Evaluation of AFP surveillance indicators in polio-free Ghana, 2009–2013

BMC Public Health

Jacob S Barnor³  Jacob Arthur-Quarm³  Michael Adjabeng²  Stanley Diamenu¹  Vincent V Ahove¹  Miriam Eshun³  Evangeline Obodai³  Keren Minta-Asare³  James Addo²  Badu Sarkodie²  Nana Afia Asante Ntim³  John Kofi Odoom³ 

[1] World Health Organization, Country Office, Accra, Ghana;Disease Surveillance Department, Accra, Ghana;Department of Virology, Noguchi Memorial Institute for Medical Research, University of Ghana, P.O. Box LG 581, Legon, Accra, Ghana

关键词: Ghana;    Regional Reference Polio Laboratory;    AFP;    Indicators;    Surveillance;   

Others  :  866309
DOI  :  10.1186/1471-2458-14-687

 received in 2014-03-07, accepted in 2014-07-01,  发布年份 2014

【 摘 要 】

Background

Ghana recorded the last case of indigenous wild poliovirus in 1999 but suffered two more outbreaks in 2003 and 2008. Following the World Health Organization (WHO) guidelines, transmission was interrupted through high routine immunisation coverage with live-attenuated oral polio vaccine (OPV), effective acute flaccid paralysis (AFP) surveillance and supplementary immunisation activities (SIA). This article describes the results of a five-year surveillance of AFP in polio-free Ghana, evaluate the surveillance indicators and identify areas that need improvement.

Methods

We investigated 1345 cases of AFP from children aged less than 15 years reported to the Disease Surveillance Department from January 2009 to December 2013. Data on demographic characteristics, vaccination history, clinical presentation and virological investigation on stool specimens collected during investigation were analysed.

Results

Of the specimens analysed, 56% were from males and 76.3% were from children less than 5 years of age. Twenty-four percent of the children received up to 3 doses of OPV, 57% received at least 4 doses while the status of 19% was unknown. Core AFP surveillance indicators were partly met for non-polio AFP rate while the WHO target for stool adequacy and timeliness was exceeded over the period of study. All the cases were classified virologically, however no wild polio was found. Sixty-day follow-up was conducted for 56.3% of cases and 8.6% cases classified as compactible with polio.

Conclusion

Both laboratory and epidemiological surveillance for AFP were efficient and many WHO targets were met. However, due to the risk of poliovirus importation prior to global eradication, longterm surveillance is required to provide a high degree of confidence in prevention of poliovirus infection in Ghana. Thus, efforts should be made to strengthen regional performance and to follow–up on all AFP cases in order to establish proper diagnoses for the causes of the AFP leading to proper care.

【 授权许可】

   
2014 Odoom et al.; licensee BioMed Central Ltd.

【 图 表 】

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