Citation: Saravoye T, Nyandoro M, Bangure D, Gombe NT and Tshimanga M. An Evaluation of the Acute Flaccid
Paralysis (AFP) Surveillance System in Zvimba District, Mashonaland West Province; a Descriptive Cross
Sectional Study. Austin J Public Health Epidemiol. 2015;2(1): 1017.
Austin J Public Health Epidemiol - Volume 2 Issue 1 - 2015
ISSN : 2381-9014 | www.austinpublishinggroup.com
Bangure et al. © All rights are reserved
Austin Journal of Public Health and
Epidemiology
Open Access
Abstract
Background: In 2013, Zvimba district investigated 7 cases of AFP. Among
the seven cases investigated, three had stool specimens collected more than
21 days after the onset of symptoms against a target of within 14 days. Only
one of the seven cases had physical examination after 60 days from onset of
symptoms. We therefore carried out this study to evaluate the AFP surveillance
system in Zvimba district, Mashonaland West Province, Zimbabwe.
Methods: A descriptive cross sectional study was conducted at 36 health
facilities in Zvimba District, Zimbabwe. Structured questionnaires, checklist and
AFP notiication forms were used to collect data. Permission to proceed was
sought and granted from the Mashonaland West Provincial Medical Director,
Zvimba District Medical Oficer and the Zimbabwe Health Studies Ofice.
Results: Eighty-ive percent of respondents were nurses. The median years
in service was 7 years (Q
1
=4; Q
3
=10). Knowledge was good (83%). Ninety-six
percent were willing to participate in the surveillance. Twenty four percent had
ever completed an AFP form and eighty one percent reported that completion
of the form was simple. All the 36 health centres in the district were accessible
by road and had a cell phone and a working network reception. No form had
laboratory results. Ninety nine percent perceived the AFP surveillance system
as useful and 82% used data at local level.
Conclusion: knowledge of health workers was good. The AFP surveillance
system was useful, simple, stable, sensitive and representative. However the
system was not timely. Completeness of data on the notiication forms was also
poor. Follow up physical examination on AFP cases was not done.
Keywords: Acute laccid paralysis, Polio, Surveillance, Zvimba district,
Zimbabwe
in the presence of certiication standard surveillance. In addition, all
facilities holding wild poliovirus infectious and potentially infectious
materials must have implemented bio-containment measures
according to the Global action plan for laboratory containment of
wild poliovirus [2].
Out of the six WHO regions, four regions have so far been
certiied polio free, with two regions yet to be certiied polio free.
he certiied regions are: WHO Region of the Americas (1994); the
Western Paciic Region (2000); the WHO European Region (2002)
and the WHO South-East Asia Region (2014). he WHO Eastern
Mediterranean and the WHO African Regions are yet to be certiied
as free from polio [3].
Disease surveillance is the ongoing systematic collection, analysis,
interpretation and dissemination of data regarding a health-related
event for use in public health action to reduce morbidity and mortality
and to improve health [4].
he quality of AFP surveillance is measured by using a standard
deinition for sensitivity and completeness, as follows: a rate of one
or more non-polio AFP cases per 100,000 population aged 15 years
Introduction
Poliomyelitis is an infectious disease caused by the polio virus
which afects mostly young children below iteen years of age.
he natural or wild polio infects human beings only. he virus is
contracted through faecal-oral route. he incubation period for
poliomyelitis is seven to fourteen days. Symptoms of polio infection
include fever, headache, stif neck, muscle pain, nausea, vomiting and
diarrhoea [1,2].
About one per 200 of infected people develop some degree of
paralysis which is sudden and rapid and oten reach full development
within a few hours but usually within three days. Guillain-Barre
Syndrome and acute transverse myelitis are common diferential
diagnosis of poliomyelitis [3]. his is the reason why it is necessary to
investigate all cases of Acute Flaccid Paralysis for polio. he deinite
diagnosis for polio is isolation of the poliovirus from patient’s stools
[1,2,3].
Polio is targeted for eradication. A region can consider
certiication when all countries in the region demonstrate the absence
of wild poliovirus transmission for at least three consecutive years
Review Article
An Evaluation of the Acute Flaccid Paralysis (AFP)
Surveillance System in Zvimba District, Mashonaland
West Province; a Descriptive Cross Sectional Study
Tapera Saravoye
1
, Margret Nyandoro
2
, Donewell
Bangure
1
*, Notion Tafara Gombe
1
and Mufuta
Tshimanga
1
1
Department of Community Medicine, University of
Zimbabwe, Zimbabwe.
2
Department of Family Health, Ministry of Health and
Child Care, Zimbabwe
*Corresponding author: Donewell Bangure,
Department of Community Medicine, University of
Zimbabwe, P.O. Box A178, Avondale, Harare, Zimbabwe,
Email: bangured@yahoo.com
Received: March 10, 2015; Accepted: April 15, 2015;
Published: April 20, 2015