Makoni Annamercy, Chemhuru Milton, Gombe Notion, Shambira Gerald, Juru Tsitsi, Bangure Donewell, Tshimanga Mufuta
Department of Community Medicine, University of Zimbabwe, Zimbabwe.
Ministry of Health and Child Care, Zimbabwe.
Pan Afr Med J. 2017 Jul 18;27:203. doi: 10.11604/pamj.2017.27.203.10956. eCollection 2017.
AFP surveillance was adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Gokwe North district with an estimated 119 655 children <15 years detected 2 cases, 4 cases and 1 case of AFP in 2012, 2013 and 2014 respectively against a target of 5 cases per year. We therefore set out to evaluate the system and find out why it was failing to detect at least 5 cases per year.
A descriptive cross sectional study was carried out. All three hospitals in the district were purposively selected. Twelve of the nineteen health facilities were randomly selected and forty nine health workers were purposively recruited. An interviewer administered questionnaire and key informant interview guide were used to collect data. Quantitative data was analysed using Epi info.
Out of the 49 respondents, 17(34.7%) knew the target age group for AFP surveillance. Twelve (24.5%) knew the number of notification forms to be filled. Seven (14.3%) and ten (20.4%) respondents knew when to follow up an AFP case and when an AFP case should be followed up and completely notified and investigated respectively. Forty one (83.7%) respondents were not trained on AFP surveillance. Nineteen (39%) had AFP notification forms at the clinic and 33(67%) had displayed AFP case definitions. All the 22 health facilities in the district participate in AFP surveillance; however, all have hard to reach areas. Seventeen (34.7%) reportedly took public health actions based on AFP data.
The system was found to be useful, simple, acceptable, timely, unstable, not representative and not sensitive. The system was threatened by lack of health worker knowledge and community active search. Advocacy, communication and social mobilization on AFP surveillance might improve the performance of the system in Gokwe North district.
急性弛缓性麻痹（AFP）监测作为全球监测脊髓灰质炎根除倡议进展的关键策略被广泛采用。戈奎北区估计有119655名15岁以下儿童，2012年、2013年和2014年分别检测到2例、4例和1例AFP病例，而目标是每年5例。因此，我们着手评估该系统，以查明为何每年未能检测到至少5例病例。
开展了一项描述性横断面研究。该地区的所有三家医院均被有目的地选中。从19个卫生设施中随机选取了12个，并特意招募了49名卫生工作者。使用访谈员管理的问卷和关键信息提供者访谈指南收集数据。定量数据使用Epi info进行分析。
在49名受访者中，17人（34.7%）知道AFP监测的目标年龄组。12人（24.5%）知道要填写的报告表格数量。7人（14.3%）和10人（20.4%）的受访者分别知道何时对AFP病例进行随访以及何时应对AFP病例进行随访、完整报告和调查。41人（83.7%）的受访者未接受过AFP监测培训。19个（39%）诊所备有AFP报告表格，33个（67%）展示了AFP病例定义。该地区所有22个卫生设施均参与AFP监测；然而，所有设施都有难以到达的地区。据报告，17个（34.7%）根据AFP数据采取了公共卫生行动。
该系统被认为有用、简单、可接受、及时、不稳定、不具代表性且不敏感。该系统受到卫生工作者知识不足和社区主动搜索缺乏的威胁。对AFP监测进行宣传、沟通和社会动员可能会改善戈奎北区该系统的运行情况。
