TY - JOUR AU - Anyanwu, Maureen PY - 2017/05/02 Y2 - 2024/03/28 TI - Acute Flaccid Paralysis Surveillance system Evaluation, Oyo state, Nigeria; 2008-2014 JF - Online Journal of Public Health Informatics JA - OJPHI VL - 9 IS - 1 SE - Communicable Disease Surveillance Use Cases for Human, Animal, and Zoonotic Diseases DO - 10.5210/ojphi.v9i1.7674 UR - https://ojphi.org/ojs/index.php/ojphi/article/view/7674 SP - AB - <div style="left: 86.4px; top: 322.328px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.08175);" data-canvas-width="61.227199999999996">Objective</div><div style="left: 100.8px; top: 336.681px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01939);" data-canvas-width="363.90471999999994">We evaluated the AFP surveillance system in Oyo State to assess</div><div style="left: 86.4px; top: 352.681px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00161);" data-canvas-width="338.8439999999998">its attributes and determine if it was meeting its set objectives.</div><div style="left: 86.4px; top: 383.128px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.11862);" data-canvas-width="79.3288">Introduction</div><div style="left: 100.8px; top: 397.481px; font-size: 13.6px; font-family: serif; transform: scaleX(0.959092);" data-canvas-width="364.95055999999977">In September, 2015, Nigeria was delisted from the list of polio</div><div style="left: 86.4px; top: 413.481px; font-size: 13.6px; font-family: serif; transform: scaleX(0.965257);" data-canvas-width="379.1367199999999">endemic countries globally. To be certified polio free, the country</div><div style="left: 86.4px; top: 429.481px; font-size: 13.6px; font-family: serif; transform: scaleX(0.975193);" data-canvas-width="376.99335999999994">must attain and maintain certification standard Acute Flaccid Paralysis</div><div style="left: 86.4px; top: 445.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00044);" data-canvas-width="377.76583999999997">(AFP) surveillance for additional two-years. In Oyo State, no case of</div><div style="left: 86.4px; top: 461.481px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00745);" data-canvas-width="356.1839999999999">Wild Polio Virus (WPV) has been reported since February, 2009.</div><div style="left: 86.4px; top: 491.928px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.07381);" data-canvas-width="55.9096">Methods</div><div style="left: 100.8px; top: 506.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.03966);" data-canvas-width="364.4337599999999">We used the Centre for Disease Control and Prevention updated</div><div style="left: 86.4px; top: 522.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.09483);" data-canvas-width="382.8631199999999">guidelines for evaluating public health surveillance system.</div><div style="left: 86.4px; top: 538.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.02252);" data-canvas-width="380.83944000000025">We conducted a retrospective review of AFP surveillance data</div><div style="left: 86.4px; top: 554.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.0227);" data-canvas-width="56.72560000000001">between 1</div><div style="left: 143.115px; top: 554.641px; font-size: 8.16px; font-family: serif; transform: scaleX(1.01074);" data-canvas-width="5.49168">st</div><div style="left: 148.605px; top: 554.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.04376);" data-canvas-width="123.96400000000003">January, 2008 and 31</div><div style="left: 272.567px; top: 554.641px; font-size: 8.16px; font-family: serif; transform: scaleX(1.01074);" data-canvas-width="5.49168">st</div><div style="left: 278.057px; top: 554.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.04006);" data-canvas-width="187.0544">December, 2014. We conducted</div><div style="left: 86.4px; top: 570.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01038);" data-canvas-width="379.97039999999987">in-depth interviews with identified stakeholders. Semi-structured</div><div style="left: 86.4px; top: 586.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.05192);" data-canvas-width="381.7247999999999">questionnaires were administered to Disease Surveillance and</div><div style="left: 86.4px; top: 602.281px; font-size: 13.6px; font-family: serif; transform: scaleX(0.976047);" data-canvas-width="378.9340799999999">Notification Officers (DSNOs) and AFP focal persons. Univariate</div><div style="left: 86.4px; top: 618.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.03209);" data-canvas-width="381.20119999999986">analysis was performed by calculating frequencies, means and</div><div style="left: 86.4px; top: 634.281px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00122);" data-canvas-width="220.98640000000003">proportions using Microsoft Excel 2010.</div><div style="left: 86.4px; top: 664.728px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.0848);" data-canvas-width="49.123200000000004">Results</div><div style="left: 100.8px; top: 679.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.01612);" data-canvas-width="363.7877600000001">The case definition of AFP and the tools for reporting are simple.</div><div style="left: 86.4px; top: 695.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00187);" data-canvas-width="380.32671999999997">Of the 897 AFP cases detected during the period under review</div><div style="left: 86.4px; top: 711.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.03883);" data-canvas-width="381.09648000000004">(2008-2014), 20 (2.2%) were laboratory confirmed WPV. The</div><div style="left: 86.4px; top: 727.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.953484);" data-canvas-width="379.2482399999999">sensitivity of the system between 2008 and 2014 measured by the</div><div style="left: 86.4px; top: 743.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.979186);" data-canvas-width="379.2876800000001">Annualized Non-Polio AFP (NPAFP) rate was consistently above</div><div style="left: 86.4px; top: 759.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.980858);" data-canvas-width="70.8016">the target. of</div><div style="left: 157.204px; top: 761.664px; font-size: 13.6px; font-family: sans-serif;">≥</div><div style="left: 164.657px; top: 759.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.986876);" data-canvas-width="121.35279999999999">2/100,000 population</div><div style="left: 286.03px; top: 759.081px; font-size: 13.6px; font-family: serif;">(</div><div style="left: 290.548px; top: 759.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.990562);" data-canvas-width="173.10079999999994">Mean=3.96, Standard deviation</div><div style="left: 86.4px; top: 775.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.981897);" data-canvas-width="377.3592">(SD): 0.48). The mean NPAFP rate for underperforming LGAs during</div><div style="left: 86.4px; top: 791.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.02577);" data-canvas-width="378.5423999999999">the review period was 1.6, SD: 0.31. The mean Stool adequacy and</div><div style="left: 86.4px; top: 807.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.972016);" data-canvas-width="379.62087999999994">Timeliness were 91.43% (SD: 18.3) and 91.3% (SD: 20.3) above</div><div style="left: 86.4px; top: 823.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.928783);" data-canvas-width="73.3584">the target of</div><div style="left: 159.757px; top: 825.664px; font-size: 13.6px; font-family: sans-serif;">≥</div><div style="left: 167.304px; top: 823.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.9483);" data-canvas-width="298.00320000000005">80% respectively. The mean Data quality was 90%</div><div style="left: 86.4px; top: 839.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.939658);" data-canvas-width="54.35920000000001">(target is</div><div style="left: 140.757px; top: 841.664px; font-size: 13.6px; font-family: sans-serif;">≥</div><div style="left: 148.304px; top: 839.081px; font-size: 13.6px; font-family: serif; transform: scaleX(0.948163);" data-canvas-width="317.0023999999999">90; SD: 3.8). Positive Predictive Value (PVP) was 2%</div><div style="left: 86.4px; top: 855.081px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00099);" data-canvas-width="199.0632">(2008 -2009), and 0% in 2010-2014.</div><div style="left: 86.4px; top: 885.528px; font-size: 13.6px; font-family: sans-serif; transform: scaleX(1.10338);" data-canvas-width="81.6136">Conclusions</div><div style="left: 100.8px; top: 899.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.03579);" data-canvas-width="366.6015999999999">The Oyo State AFP surveillance system is simple, flexible,</div><div style="left: 86.4px; top: 915.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.013);" data-canvas-width="378.16975999999994">sensitive and meeting its set objectives. However, PVP was low and</div><div style="left: 86.4px; top: 931.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.990335);" data-canvas-width="377.38367999999986">the system’s operating conditions are not stable. All the LGAs, at one</div><div style="left: 86.4px; top: 947.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.04656);" data-canvas-width="378.61039999999997">point during the period under review did not meet the NPAFP and</div><div style="left: 86.4px; top: 963.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.04286);" data-canvas-width="378.92319999999984">NPENT rates. We recommended that more logistic support should</div><div style="left: 86.4px; top: 979.881px; font-size: 13.6px; font-family: serif; transform: scaleX(0.972995);" data-canvas-width="379.1761599999999">be provided for non-performing LGAs to improve case reporting,</div><div style="left: 86.4px; top: 995.881px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00317);" data-canvas-width="380.0520000000002">investigation, and response. DSNOs should be re -sensitized on</div><div style="left: 86.4px; top: 1011.88px; font-size: 13.6px; font-family: serif; transform: scaleX(1.00103);" data-canvas-width="286.2936">reverse cold chain, so as to improve the NPENT rate</div> ER -