Background Poliomyelitis is a highly infectious viral disease transmitted feco-orally, mainly affecting children under 15 years old. One in 200 infections leads to irreversible paralysis and immunisation can prevent poliomyelitis. Acute Flaccid Paralysis (AFP) surveillance, is used to documents the presence or absence of wild polio-virus. An in-depth review of AFP data in the Eastern Region was undertaken to assess the progress towards interruption of polio-virus transmission and to identify opportunities for system improvement.
Methods We conducted a secondary data analysis of AFP cases reported to the Regional Health Directorate from 1997 to July 2009. We reviewed records, calculated AFP surveillance performance indicators and described AFP-cases, surveillance indicators and polio vaccination by person, place and time.
Results Between 1999 and July 2009, of the 273 AFP-cases reported, one wild polio-virus was recorded. The non-polio AFP rate ranged from 0.12 to 3.94/100 000 and stool adequacy from 60% to 80%. The prevalence of non-polio entero-viruses was 8.4%. Thirty seven percent of the AFP-cases were males <5 years old. Most AFP-cases 38/273 (14.0%) occurred in October with Suhum District recording the highest 30/273 (11.0%). The commonest site of paralysis was the right lower limb 85/273 (31.0%) and asymmetric paralysis represented169/273 (62%). Forty percent (109/273) of AFP-cases had three polio-vaccine doses. Completeness of data from case-based forms was however inadequate.
Conclusions The AFP surveillance indicators reflect consistent progress towards interruption of polio-virus transmission. However, the programme needs to improve on the completeness of case-based forms and stool quality. Surveillance officers have been re-trained on data management.
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