Analysis of acute flaccid paralysis surveillance in Ethiopia, 2005-2015: progress and challenges

Tegegne, Ayesheshem Ademe; Braka, Fiona; Shebeshi, Meseret Eshetu; Hailemariam, Fasal Teshager; Aregay, Aron Kassahun; Beyene, Berhane; Asemahgne, Eshetu Wassie; Woyessa, Daddi Jima; Woyessa, Abyot Bekele

doi:10.11604/pamj.supp.2017.27.2.10694

Cited by 14 publications

(11 citation statements)

References 6 publications

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“…Our results revealed that the mean proportion of AFP cases was higher in boys (55.1%) as compared to girls (44.9%), although the difference was not statistically significant. The result from this study is in line with previous studies conducted in Ghana, Iran, Ethiopia and Italy [8,24,32,33].…”

Section: Discussionsupporting

confidence: 92%

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An epidemiological analysis of Acute Flaccid Paralysis (AFP) surveillance in Kenya, 2016 to 2018

Tesfaye¹,

Sowe²,

Kisangau³

et al. 2020

BMC Infect Dis

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Background The poliovirus has been targeted for eradication since 1988. Kenya reported its last case of indigenous Wild Poliovirus (WPV) in 1984 but suffered from an outbreak of circulating Vaccine-derived Poliovirus type 2 (cVDPV2) in 2018. We aimed to describe Kenya’s polio surveillance performance 2016–2018 using WHO recommended polio surveillance standards. Methods Retrospective secondary data analysis was conducted using Kenyan AFP surveillance case-based database from 2016 to 2018. Analyses were carried out using Epi-Info statistical software (version 7) and mapping was done using Quantum Geographic Information System (GIS) (version 3.4.1). Results Kenya reported 1706 cases of AFP from 2016 to 2018. None of the cases were confirmed as poliomyelitis. However, 23 (1.35%) were classified as polio compatible. Children under 5 years accounted for 1085 (63.6%) cases, 937 (55.0%) cases were boys, and 1503 (88.1%) cases had received three or more doses of Oral Polio Vaccine (OPV). AFP detection rate substantially increased over the years; however, the prolonged health workers strike in 2017 negatively affected key surveillance activities. The mean Non-Polio (NP-AFP) rate during the study period was 2.87/ 100,000 children under 15 years, and two adequate specimens were collected for 1512 (88.6%) AFP cases. Cumulatively, 31 (66.0%) counties surpassed target for both WHO recommended AFP quality indicators. Conclusions The performance of Kenya’s AFP surveillance system surpassed the minimum WHO recommended targets for both non-polio AFP rate and stool adequacy during the period studied. In order to strengthen the country’s polio free status, health worker’s awareness on AFP surveillance and active case search should be strengthened in least performing counties to improve case detection. Similar analyses should be done at the sub-county level to uncover underperformance that might have been hidden by county level analysis.

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Section: Discussionsupporting

confidence: 92%

“…3 Mean NP-AFP rate and stool adequacy, Kenya, 2016Kenya, -2018 investigation to determine if the reported case meets the case definition for AFP or not. Different studies across the globe have upheld the same finding [24,33,34].…”

Section: Discussionmentioning

confidence: 96%

An epidemiological analysis of Acute Flaccid Paralysis (AFP) surveillance in Kenya, 2016 to 2018

Tesfaye¹,

Sowe²,

Kisangau³

et al. 2020

BMC Infect Dis

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“…Additionally, these technologies have the capacity to strengthen record keeping and documentation of AFP surveillance activities, as the quality of AFP surveillance is as good as the documented evidence of the activities conducted, as it is the only way to demonstrate the quality of the surveillance system [17]. Furthermore, documentation of AFP surveillance activities and other Polio eradication program (PEP) activities is critical to maintaining polio free certification and archiving of legacy of polio eradication in Liberia [1, 14, 18-20]. On this note, there are various ways in which AFP surveillance can contribute to the polio legacy and continued strengthening of the overall health system [18, 19].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, documentation of AFP surveillance activities and other Polio eradication program (PEP) activities is critical to maintaining polio free certification and archiving of legacy of polio eradication in Liberia [1, 14, 18-20]. On this note, there are various ways in which AFP surveillance can contribute to the polio legacy and continued strengthening of the overall health system [18, 19]. For instance, the PEP personnel at both national and sub-national level contributing to build capacity of district teams and health workers on immunization service delivery and VPD surveillance.…”

Section: Discussionmentioning

confidence: 99%

Strengthening acute flaccid paralysis surveillance post Ebola virus disease outbreak 2015 - 2017: the Liberia experience

Clarke¹,

Blidi²,

Dahn³

et al. 2019

Pan Afr Med J

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Introduction Liberia remains at high risk of poliovirus outbreaks due to importation. The country maintained certification level acute flaccid paralysis (AFP) surveillance indicators each year until 2014 due to Ebola outbreak. During this time, there was a significant drop in non-polio AFP rate to (1.2/100,000 population under 15 years) in 2015 from 2.9/100, 000 population in 2013, due to a variety of reasons including suspension on shipment of acute flaccid paralysis stool specimen to the polio regional lab in Abidjan, refocusing of surveillance officers attention solely on Ebola virus disease (EVD) surveillance, inactivation of national polio expert committee (NPEC) and National Certification Committee (NCC). The Ministry of Health (MOH) supported by partners worked to restore AFP surveillance post EVD outbreak and ensure that Liberia maintains its polio free certification. Methods We conducted a desk review to summarize key activities conducted to restore acute flaccid paralysis (AFP) surveillance based on World Health Organization (WHO) AFP surveillance guidelines for Africa region. We also reviewed AFP surveillance indicators and introduction of new technologies. Data sources were from program reports, scientific and gray literature, AFP database, auto visual AFP detection and reporting (AVADAR) and ONA Servers. Data analysis was done using Microsoft excel and access spread sheets, ONA software and Geographic Information System (Arc GIS). Results AFP surveillance indicators improved with a rebound of non-polio AFP rate (NPAFP) rate from 1.2/100, 000 population under 15 years in 2015 to 4.3 in 2017. The stool adequacy rate at the national level also improved from 79% in 2016 to 82% in 2017, meeting the global target. The percentage of counties meeting the two critical AFP surveillance indicators NPAFP rate and stool adequacy improved from 47% in 2016 to 67% in 2017.The Last polio case reported in Liberia was in late 2010. Conclusion There was significant improvement in the key AFP surveillance indicators such as NPAFP rate and stool adequacy with a 3.5 fold increase in NPAFP from 2014 to 2017. By 2017, the stool adequacy rate was up to target levels compared to 2016, which was below target level of 80%. The number of counties meeting target for the two critical AFP surveillance indicators also increased by 20% points between 2016 and 2017. Similarly there was approximately two-fold increase in the oral polio vaccines (OPV) coverage for the reported AFP cases between 2015 and 2017. Strategies employed to address gaps in AFP surveillance included enhanced active case search for AFP, re-instatement of laboratory testing, supportive supervision in addition to facilitating enhanced community engagement in surveillance activities. New technologies such as AVADAR Pilot, electronic integrated supportive supervision (ISS) and electronic surveillance (eSurv) tools were introduced to improve real time AFP case report...

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“…6 The last case of wild-type poliovirus in Ethiopia was reported in 2013. 7 Until 2016, Ethiopia used the trivalent OPV (PV serotype 1-3), which has then been replaced since by bivalent OPV (PV1 and PV3) and trivalent IPV.…”

Section: Introductionmentioning

confidence: 99%

Genotyping of enteroviruses and human parechoviruses highlights their diversity in Northwest Ethiopia

Gelaw

Pietsch

Tigabu

et al. 2020

Journal of Medical Virology

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Enteroviruses (EVs) and human parechoviruses (HPeVs) infections are associated with various forms of disease, including gastroenteritis. As information on the molecular epidemiology of these viruses is limited in Ethiopia, the genetic diversity of EV and HPeV was investigated in the Northwestern part of the country. Of the total 450 stool samples obtained from infants and young children with diarrhea, 157 (34.9%) were positive for EV and 49 (10.9%) for HPeV RNA when tested by real‐time reverse transcription polymerase chain reaction. Genotyping was performed by sequencing of the EV VP1 gene and the HPeV VP3/VP1 gene, respectively. Genotyping of EV was successful in 118 samples. Thereof, 82 (69.5%) belonged to non‐polio EVs as a broad range of genotypes within species C, B, and A. Sabin polioviruses were found in 36 cases. HPeV sequences were also heterogeneous with a relative dominance of genotype 3. In conclusion, diverse EV and HPeV genotypes were found cocirculating in Northwest Ethiopia. The findings highlight the importance of continuous surveillance of these viruses in Ethiopia.

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Analysis of acute flaccid paralysis surveillance in Ethiopia, 2005-2015: progress and challenges

Cited by 14 publications

References 6 publications

An epidemiological analysis of Acute Flaccid Paralysis (AFP) surveillance in Kenya, 2016 to 2018

An epidemiological analysis of Acute Flaccid Paralysis (AFP) surveillance in Kenya, 2016 to 2018

Strengthening acute flaccid paralysis surveillance post Ebola virus disease outbreak 2015 - 2017: the Liberia experience

Genotyping of enteroviruses and human parechoviruses highlights their diversity in Northwest Ethiopia

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