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 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 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 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 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 Surveillance of acute flaccid paralysis (AFP) in Lombardy, Northern Italy, from 1997 to 2011 in the context of the national AFP surveillance system

2014 ◽  
Vol 11 (1) ◽  
pp. 277-281 ◽  
Author(s):  
Laura Pellegrinelli ◽  
Valeria Primache ◽  
Lucia Fiore ◽  
Concetta Amato ◽  
Stefano Fiore ◽  
...  
Keyword(s):  
Surveillance System ◽  
Acute Flaccid Paralysis ◽  
Northern Italy ◽  
Flaccid Paralysis ◽  
Afp Surveillance

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 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
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