Assessment of Acute Flaccid Paralysis core surveillance indicators reported in Jigawa State, Nigeria

Abstract

Poliomyelitis is a highly infectious viral disease transmitted through the faeco-oral route. Standardized and accurate core Acute Flaccid Paralysis (AFP) surveillance indicators allow progress to be monitored over time. The indicator used to determine if surveillance is sufficiently sensitive to detect polio virus circulation is the annual proportion of AFP cases that are caused by other diseases or conditions apart from polio virus amongst children aged <15 years. The aim of this work was to assess and validate the high AFP surveillance core indicators reported by Jigawa state. A peer review assessment of the high stool adequacy and non-polio AFP rate was undertaken. The local government areas (LGAs) were selected by varying the two core indicators in 3 by 3 table. The peer review conducted was the first of its kind as per our search shows. Out of 103 AFP cases earlier classified as true and adequate by the state, only 71 (68%) were true AFP cases with 81 (78.6%) cases having adequate stool. Buji LGA had the highest number of not true AFP cases 10 (53%) and inadequate cases 4 (21%). True AFP cases had higher adequate stool samples than not true AFP cases. It was apparent from the result that there was over reporting of core surveillance indicators in the state. This work will be of great importance to countries such as Afghanistan, Pakistan and Nigeria which are still polio endemic to evaluate their surveillance system and act accordingly. Training of all officers involved with verification of AFP cases and stool sample collection should be undertaken so that the programme is not misrepresented