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

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

doi:10.1093/infdis/jiw593

Abstract

Surveillance for acute flaccid paralysis (AFP) is a fundamental cornerstone of the global polio eradication initiative (GPEI). Active surveillance (with visits to health facilities) is a critical strategy of AFP surveillance systems for highly sensitive and timely detection of cases. Because of the extensive resources devoted to AFP surveillance, multiple opportunities exist for additional diseases to be added using GPEI assets, particularly because there is generally 1 district officer responsible for all disease surveillance. For this reason, integrated surveillance has become a standard practice in many countries, ranging from adding surveillance for measles and rubella to integrated disease surveillance for outbreak-prone diseases (integrated disease surveillance and response). This report outlines the current level of disease surveillance integration in 3 countries (Nepal, India, and Nigeria) and proposes that resources continue for long-term maintenance in resource-poor countries of AFP surveillance as a platform for surveillance of vaccine-preventable diseases and other outbreak-prone diseases.

Highlights

The Global Polio Eradication Initiative (GPEI) is close to achieving the long-sought eradication goal, with ongoing transmission of wild poliovirus type 1 (WPV1) being restricted to limited areas of just 3 countries, Nigeria, Afghanistan, and Pakistan
In August 2016, indigenous WPV1 was again detected in Nigeria, following an absence of reported cases since July 2014, which had resulted in removing Nigeria from the World Health Organization’s (WHO’s) list of endemic countries
The second performance indicator is the proportion of acute flaccid paralysis (AFP) cases for which adequate stool specimens were collected; the target is ≥80%, indicating surveillance can effectively identify poliovirus among children with AFP [4]

Summary

Introduction

The Global Polio Eradication Initiative (GPEI) is close to achieving the long-sought eradication goal, with ongoing transmission of wild poliovirus type 1 (WPV1) being restricted to limited areas of just 3 countries, Nigeria, Afghanistan, and Pakistan. Knowledge and lessons learned from polio eradication activities will be shared, and polio program capacities, resources, and infrastructure will be transitioned to support other public health priorities, in order to strengthen surveillance for other vaccine-preventable diseases (VPDs) through the integration of disease surveillance activities.

Results

Conclusion