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

Clarke, Adolphus T; Blidi, Nicholas; Dahn, Bernice; Agbo, Chukwuemeka; Tuopileyi, Roland; Rude, Monday Julius; Williams, George S.B.; Seid, Mohammed Abdu; Gasasira, Alex; Wambai, Zakari; Skrip, Laura; Nagbe, Thomas; Nyenswah, Tolbert; Chukwudi, Joseph Okeibunor; Johnson, Ticha; Talisuna, Ambrose; Yahaya, Ali Ahmed; Rajatonirina, Soatiana; Fall, Ibrahima Socé

doi:10.11604/pamj.supp.2019.33.2.16848

Cited by 8 publications

(5 citation statements)

References 15 publications

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“…The proportion of districts with target stool adequacy rate significantly increased between 2015 and 2020, with mean stool adequacy rate in the study period being higher than the recommended target of 80%. This finding is in line with what was found in other countries including Ethiopia [ 17 ], some eastern and southern African countries [ 22 ], and Liberia [ 28 ]. There were sub-regional variations in terms of stool adequacy.…”

Section: Discussionsupporting

confidence: 93%

Trends of key surveillance performance indicators of acute flaccid paralysis: a descriptive analysis, Uganda, 2015–2020

Amodan

Kisakye

Okumu³

et al. 2022

BMC Public Health

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Background Polio is disease caused by poliovirus which can in turn cause irreversible paralytic disease, presenting as Acute Flaccid Paralysis (AFP). A sensitive AFP surveillance system, in which all reported AFP cases are evaluated, first to determine if they are true AFP cases or not, is key for tracking polio eradication. True AFP cases are then later categorized as polio AFP or non-polio AFP (NPAFP) cases. Sensitivity is defined by meeting an annual NPAFP rate/100,000 population < 15 years of ≥ 4/100,000, and an annual stool adequacy (SA) rate of ≥ 80%. We describe Uganda’s AFP surveillance performance between 2015–2020, based on the WHO-recommended indicators, including; NPAFP and stool adequacy rate. Methods We performed a descriptive analysis of national AFP surveillance data, 2015–2020 obtained from ministry of health. We evaluated proportion of reported AFP cases that were true AFP, and changes in NPAFP and stool adequacy (SA) rate over the study period. We evaluated the trends in achieving the targeted NPAFP and SA rates from 2015–2020. We used QGIS to illustrate patterns in NPAFP and SA rates across districts and subregions. Results Among 3,605 AFP cases reported and investigated countrywide from 2015–2020, 3,475 (96%) were true AFP cases. All the true AFP cases were non-polio related. District reporting was near-complete (97–100% each year). Overall, the mean NPAFP rate declined from 3.1/100,000 in 2015 to 2.1/100,000 in 2020. Less than 40% of districts met the NPAFP target rate in all years. The proportion of districts achieving the NPAFP target rate of ≥ 4/100,000 significantly declined from 35% in 2015 to 20% in 2020. The mean annual SA rate nationally was 88% from 2015–2020. Only 66% of districts achieved the SA target rate of ≥ 80% in the study period. The proportion of districts with SA rate ≥ 80% significantly increased from 68 to 80% between 2015 and 2020. Conclusion Most districts reported AFP cases. However, there was a decline in the NPAFP rate from 2015–2020 and few districts achieved the target rate. The suboptimal AFP surveillance system performance leaves the country at risk of missing ongoing poliovirus transmission. We recommend health worker training on active AFP searches, intensified supportive supervision, increase the number of environmental surveillance sentinel sites to boost AFP surveillance in the country, and periodic review meetings with districts to assess AFP surveillance performance.

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Section: Discussionsupporting

confidence: 93%

Trends of key surveillance performance indicators of acute flaccid paralysis: a descriptive analysis, Uganda, 2015–2020

Amodan

Kisakye

Okumu³

et al. 2022

BMC Public Health

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“…African countries [23], and Liberia [33], our ndings showed that it is even more critical that the AFP surveillance system should be strengthened in Niger. Niger should analyse routine AFP index to identify any subnational gaps to guide AFP activities and thereby minimize the consequences of any new virus introduction.…”

Section: Discussionmentioning

confidence: 80%

Tracking Acute Flaccid Paralysis in Niger: A Half-Decade Epidemiological Portrait (2016-2021)

Ishagh,

Talatou,

Oumarou

et al. 2023

Preprint

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Background: The global incidence of wild poliovirus cases has dramatically declined, with fewer than 350,000 cases in over 125 endemic countries. Despite progress, Niger experienced vaccine-derived poliovirus outbreaks in 2018, highlighting the importance of maintaining Acute Flaccid Paralysis (AFP) surveillance as a tool for polio eradication. This analysis aims to comprehensively assess AFP surveillance trends, patterns, and challenges in Niger, offering insights for public health initiatives in conflict-affected contexts. Methods: Nationwide AFP surveillance data spanning 2016 to 2021 were analyzed. Data included demographic information, vaccination status, clinical history, circulating vaccine-derived polioviruses (cVDPV), AFP cases, stool specimens, and non-polio enteroviruses (NPEV). Study findings were presented through tables, graphs, and maps. Results: A total of 4,134 AFP cases under 15 years old were included, with a Sex Ratio of 1.3. Most cases (79.85%) were aged 1 to 4 years, and 79.44% received three or more doses of oral polio vaccine (OPV). Fever onset (90.13%), asymmetric paralysis (80.33%), and a 3-day progression (80.48%) were common. Wild poliovirus type 2 was found in 33 cases, predominantly in Zinder province. The annualized non-polio AFP rate per 100,000 population <15 years fluctuated, with the lowest at 2.5 in 2016 and highest at 8.7 in 2018 (mean 5.93). Surveillance indicators, including faecal specimen collection, follow-up exams, NPEV detection, and timely laboratory results, performed well. However, stool specimen quality was suboptimal (69% in 2016), and stool transportation times exceeded 7 days. Five districts reported less than 80% stool adequacy. Conclusion: This study underscores the importance of continued AFP surveillance in Niger, with room for improvement in stool specimen quality and transportation times. Enhancing these aspects can improve public health efforts conflict-affected areas and contribute to polio eradication in the region.

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“…The demand for quality and real-time information using geographic information systems (GIS) and other technologies by policymakers at levels by different stakeholders in the polio eradication programme is increasing and several approaches and tactics had been adopted to meet these demands. Digital technologies had proven to have supported positively the polio eradication programme through enhancing surveillance performance [ 7 - 10 ], support the implementation of real-time supplemental immunisation activities (SIAs) [ 11 - 13 ], use of mobile phones to support polio vaccination [ 14 ], tracking vaccination teams during the conduct of polio campaigns in northern Nigeria [ 15 ], creating maps using a geographical information system to aid microplanning for enhanced close supervision [ 16 ], the use of mobile phones short text messages (SMS) for community mobilization and conduct of surveys to support polio campaigns [ 17 , 18 ], use of real-time data transmission approach in campaign monitoring [ 19 ], the use of mobile data collection tools in the conduct of lot quality assurance sampling (LQAs) to support post-campaign monitoring [ 20 ] and leveraging the use of mobile technology in support of polio post-campaign evaluation [ 21 ] among others.…”

Section: Introductionmentioning

confidence: 99%

Real-time monitoring of a circulating vaccine-derived poliovirus outbreak immunization campaign using digital health technologies in South Sudan

Bello¹,

Maleghemi²,

Ferede³

et al. 2021

Pan Afr Med J

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Introduction the use of digital health technologies and geographical information systems (GIS) in the conduct of immunization campaigns had proven to be a success story, and is gaining acceptance towards improving supervision, accountability, and real-time access to quality information. The demand for real-time information by policymakers and stakeholders in the polio eradication programme is increasing towards ensuring a world free from all polioviruses. This study aims to develop a tool that monitor and evaluate the circulating vaccine-derived poliovirus (cVDPV) campaign processes in real-time using open data kits (ODK) to collect data, analyze and visualize using an interactive dashboard in Power BI, towards improving timeliness and completeness of data reporting and providing real-time quality information to stakeholders. Methods electronic checklists were developed using open data kits (ODK) and uploaded onto android-based smartphones for data collection during a round of cVDPV outbreak response immunization. Supervisors were deployed to the field and the checklists were utilized at both stages of the campaign activities. A Power BI data visualization tool was used for reporting, analysis, and monitoring the activities of the campaign. Results an interactive dashboard was developed, providing real-time information that supports stakeholders during the campaign processes with improved timeliness and completeness of data reporting. The usage of the tool during the campaign enhanced close supervision, and increased transparency in data availability and accessibility by all partners. Conclusion the study had shown that real-time information has significantly improved the smooth conduct of the immunization campaign processes through identifying gaps, and challenges in the field and can be utilized in similar resource settings including complex and humanitarian. It has demonstrated the capability of mobile phones using ODK for data collection and linked to a Power BI dashboard for enhanced supervision and transparency, and we encourage further studies to assess the effects of the tools on the campaign results.

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

Cited by 8 publications

References 15 publications

Trends of key surveillance performance indicators of acute flaccid paralysis: a descriptive analysis, Uganda, 2015–2020

Trends of key surveillance performance indicators of acute flaccid paralysis: a descriptive analysis, Uganda, 2015–2020

Tracking Acute Flaccid Paralysis in Niger: A Half-Decade Epidemiological Portrait (2016-2021)

Real-time monitoring of a circulating vaccine-derived poliovirus outbreak immunization campaign using digital health technologies in South Sudan

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