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AFP surveillance varied at subnational levels
CDC. MMWR. 2011 / 60(14);441-445.
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Last year, 77% of polio-affected countries met national performance standards for acute flaccid paralysis surveillance, but surveillance quality varied substantially at state and province levels, according to a CDC report published recently online.
Officials with the Global Polio Eradication Initiative, which launched in 1988, track their progress by monitoring acute flaccid paralysis (AFP) detection rates and environmental surveillance.
AFP surveillance “identifies areas in countries with wild poliovirus circulation where polio cases might go undetected and supplementary immunization activities are needed,” according to CDC officials, who detailed the surveillance performance in this week’s Morbidity and Mortality Weekly Report.
For 15 of 30 polio-affected countries, subnational indicators were met in less than half of the population: nine of 22 countries with outbreaks, all four countries with endemic WPV circulation: Afghanistan, India, Nigeria, and Pakistan, and two (Angola and Sudan) of the four countries which have recently reestablished transmission.
The researchers said that monitoring performance indicators at subnational levels is critical for identifying gaps that could allow wild polio virus circulation to be missed in areas or subpopulations. They noted that subpopulation monitoring is critical to meet the 2010–2012 GPEI strategic plan, which is to promptly detect importation into previously polio-free countries, and to minimize the extent of any additional outbreaks.
The researchers noted that three WHO regions certified as polio-free – the Region of the Americas, the Western Pacific Region and the European Region - maintained overall AFP surveillance, numbers, but surveillance quality varied substantially at subnational levels, particularly in polio-affected countries, the researchers said.
“Continuing indigenous and reestablished transmission and recent outbreaks in previously polio-free countries highlight the necessity to continuously monitor AFP surveillance indicators everywhere,” the researchers wrote.
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