Bassey Bassey Enya, Gasasira Alex, Mitula Pamela, Frankson Umoh Utobong, Adeniji Johnson Adekunle
World Health Organization, UN HOUSE, Plot 617/618, Central Area District Garki, FCT, Abuja, Nigeria.
Pan Afr Med J. 2011;9:32. doi: 10.4314/pamj.v9i1.71208. Epub 2011 Jul 22.
The last case of wild polio virus transmission occurred in Akwa Ibom state in October 2001; however, combination high routine immunization coverage with OPV, high quality AFP surveillance, mass immunization campaign in which two doses of potent oral polio vaccine is administered to eligible children and mop-up campaigns in areas with identified immunization or surveillance gaps has help the state in maintaining a free polio status for over ten years. This study was carried out to describe the characteristics of reported acute flaccid paralysis cases between 2004 and 2009, and to evaluate the performance of the acute flaccid paralysis surveillance system using indicators recommended by the World Health Organization.
A retrospective study was conducted among children, 0-15 years, by the World Health Organization (WHO) and Epidemiology unit of State Ministry of Health (SMOH), Uyo. The demographic characteristics and the results of isolation and identification of polio and other enteroviruses in stool samples sent to the WHO Polio Laboratory Ibadan for cases was analyzed.
A total of 521 cases of AFP (270 males and 251 females) aged 0 month to=15 years were reported by the surveillance system between 2004 and 2009. Those below 5 years of age accounted for 82.5% of cases reported and investigated. Of the 521 cases investigated 512 (98.3%) received at least three doses of oral polio vaccine, while 9(1.7) never received any oral polio vaccine (zero-dose). In all 5.1% of the isolates were Sabin, 7.9% non polio enterovirus (NPEV) and 2.3% were classified by national expert committee as compatible with poliomyelitis. There was consistent and steady increase in three critical indicators; Non polio AFP rate in children <15 years from 4.5 to 6.4 per 100,000 population, proportion of AFP cases with 2 stool specimens collected within 14 days of onset of paralysis from 57% in 2005 to 91% in 2009 and proportion of Local Government Areas (Districts) meeting both core indicators from 23% in 2005 to 87% in 2009. The highest numbers of cases were seen in the months of March, May and September.
This study showed high levels of surveillance performance with some challenges in reverse the cold chain system, the continuation and sustained AFP case detection, prompt investigation and response, improvement in the reserve cold chain system would achieve optimal standards recommended by WHO and might provide a good model for the eradication of poliomyelitis.
野生脊髓灰质炎病毒的最后一例传播病例于2001年10月发生在阿夸伊博姆州；然而，口服脊髓灰质炎疫苗常规免疫覆盖率高、急性弛缓性麻痹（AFP）监测质量高、对符合条件的儿童接种两剂高效口服脊髓灰质炎疫苗的大规模免疫运动以及在确定的免疫或监测空白地区开展的查漏补种活动，已帮助该州保持了十多年的无脊髓灰质炎状态。本研究旨在描述2004年至200年期间报告的急性弛缓性麻痹病例的特征，并使用世界卫生组织推荐的指标评估急性弛缓性麻痹监测系统的性能。
世界卫生组织（WHO）和乌约州卫生部流行病学股对0至15岁的儿童进行了一项回顾性研究。分析了送往伊巴丹世卫组织脊髓灰质炎实验室的病例粪便样本中脊髓灰质炎和其他肠道病毒的分离和鉴定结果以及人口统计学特征。
监测系统在2004年至2009年期间共报告了521例AFP病例（270例男性和251例女性），年龄在0个月至15岁之间。5岁以下儿童占报告和调查病例的82.5%。在521例接受调查的病例中，512例（98.3%）至少接种了三剂口服脊髓灰质炎疫苗，而9例（1.7%）从未接种过任何口服脊髓灰质炎疫苗（零剂次）。所有分离株中，5.1%为萨宾株，7.9%为非脊髓灰质炎肠道病毒（NPEV），2.3%被国家专家委员会归类为与脊髓灰质炎相符。三个关键指标持续稳定上升；15岁以下儿童的非脊髓灰质炎AFP发病率从每10万人口4.5例增至6.4例，麻痹发作后14天内采集2份粪便标本的AFP病例比例从2005年的57%增至2009年的91%，同时满足两项核心指标的地方政府辖区（区）比例从2005年的23%增至2009年的87%。病例数最多的月份是3月、5月和9月。
本研究显示监测性能水平较高，但在冷链系统方面存在一些挑战，在持续和持续检测AFP病例、及时调查和应对方面，改进备用冷链系统将达到世卫组织推荐的最佳标准，并可能为根除脊髓灰质炎提供一个良好的模式。
