s):  
Cell Culture ◽  
Acute Flaccid Paralysis ◽  
Direct Detection ◽  
Rna Extraction ◽  
Clinical Specimen ◽  
Flaccid Paralysis ◽  
Surveillance Program ◽  
Two Samples ◽  
Afp Surveillance ◽  
Stool Samples

AbstractsRecently, a reverse transcriptase seminested polymerase chain reaction (RT-snPCR) assay was recommended by the WHO for direct detection of enteroviruses from clinical specimen. In this study, we use the assay and its modification to screen acute flaccid paralysis (AFP) samples previously confirmed negative for enteroviruses by the RD-L20B algorithm.Thirty paired stool suspensions collected in 2015 as part of the national AFP surveillance program in different states of Nigeria were analyzed in this study. The samples were previously confirmed negative for enteroviruses by the polio laboratory in accordance with the WHO recommended RD-L20B cell culture based algorithm. Two samples previously confirmed to contain enteroviruses were included as positive controls. All samples were subjected to RNA extraction, and the RT-snPCR assay and its modifications. All amplicons were sequenced and enteroviruses identified using the enterovirus genotyping tool.Overall, amplicons were recovered from the two controls and 50% (15/30) of samples screened. Fourteen were successfully typed of which, 7.1% (1/14), 21.4% (3/14), 64.3% (9/14) and 7.1% (1/14) were EV-A, EV-B, EV-C and a mixture of EV-B and C (EV-C99 and E25), respectively. The two controls were identified as EV-C99 and CV-A1, both EV-Cs. The PV-2 detected had VP1 ILE143. Hence, a vaccine strain.The results of this study showed that about 50% of enterovirus infections (including some Sabin PV2s) are being missed by the RD-L20B cell culture based algorithm. This highlights the value of the RT-snPCR assay and its modifications. The circulation and preponderance of EV-Cs in Nigeria was also confirmed.

scholarly journals Evaluation of Acute Flaccid Paralysis (AFP) surveillance system, Kebbi State, Nigeria, 2013-2018

2020 ◽  
Author(s):  
Hashim Abdulmumin Bala ◽  
Yahaya Mohammed ◽  
Nyampa Barau ◽  
Lukman Surajudeen ◽  
Polycarp Uche Ori
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Performance Standards ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Suspected Case ◽  
Surveillance Systems ◽  
Case Definitions ◽  
Wild Poliovirus ◽  
Afp Surveillance

Abstract Background Since 1988, the incidence of polio has reduced by more than 99 percent, worldwide, according to the WHO. Each year, more than 350,000 children were paralyzed, in more than 125 endemic countries. Today, only two countries are still having transmission of polio: Pakistan and Afghanistan. No wild poliovirus has been reported anywhere in Africa since 2016. A good and effective Acute Flaccid Paralysis (AFP) surveillance system is necessary to detect any suspected case of polio to interrupt the transmission of polio within any country. We evaluated the AFP surveillance system to identify gaps in its operations. Methods We used the updated CDC guidelines for evaluating public health surveillance systems and the WHO performance standards to assess the system. We also interviewed stakeholders using an adapted questionnaire, and a key informant interview. We also reviewed AFP surveillance data from 2013–2018. We summarized data using means, frequencies, and proportion. Results We interviewed a total of 49 respondents. Of these, 47 (98%) reported case definitions as being easy to use, and case investigation forms as being easy to fill, 46 (97%) reported data tools could easily accommodate changes, and all the surveillance officers understand the case definition of AFP. All respondents were willing to continue with the system. The non-polio AFP rate (24.6–55.2), stool adequacy (95-99.7%), timeliness, and completeness of reporting were found to be consistently above the WHO minimum standard. Conclusion The AFP surveillance system in Kebbi State was found to be useful, simple, flexible, acceptable, sensitive, representative, timely, and stable, though donor-driven. Absence of data on 60-day follow up and feedback from the laboratory was a major problem with the system.

scholarly journals Evaluation of Acute Flaccid Paralysis (AFP) surveillance system, Kebbi State, Nigeria, 2013-2018

2020 ◽  
Author(s):  
Hashim Abdulmumin Bala ◽  
Yahaya Mohammed ◽  
Nyampa Barau ◽  
Lukman Surajudeen ◽  
Polycarp Uche Ori
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Performance Standards ◽  
Case Definition ◽  
Flaccid Paralysis ◽  
Suspected Case ◽  
Surveillance Systems ◽  
Case Definitions ◽  
Wild Poliovirus ◽  
Afp Surveillance

Abstract Background: Since 1988, the incidence of polio has reduced by more than 99 percent, worldwide, according to the WHO. Each year, more than 350,000 children were paralyzed, in more than 125 endemic countries. Today, only two countries are still having transmission of polio: Pakistan and Afghanistan. No wild poliovirus has been reported anywhere in Africa since 2016. A good and effective Acute Flaccid Paralysis (AFP) surveillance system is necessary to detect any suspected case of polio to interrupt the transmission of polio within any country. We evaluated the AFP surveillance system to identify gaps in its operations.Methods: We used the updated CDC guidelines for evaluating public health surveillance systems and the WHO performance standards to assess the system. We also interviewed stakeholders using an adapted questionnaire, and a key informant interview. We also reviewed AFP surveillance data from 2013-2018. We summarized data using means, frequencies, and proportion. Results: A total of 49 respondents were interviewed. Of these, 47 (98%) reported case definitions as being easy to use, and case investigation forms as being easy to fill, 46 (97%) reported data tools could easily accommodate changes, and all the surveillance officers understand the case definition of AFP. All respondents were willing to continue with the system. The non-polio AFP rate (24.6-55.2), stool adequacy (95-99.7%), timeliness, and completeness of reporting were found to be consistently above the WHO minimum standard.Conclusion: The AFP surveillance system in Kebbi State was found to be useful, simple, flexible, acceptable, sensitive, representative, timely, and stable, though donor-driven. The absence of data on 60-day follow up and feedback from the laboratory was a major problem with the system.

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.

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