Acute flaccid paralysis in North East Delta, Egypt: A retrospective analysis of prospectively collected surveillance data

Abstract

BackgroundEffective acute flaccid paralysis (AFP) surveillance is crucial in countries approaching the final phase of polio eradication. Thus this study was conducted to highlight the epidemiological pattern of AFP as a surveillance tool for polio in Egypt. MethodsA record-based descriptive study was conducted to include all AFP cases (599) reported in the last 9 years starting from January 2009 to December 2017 in Dakahlia, North East of Delta, Egypt. ResultsThe overall non-polio AFP rate in less than 15 years old children was 2.99/100,000 during the study period. The majority of cases (98%) were notified within 7 days from onset of the disease, and investigated within 48 h of reporting. The commonest diagnoses were encephalitis (21.3%), myositis (20.2%), neuropathies (19.2%) and Guillain–Barre syndrome (17.8%) with no recorded cases diagnosed as poliomyelitis. The mean annual vaccination coverage rate was 96.1 ± 1.6. ConclusionsAFP surveillance system in Dakahlia, Egypt was effective in meeting the WHO surveillance performance indicators ensuring polio-free status and absence of wild polio virus transmission over the last 9 years in this locality. High routine immunization coverage, maintenance and improvement of current levels of surveillance performance are required for optimum surveillance.