Wassie Eshetu, Ademe Ayesheshem, Gallagher Kathleen, Braka Fiona, Beyene Berhane, Woyessa Abyot Bekele, Jima Daddi
World Health Organization, Ethiopia Country Office.
World Health Organization, Nigeria Country Office.
Pan Afr Med J. 2017 Jun 9;27(Suppl 2):8. doi: 10.11604/pamj.supp.2017.27.2.10731. eCollection 2017.
The World Health Organization acute flaccid paralysis (AFP) surveillance standards recommend documentation of the role of each potentially reporting site for evidence -based planning and tailoring support for active surveillance visits. This study assessed the contribution of various sites as source and quality of AFP cases reported over a five -year period in Ethiopia.
We conducted a retrospective analysis of AFP surveillance data collected from 2010-2014 in Ethiopia. Analyses were done using EPI-INFO version 7 for calculating frequencies and proportions, and testing possible associations between reporting sites and key dependent variables.
Of the 5,274 AFP cases reported, hospitals and health centers reported 4627 (88%) of the cases. Hospitals in Addis Ababa (53%) and health posts in Benishangul Gumuz (48%) regions have contributed majority of the cases reported. Only 3% of cases were reported by private clinics nationally. The stool adequacy rate for health posts (81%) was lower than the overall national rate of 88% .Cases from health posts are more likely to be reported after 14 days of onset of paralysis, and 62% less likely to be investigated within two days of notification(OR: 1.82, 95% CI OR : 1.41-2.36, p-value <0.0001). Greater proportion (2.4%) of cases reported from health posts were either compatible, VDPV or WPV compared to cases reported by health centers (1.14%) or hospitals (1.4%).
Though majority of the cases were reported by health centers followed by hospitals ,our findings suggest that all potentially reporting sites should be exhaustively identified, prioritized and regularly supported for quality case detection, investigation and reporting.
世界卫生组织急性弛缓性麻痹（AFP）监测标准建议记录每个潜在报告地点的作用，以便进行循证规划并为主动监测访视量身定制支持措施。本研究评估了埃塞俄比亚五年期间各地点作为AFP病例来源和报告质量的贡献。
我们对2010 - 2014年在埃塞俄比亚收集的AFP监测数据进行了回顾性分析。使用EPI-INFO 7版进行分析，以计算频率和比例，并检验报告地点与关键因变量之间可能的关联。
在报告的5274例AFP病例中，医院和卫生中心报告了4627例（88%）。亚的斯亚贝巴的医院（53%）和本尚古勒-古穆兹地区的卫生站（48%）贡献了大部分报告病例。全国私人诊所仅报告了3%的病例。卫生站的粪便充足率（81%）低于全国总体率88%。来自卫生站的病例更有可能在麻痹发作14天后报告，且在通知后两天内接受调查的可能性低62%（比值比：1.82，95%置信区间比值比：1.41 - 2.36，p值<0.0001）。与卫生中心（1.14%）或医院（1.4%）报告的病例相比，卫生站报告的病例中更大比例（2.4%）为可能病例、VDPV或WPV。
尽管大多数病例由卫生中心报告，其次是医院，但我们的研究结果表明，应全面识别所有潜在报告地点，确定其优先级并定期提供支持，以进行高质量的病例检测、调查和报告。
