Polio eradication initiative in Africa: influence on other infectious disease surveillance development.

Peter Nsubuga,Stephen Cochi,Mark White,Mac Otten,Bradley Perkins,Roland Sutter,Linda Quick,Sharon Mcdonnell

doi:10.1186/1471-2458-2-27

Abstract

BackgroundThe World Health Organization (WHO) and partners are collaborating to eradicate poliomyelitis. To monitor progress, countries perform surveillance for acute flaccid paralysis (AFP). The WHO African Regional Office (WHO-AFRO) and the U.S Centers for Disease Control and Prevention are also involved in strengthening infectious disease surveillance and response in Africa. We assessed whether polio-eradication initiative resources are used in the surveillance for and response to other infectious diseases in Africa.MethodsDuring October 1999-March 2000, we developed and administered a survey questionnaire to at least one key informant from the 38 countries that regularly report on polio activities to WHO. The key informants included WHO-AFRO staff assigned to the countries and Ministry of Health personnel.ResultsWe obtained responses from 32 (84%) of the 38 countries. Thirty-one (97%) of the 32 countries had designated surveillance officers for AFP surveillance, and 25 (78%) used the AFP resources for the surveillance and response to other infectious diseases. In 28 (87%) countries, AFP program staff combined detection for AFP and other infectious diseases. Fourteen countries (44%) had used the AFP laboratory specimen transportation system to transport specimens to confirm other infectious disease outbreaks. The majority of the countries that performed AFP surveillance adequately (i.e., non polio AFP rate = 1/100,000 children aged <15 years) in 1999 had added 1–5 diseases to their AFP surveillance program.ConclusionsDespite concerns regarding the targeted nature of AFP surveillance, it is partially integrated into existing surveillance and response systems in multiple African countries. Resources provided for polio eradication should be used to improve surveillance for and response to other priority infectious diseases in Africa.

Highlights

The World Health Organization (WHO) and partners are collaborating to eradicate poliomyelitis
The objectives of the survey included describing the characteristics of acute flaccid paralysis (AFP) surveillance programs in WHO-AFRO, how surveillance activities for AFP and other infectious diseases have been combined, the contribution of AFP surveillance to the surveillance of other infectious diseases, and the effect of adding surveillance and response to other infectious diseases on the performance of AFP surveillance
We obtained data from 32 (84%) of the 38 countries that regularly report on polio/AFP surveillance activities in Africa to WHO (Figure 1)

Summary

Introduction

The World Health Organization (WHO) and partners are collaborating to eradicate poliomyelitis. We assessed whether polio-eradication initiative resources are used in the surveillance for and response to other infectious diseases in Africa. Public health professionals have debated the merits and demerits of the polio-eradication initiative, regarding the priorities of developing countries. Among the demerits cited is that polio has a lower public health importance as compared to other infectious diseases – many of them epidemic prone – in poor countries [1,2,3]. Reported merits and benefits of the polio-eradication initiative have included increased national enthusiasm and funding for Expanded Programs on Immunization, enhanced surveillance capacity for other diseases, strengthened public health laboratory capacity, and improved epidemiologic skills [2].

Methods

Results

Conclusion