Evaluation of Acute Flaccid Paralysis Surveillance System in Afghanistan during 2020: A Retrospective Secondary Data Analysis
Article Sidebar
Main Article Content
Abstract
Background: We aimed to evaluate the acute flaccid paralysis (AFP) surveillance system focusing on indicators reflecting the performance of the system in Afghanistan.
Methods: This retrospective study was a secondary analysis of routinely collected AFP surveillance data during 2020 in Afghanistan. The standard WHO indicators were used to evaluate the AFP surveillance.
Results: Afghanistan reported 3972 AFP cases during 2020; of them 2228 (56%) were male while 2835 (71%) were children aged under five years. Of all AFP-reported cases, 56 were wild polio cases and almost half (n= 28, 50%) of them were reported among children aged 12–24 months. Almost 348 (8.8%) had taken zero doses of the vaccine both in routine and supplementary immunization activities (SIA). Approximately 83% (n=3290) had fever at the onset of the disease while 50.4% (n=2001) had asymmetric paralysis. Two southern provinces, i.e., Kandahar and Helmand, reported 30 (54%) wild polio cases. In 2020, the non-polio AFP rate was 17/100,000 in children below 15 years of age. Meanwhile 42 (75%) of wild polio cases patients received zero oral polio vaccine (OPV) through routine immunization while 24 (43%) wild polio cases received zero OPV through NID campaigns. All other indicators met the expected target except that 851 (21.4%) specimens arrived at the laboratory within 3 days and 180 (41.3%) were followed up after onset of paralysis in 60 days.
Conclusion: The AFP surveillance performed well in 2020. However, timely investigation of AFP cases and reaching the specimen to the lab should be improved.
Article Details
This work is licensed under a Creative Commons Attribution 4.0 International License.
References
What is polio? [Internet]. Centers for Disease Control and Prevention; 2022 [cited 2024 Mar 22]. Available from: https://www.cdc.gov/polio/what-is-polio/index.htm
Chard AN, Datta SD, Tallis G, et al. Progress toward polio eradication—worldwide, January 2018–March 2020. MMWR Morb Mortal Wkly Rep. 2020; 69:784–9.
Alleman MM, Jorba J, Greene SA, et al. Update on vaccine-derived poliovirus outbreaks—worldwide, July 2019–February 2020. MMWR Morb Mortal Wkly Rep. 2020;69:489–95.
GPEI weekly surveillance report. [https://polioeradication.org/this-week/30]
Banerjee K, Sahu S, Sarkar S. Strategies for eradication of poliomyelitis--the Indian experience. Indian J Public Health. 2000 Jan-Mar;44(1):5-14.
Surveillance to track progress toward polio eradication - worldwide, 2020–2021 [Internet]. Centers for Disease Control and Prevention; 2022 [cited 2024 Mar 22]. Available from: https://www.cdc.gov/mmwr/volumes/71/wr/mm7115a2.htm
Centers for Disease Control and Prevention. Updated guidelines for evaluating public health surveillance systems: recommendations from the guidelines working group. MMWR Recomm Rep. 2001 Jul 27;50(13):1-35.
External Review of Acute Flaccid Paralysis Surveillance. Summary Report June, 2016. https://polioeradication.org/wp-content/uploads/2017/04/AFG_Ext.AFPSurveillanceReviewRep_JUN2016.pdf
Afghanistan completes largest ever review of polio surveillance system [Internet]. World Health Organization; 2022 [cited 2024 Mar 22]. Available from: https://www.emro.who.int/afg/afghanistan-news/afghanistan-completes-largest-ever-review-of-polio-surveillance-system.html
Polio Eradication Initiative Afghanistan. National Emergency Action Plan 2022. National Emergency Operations Centre, Afghanistan. https://polioeradication.org/wp-content/uploads/2023/02/Afghanistan-NEAP-2022.pdf
World Health Organization. Recommended Surveillance standards for vaccine-preventable diseases. 2. Geneva: World Health Organization; 2018.
Ali AS, Allzain H, Ahmed OM, Mahgoub E, Bashir MB, Gorish BM. Evaluation of acute flaccid paralysis surveillance system in the River Nile State-Northern Sudan, 2021. BMC Public Health. 2023 Jan 18;23(1):125.
Nadeem-ur-Rehman S, Hafeez U, Khan MA, Bukhari MA. Acute Flaccid Paralysis Surveillance System: Current Status in Azad Jammu& Kashmir-2018. Pak J Public Health. 2019 Dec 9;9(2):54-6.
Almoayed KA, Break AB, Al-Qassimi M, Assabri A, Khader Y. The acute flaccid paralysis (AFP) surveillance system in Yemen, 2010-2015: descriptive study based on secondary data analysis. JMIR Public Health and Surveillance. 2019 Dec 6;5(4):e14413.
Davarpanah MA, Bakhtiari H, Mehrbani D, Khadem AF. A 12-years surveillance of poliomyelitis and acute flaccid paralysis in Fars Province, Southern Iran. Iran Red Cres Med J. 2024; 10:1-6.
Raji IA, Abubakar AU, Ahmad A, Gidado S, Olorukooba AA, Lawal BB, Umeokonkwo CD, Balogun M. Evaluation of acute flaccid paralysis surveillance indicators in Sokoto state, Nigeria, 2012–2019: a secondary data analysis. BMC Public Health. 2021 Dec;21:1-9.
Raji IA, Abubakar AU, Ahmad A, Gidado S, Olorukooba AA, Lawal BB, Umeokonkwo CD, Balogun M. Evaluation of acute flaccid paralysis surveillance indicators in Sokoto state, Nigeria, 2012–2019: a secondary data analysis. BMC Public Health. 2021 Dec;21:1-9.
Olaoye I, Fatiregun A, Opeyemi E, Adeleke D, Jacdonmi T, Fagbemi S, et al. An Epidemiological evaluation of Acute Flaccid Paralysis surveillance performance in Ondo State; Nigeria, 2016-2020. Int J Epidemiol Health Sci, 2021; 2(Continuous): -. doi: 10.51757/IJEHS.2.12.2021.246984
Amodan BO, Kisakye A, Okumu PT, Ahirirwe SR, Kadobera D, Driwale A, Ario AR. Trends of key surveillance performance indicators of acute flaccid paralysis: a descriptive analysis, Uganda, 2015–2020. BMC Public Health. 2022 Sep 7;22(1):1694.
Hamisu AW, Etapelong SG, Ayodeji I, Richard B, Fiona B, Gidado S, Abbott SL, Edukugho AA, Bolu O, Adeyelu A, Mawashi KY. Experience and findings from surveillance peer review in Nigeria, August 2017-May 2019. The Pan Afr Med J. 2023;45(Suppl 2).