@article{Ibrahim_Ningi_Saleh_2017, title={Performance of Acute Flaccid Paralysis surveillance in Bauchi State, Nigeria, 2016}, volume={9}, url={https://ojphi.org/ojs/index.php/ojphi/article/view/7780}, DOI={10.5210/ojphi.v9i1.7780}, abstractNote={<div style="left: 79.8182px; top: 284.47px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08117);" data-canvas-width="56.563006734006734">Objective</div><div style="left: 93.1212px; top: 297.73px; font-size: 12.564px; font-family: serif; transform: scaleX(0.997842);" data-canvas-width="335.4744139730638">To identify and address gaps in acute flaccid surveillance for polio</div><div style="left: 79.8182px; top: 312.511px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00142);" data-canvas-width="128.06457744107746">eradication in Buchi state</div><div style="left: 79.8182px; top: 340.639px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.11744);" data-canvas-width="73.28565488215487">Introduction</div><div style="left: 93.1212px; top: 353.898px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04678);" data-canvas-width="328.93360959595947">Poliomyelitis a disease targeted for eradication since 1988</div><div style="left: 421.928px; top: 354.231px; font-size: 7.53838px; font-family: serif;">1</div><div style="left: 79.8182px; top: 368.68px; font-size: 12.564px; font-family: serif; transform: scaleX(0.972859);" data-canvas-width="350.35895286195296">still pose public health challenge. The Eastern Mediterranean and</div><div style="left: 79.8182px; top: 383.461px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04289);" data-canvas-width="349.9606749158245">African Regions out of the six World Health Organization (WHO)</div><div style="left: 79.8182px; top: 398.242px; font-size: 12.564px; font-family: serif; transform: scaleX(0.955681);" data-canvas-width="213.97702525252527">Regions are yet to be certified polio free</div><div style="left: 293.667px; top: 398.574px; font-size: 7.53838px; font-family: serif;">2</div><div style="left: 297.488px; top: 398.242px; font-size: 12.564px; font-family: serif; transform: scaleX(0.948255);" data-canvas-width="132.59765892255888">. The certification of the</div><div style="left: 79.8182px; top: 413.023px; font-size: 12.564px; font-family: serif; transform: scaleX(0.997468);" data-canvas-width="348.89776279461273">WHO Africa region is largely dependent on Nigeria, while the WHO</div><div style="left: 79.8182px; top: 427.804px; font-size: 12.564px; font-family: serif; transform: scaleX(0.976841);" data-canvas-width="350.4092087542087">Eastern Mediterranean is dependent on Pakistan and Afghanistan.</div><div style="left: 79.8182px; top: 442.585px; font-size: 12.564px; font-family: serif; transform: scaleX(1.04404);" data-canvas-width="349.77095892255886">Surveillance for acute flaccid paralysis (AFP) is one of the critical</div><div style="left: 79.8182px; top: 457.366px; font-size: 12.564px; font-family: serif; transform: scaleX(0.961217);" data-canvas-width="350.28356902356916">elements of the polio eradication initiative. It provides the needed</div><div style="left: 79.8182px; top: 472.148px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03041);" data-canvas-width="349.8400607744101">information to alert health managers and clinician to timely initiate</div><div style="left: 79.8182px; top: 486.929px; font-size: 12.564px; font-family: serif; transform: scaleX(0.991466);" data-canvas-width="348.7482515151515">actions to interrupt transmission of the polio disease and evidence for</div><div style="left: 79.8182px; top: 501.71px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00374);" data-canvas-width="176.79269057239054">the absence of the wild polio virus.</div><div style="left: 256.598px; top: 502.042px; font-size: 7.53838px; font-family: serif; transform: scaleX(1.00067);" data-canvas-width="9.422979797979798">3,4</div><div style="left: 266.021px; top: 501.71px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00482);" data-canvas-width="162.93085909090908">One of the core assignments of</div><div style="left: 79.8182px; top: 516.491px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01029);" data-canvas-width="349.2897587542087">the certification committee in all regions is to review documentation</div><div style="left: 79.8182px; top: 531.272px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03833);" data-canvas-width="227.80995959595958">to verify the absence of wild poliovirus.</div><div style="left: 307.531px; top: 531.604px; font-size: 7.53838px; font-family: serif;">5</div><div style="left: 311.44px; top: 531.272px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02891);" data-canvas-width="120.5877570707071">Good and complete</div><div style="left: 79.8182px; top: 546.053px; font-size: 12.564px; font-family: serif; transform: scaleX(0.949907);" data-canvas-width="349.86644511784505">documentation is the proxy indication of the quality of the system</div><div style="left: 79.8182px; top: 560.834px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02053);" data-canvas-width="349.7860356902356">while poor documentation translates to possibilities of missing wild</div><div style="left: 79.8182px; top: 575.616px; font-size: 12.564px; font-family: serif; transform: scaleX(0.971616);" data-canvas-width="350.46197744107735">poliovirus in the past. We evaluated the performance of the AFP</div><div style="left: 79.8182px; top: 590.397px; font-size: 12.564px; font-family: serif; transform: scaleX(0.978685);" data-canvas-width="348.640201346801">surveillance system in Bauchi, which is among the 11 high risks states</div><div style="left: 79.8182px; top: 605.178px; font-size: 12.564px; font-family: serif; transform: scaleX(0.946351);" data-canvas-width="349.99208484848504">for wild polio virus in Nigeria to identify and address gaps in the</div><div style="left: 79.8182px; top: 619.959px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00141);" data-canvas-width="101.89382154882153">surveillance system.</div><div style="left: 79.8182px; top: 648.086px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.0727);" data-canvas-width="51.65049326599326">Methods</div><div style="left: 93.1212px; top: 661.346px; font-size: 12.564px; font-family: serif; transform: scaleX(0.988297);" data-canvas-width="335.26333922558905">We conducted a cross-sectional study in Bauchi State. We assessed</div><div style="left: 79.8182px; top: 676.127px; font-size: 12.564px; font-family: serif; transform: scaleX(0.959138);" data-canvas-width="348.07105336700334">the material and documentations on AFP surveillance in eighteen of the</div><div style="left: 79.8182px; top: 690.908px; font-size: 12.564px; font-family: serif; transform: scaleX(0.983013);" data-canvas-width="348.51079242424237">twenty Local Government Areas (LGAs). We assessed the knowledge</div><div style="left: 79.8182px; top: 705.69px; font-size: 12.564px; font-family: serif; transform: scaleX(0.996339);" data-canvas-width="348.7683538720537">of the clinician at focal and non-focal sites on case definition of AFP,</div><div style="left: 79.8182px; top: 720.471px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01134);" data-canvas-width="349.38273215488215">the number and method of stool specimen collection to investigate a</div><div style="left: 79.8182px; top: 735.252px; font-size: 12.564px; font-family: serif; transform: scaleX(0.999735);" data-canvas-width="348.8575580808081">case and types of training received for AFP surveillance. We verified</div><div style="left: 79.8182px; top: 750.033px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00069);" data-canvas-width="351.05876616161623">AFP case investigations for the last three years: The caregivers</div><div style="left: 79.8182px; top: 764.814px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01537);" data-canvas-width="349.6428063973064">(mothers) were interviewed to authenticate the reported information</div><div style="left: 79.8182px; top: 779.595px; font-size: 12.564px; font-family: serif; transform: scaleX(0.967591);" data-canvas-width="350.62279629629614">of AFP cases, the method used for stool specimen collection and</div><div style="left: 79.8182px; top: 794.376px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00021);" data-canvas-width="348.98947979797987">feedbacks. Community leaders’ knowledge on AFP surveillance was</div><div style="left: 79.8182px; top: 809.158px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00101);" data-canvas-width="338.4231784511783">also assessed. Data was entered and analyzed in excel spread sheet.</div><div style="left: 79.8182px; top: 837.285px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.08437);" data-canvas-width="45.38107070707071">Results</div><div style="left: 93.1212px; top: 850.545px; font-size: 12.564px; font-family: serif; transform: scaleX(0.969016);" data-canvas-width="337.36277912457894">Review of the expected deliverables of 18 out of the 20 LGA</div><div style="left: 79.8182px; top: 865.326px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03296);" data-canvas-width="349.94811094276076">disease surveillance and notification officers (DSNO) revealed that</div><div style="left: 79.8182px; top: 880.107px; font-size: 12.564px; font-family: serif; transform: scaleX(0.977567);" data-canvas-width="350.84894781144806">only 2(11%), 5(28%), 6(33%) and 7(39%) had evidence of polio</div><div style="left: 79.8182px; top: 894.888px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02192);" data-canvas-width="349.837547979798">outbreak investigation, supervisory reports, minutes of meeting and</div><div style="left: 79.8182px; top: 909.669px; font-size: 12.564px; font-family: serif; transform: scaleX(0.977289);" data-canvas-width="348.7130723905722">surveillance work plan respectively. Of the 31 AFP cases investigated,</div><div style="left: 79.8182px; top: 924.451px; font-size: 12.564px; font-family: serif; transform: scaleX(0.955701);" data-canvas-width="350.2961329966331">correct and complete information was 39% for birth day, 26% for</div><div style="left: 79.8182px; top: 939.232px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01044);" data-canvas-width="349.29352794612794">birth month of the child, 23% for date of onset of paralysis and 23%</div><div style="left: 79.8182px; top: 954.013px; font-size: 12.564px; font-family: serif; transform: scaleX(0.958202);" data-canvas-width="350.318748148148">for date of investigation. Contacts of informants, AFP 001-3 were</div><div style="left: 79.8182px; top: 968.794px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02811);" data-canvas-width="349.79859966329957">deficient in the focal and non-focal sites. The non-focal also lacked</div><div style="left: 79.8182px; top: 983.575px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0379);" data-canvas-width="350.170493265993">guidelines for integrated disease surveillance and response (IDSR)</div><div style="left: 79.8182px; top: 998.356px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00095);" data-canvas-width="262.3483215488215">and terms of reference for surveillance focal person.</div><div style="left: 93.1212px; top: 1013.14px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0385);" data-canvas-width="336.4380707070709">Knowledge of case definition of AFP was 71% and 30% among</div><div style="left: 79.8182px; top: 1027.92px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03262);" data-canvas-width="349.8501119528615">clinician at the focal and non-focal sites, respectively and 88% and</div><div style="left: 79.8182px; top: 1042.7px; font-size: 12.564px; font-family: serif; transform: scaleX(0.99718);" data-canvas-width="345.9050244107743">55% for method of stool collection among clinician at focal and non-</div><div style="left: 79.8182px; top: 1057.48px; font-size: 12.564px; font-family: serif; transform: scaleX(0.983827);" data-canvas-width="348.5371767676768">focal sites. Among the 38 care givers (mothers) interviewed 16 (42%)</div><div style="left: 79.8182px; top: 1072.26px; font-size: 12.564px; font-family: serif; transform: scaleX(0.952869);" data-canvas-width="350.4016703703703">did not remember the day or month the investigation for the AFP</div><div style="left: 452.303px; top: 282.949px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02849);" data-canvas-width="349.94434175084183">was conducted, 36(95%) gave the correct number of stool samples,</div><div style="left: 452.303px; top: 297.73px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03663);" data-canvas-width="349.8450863636364">15(40%) mentioned that the stool samples were collected 24 hours</div><div style="left: 452.303px; top: 312.511px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02579);" data-canvas-width="349.79357407407394">apart and only 12 (32%) received feedbacks. Majority (79%) of the</div><div style="left: 452.303px; top: 327.292px; font-size: 12.564px; font-family: serif; transform: scaleX(0.953832);" data-canvas-width="349.9292649831649">community leaders interviewed were aware of AFP and knew that</div><div style="left: 452.303px; top: 342.073px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00605);" data-canvas-width="349.18296498316505">stool was the specimen for investigation of the AFP but 21% did not</div><div style="left: 452.303px; top: 356.855px; font-size: 12.564px; font-family: serif; transform: scaleX(1.0006);" data-canvas-width="281.2696649831649">know whom to report a case of AFP in their community</div><div style="left: 452.303px; top: 384.982px; font-size: 12.564px; font-family: sans-serif; transform: scaleX(1.10256);" data-canvas-width="75.39640235690236">Conclusions</div><div style="left: 465.606px; top: 398.242px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03189);" data-canvas-width="336.3802764309764">Our study revealed knowledge and documentations gaps in AFP</div><div style="left: 452.303px; top: 413.023px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01942);" data-canvas-width="351.53117154882136">surveillance for certification of polio-free in Nigeria. The state</div><div style="left: 452.303px; top: 427.804px; font-size: 12.564px; font-family: serif; transform: scaleX(1.01569);" data-canvas-width="349.51716666666664">ministry of health and the WHO consultants in the polio eradication</div><div style="left: 452.303px; top: 442.585px; font-size: 12.564px; font-family: serif; transform: scaleX(1.03873);" data-canvas-width="349.87900909090916">unit should update the knowledge of the health care workers at the</div><div style="left: 452.303px; top: 457.366px; font-size: 12.564px; font-family: serif; transform: scaleX(1.02283);" data-canvas-width="349.7910612794612">operational levels on AFP surveillance. The state ministry of health</div><div style="left: 452.303px; top: 472.148px; font-size: 12.564px; font-family: serif; transform: scaleX(0.985517);" data-canvas-width="348.363793939394">and the WHO consultants should also provide all essential documents</div><div style="left: 452.303px; top: 486.929px; font-size: 12.564px; font-family: serif; transform: scaleX(1.00105);" data-canvas-width="343.36081986531974">required for quality AFP surveillance and ensure their judicious use.</div>}, number={1}, journal={Online Journal of Public Health Informatics}, author={Ibrahim, Luka M. and Ningi, Adamu and Saleh, Jalal-Eddeen}, year={2017}, month={May} }