Okiror Samuel, Ogange John, Shukla Hemant, Lamoureau Christine, Monze Mwaka, Ismail Amina, Kazoka Anthony, Nkowane Ben, Kamadjeu Raoul, Igweonu Obianuju, Okeibunor Joseph, Nwogu Chidiadi
WHO Horn of Africa Coordination Office (HOA), Nairobi, Kenya.
World Health Organization, Kenya Country Office.
J Immunol Sci. 2021 Apr 16;Spec Issue(2):1111. doi: 10.29245/2578-3009/2021/S2.1111.
The risk for importation and reintroduction wild poliovirus in areas that have been cleared of the wild poliovirus in the Horn of Africa will remain if the surveillance systems are weak and porous.
Consequently, the Horn of Africa Polio Coordinating Office in Nairobi, together with partners conducted surveillance reviews for some of the countries in the Horn of Africa, especially Ethiopia, Kenya and Somalia to identify gaps in the polio surveillance and provided recommendations for improved surveillance. Structured questionnaires collected information about acute flaccid paralysis (AFP) surveillance resources, training, data monitoring, and supervision at provincial, district, and health facility levels. Other information collected included resource availability, management and monitoring of AFP surveillance.
The result revealed that although AFP surveillance systems were well established in these countries, a number of gaps and constraints existed. Widespread deficiencies and inefficient resource flow systems were observed and reported at all levels. There were also deficiencies related to provider knowledge, funding, training, and supervision, and were particularly evident at the health facility level. These weaknesses were corroborated with the sustained transmission of polioviruses in the region, where the surveillance systems were not sensitive enough to pick the viruses.
The review teams made useful recommendations that led to strengthening of the surveillance systems in these countries, including the formation and use of village polio volunteers in the south and central zones of Somalia, where security was heavily compromised and surveillance officers lacked regular access to the communities.
如果监测系统薄弱且漏洞百出，在非洲之角已肃清野生脊髓灰质炎病毒的地区，仍存在野生脊髓灰质炎病毒输入和重新传播的风险。
因此，位于内罗毕的非洲之角脊髓灰质炎协调办公室与合作伙伴对非洲之角的一些国家，特别是埃塞俄比亚、肯尼亚和索马里进行了监测审查，以确定脊髓灰质炎监测中的差距，并为加强监测提供建议。结构化问卷收集了省级、地区级和卫生设施级有关急性弛缓性麻痹（AFP）监测资源、培训、数据监测和监督的信息。收集的其他信息包括AFP监测的资源可用性、管理和监测。
结果显示，尽管这些国家的AFP监测系统已建立完善，但仍存在一些差距和限制。在各级都观察到并报告了广泛存在的缺陷和低效的资源流动系统。在提供者知识、资金、培训和监督方面也存在不足，在卫生设施层面尤为明显。这些弱点与该地区脊髓灰质炎病毒的持续传播相印证，在该地区监测系统对病毒的敏感度不够。
审查小组提出了有益的建议，促使这些国家加强监测系统，包括在索马里南部和中部地区组建并利用乡村脊髓灰质炎志愿者，这些地区安全严重受影响，监测人员难以定期接触社区。
