Using Acute Flaccid Paralysis Surveillance as a Platform for Vaccine-Preventable Disease Surveillance

Wassilak, Steven G. F.; Williams, Cheryl L.; Murrill, Christopher S.; Dahl, Benjamin A.; Ohuabunwo, Chima; Tangermann, Rudolf H.

doi:10.1093/infdis/jiw593

Cited by 19 publications

(21 citation statements)

References 8 publications

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“…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. The logistic supplies for AFP surveillance also support surveillance for other VPDs and integrated supportive supervision for immunization activities [21-23]. Furthermore, the introduction of new technologies is already being leveraged by other programs especially the IDSR team to strengthen real time data collection, supportive supervision, feedback systems and accountability systems for staff in Liberia.…”

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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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

View full text Add to dashboard Cite

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“…Every health facility in each LGA reports to the Disease Surveillance and Notification Officer (DSNO) in charge in the local government. The DSNO ensures the safe and prompt transport of the specimens collected to 1 of the 2 national laboratories present in the country [19]. The financial remuneration of the AFP staff is borne by WHO and other donor agencies such as the Bill and Melinda Gates foundation [18,20].…”

Section: Acute Flaccid Paralysis (Afp) Surveillancementioning

confidence: 99%

Current Status and Underlying Problems of Eradication of Poliomyelitis in the Remaining Endemic Countries

Ike¹,

Reward²,

Mbaawuaga³

et al. 2018

EJPM

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In 1988, the World Health Assembly of the World Health Organization (WHO) launched the Global Polio Eradication Initiative (GPEI), with the resolve to interrupt transmission of wild poliovirus (WPV) worldwide by the year 2000.Eighteen years after the intended year of eradication, that target is yet to be achieved. To investigate the reasons behind this, a check of recent publications on poliomyelitis and polio virus was carried out. The databases and websites of institutions and organizations involved in the polio eradication programme were also checked. The findings showed that although the goal of interrupting polio transmission has not been meet, a lot of progress has been made. By 2006, transmission of WPV had been interrupted in all but four countries: Afghanistan, India, Nigeria and Pakistan. In February 2012, India was delisted from the list of polio-endemic countries leaving the remaining 3 countries as the only endemic countries in the world. Wild type 2 and 3 viruses have both been eliminated from circulations. The number of polio cases in the remaining endemic countries has reduced drastically. Nigeria is close to the target, but is yet to be certified polio-free, having experienced a setback in 2016. However, as long as transmission of WPV continues in these countries, the world cannot be free from the disease, as these countries serve as reservoirs of infection and sources of export of the virus to other countries. To be able to achieve the target of interrupting the transmission of WPV in the remaining endemic countries, the identified problems, particularly conflict in the countries concerned, will have to be factored into the programmes geared toward eradication of the disease.

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“…Several articles highlight how the capacities and assets of the GPEI have been supporting other immunization and global health priorities and how this support must continue or risk negative consequences to immunization and health systems. Williams et al describe how the polio surveillance system serves as a platform for vaccine-preventable disease surveillance [87]. The associated support, experience, and lessons learned have played a key role in the development of the global and regional networks for vaccine-preventable diseases [88,89].…”

Section: Transition Planningmentioning

confidence: 99%

Addressing the Challenges and Opportunities of the Polio Endgame: Lessons for the Future

Patel

Cochi

2017

The Journal of Infectious Diseases

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The Global Commission for the Certification of the Eradication of Poliomyelitis certified the eradication of type 2 poliovirus in September 2015, making type 2 poliovirus the first human pathogen to be eradicated since smallpox. The eradication of type 2 poliovirus, the absence of detection of type 3 poliovirus worldwide since November 2012, and cornering type 1 poliovirus to only a few geographic areas of 3 countries has enabled implementation of the endgame of polio eradication which calls for a phased withdrawal of oral polio vaccine beginning with the type 2 component, introduction of inactivated poliovirus vaccine, strengthening of routine immunization in countries with extensive polio resources, and initiating activities to transition polio resources, program experience, and lessons learned to other global health initiatives. This supplement focuses on efforts by global partners to successfully launch polio endgame activities to permanently secure and sustain the enormous gains of polio eradication forever.

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Using Acute Flaccid Paralysis Surveillance as a Platform for Vaccine-Preventable Disease Surveillance

Cited by 19 publications

References 8 publications

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

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

Current Status and Underlying Problems of Eradication of Poliomyelitis in the Remaining Endemic Countries

Addressing the Challenges and Opportunities of the Polio Endgame: Lessons for the Future

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