Acute flaccid paralysis surveillance and management in rural and urban reporting sites in Northern Nigeria

Abstract

Abstract Background: The study evaluated the significance of acute flaccid paralysis (AFP) surveillance within the polio eradication strategy and its integral role in the overall eradication efforts. Specifically, the research assessed the implementation of AFP surveillance and its management at reporting sites in Northern Nigeria. Materials and Methods: This study utilized quantitative research methods, including administering interviewer-administered questionnaires to health facility staff and caregivers of children within the community. The research was conducted between May and July 2019 and involved 592 participating health facilities enrolled in the AFP surveillance program for polio eradication. These facilities were spread across 11 states in Nigeria’s Northeast and Northwest regions. Data were analyzed using IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, Version 25.0 (Armonk, New York). Results: A total of 171 AFP cases were reported 6 months prior, with the highest proportion recorded in Kano (18.7%), Bauchi, and Kaduna (13.5% each) states. Most cases were seen in rural areas (73.1%), with an average of 1–3 cases (80.8%). Of the 171 AFP cases reported in the past 6 months, >90% were investigated, >80% had a complete clinical investigation, and >70 were followed up for residual paralysis examination. Most rural health facilities (>80%) had 1–3 trained staff compared with 70.9% of facilities in urban areas. On the other hand, the proportion of facilities in urban areas with 4–6 trained staff was almost double rural area facilities (18.4% vs. 9.8%). It was a surprise that a higher proportion of pastoral facility staff was able to define AFP correctly (94%) than urban facilities with 85.1% (P < 0.05). Also, AFP surveillance and management were better in rural facilities than in urban. Conclusion: According to the research findings, the AFP surveillance system in the northern region demonstrated strong performance. However, urban and rural healthcare providers require regular training in AFP surveillance to maintain practical surveillance standards.