Evaluation of acute flaccid paralysis surveillance system, 2013 to 2017 – Bayelsa State, Nigeria

Abstract

Background: Nigeria is one of the three countries where transmission of Wild Polio Virus (WPV) still occurs. Documented transmission occurs mainly in the northern part of the country. Acute flaccid paralysis (AFP) surveillance is one of polio eradication and endgame strategic plan. On this basis, we evaluated the AFP surveillance system in Bayelsa state, Nigeria with the aim of assessing the attributes of the system. Methods & Materials: We interviewed Stakeholders and reviewed AFP surveillance data from 2013 to 2017 using the updated CDC guidelines for evaluating the public health surveillance systems and the WHO performance standards to assess the performance of the system. Relevant data were extracted and analyzed using Microsoft Excel spreadsheet. Results: All 27 respondents knew that poliomyelitis was caused by a virus and they all felt that AFP case definition was easy to understand. 73% percent of them reported that completion of the Case Investigation Form (CIF) was simple. All the respondents were willing to continue to participate in the AFP surveillance. The non-polio AFP rate (12.3–16.6%) and stool specimen adequacy rate (98–100%) indicate high sensitivity. Proportion of AFP cases investigated within 48 h of notification, timely transportation, specimen arriving laboratory in good condition were all above WHO minimum standard of 80%. The surveillance system has dedicated staff from state ministry of health and support from National Stop Transmission of Polio (NSTOP). Conclusion: The AFP surveillance system in Bayelsa State is performing well. The system is useful, simple, flexible, acceptable, sensitive, representative, timely and stable. We recommended that regular training of data collectors should be implemented.