With expansion of AFP surveillance programs, in MMWR 2004;53:304--6. World Health Organization. Notification Procedure6 4. This study describes AFP surveillance in Spain from 1998 to 2015. Improving Acute Flaccid Paralysis (AFP) Surveillance Performance in South Sudan: The Contribution of Open Data Kit Mobile Data Collection Technology Abstract Background: Of all the mobile platforms used for data collection, the Open Data kit application has been the most reliable and most effective especially for polio surveillance. Administrator 9. World Health Organization. ; 2000. uuid:3b92b258-f779-4408-826e-c4ccb35c6693 determine whether paralysis is caused by poliovirus infection. <. certain countries, SMOs now search for cases of NT and other diseases in addition to cases of AFP when they visit health centers endstream The objective of AFP surveillance is to detect poliovirus wherever it may still circulate. Non-Polio Enterovirus (NPENT) detection rate. and Response Task Force. URL addresses listed in MMWR were current as of * A total of 192 member states, one WHO associate, and 21 reporting entities report to WHO. Measles laboratories also perform serologic diagnosis of yellow fever in countries in the Africa and Americas regions where yellow fever is endemic (Figure). The surveillance system monitors for all forms of AFP. is endemic has decreased from 125 in 1988 to six at the end of 2003 authorities. the original MMWR paper copy for the official text, figures, and tables. measles surveillance (i.e., as measured by the proportion of suspect cases that are tested) and the manner in which AFP strategies have been adapted for measles surveillance vary according RSS polio laboratory network (4). provided as a service to MMWR readers and do not constitute or imply the date of publication. of accredited laboratories to perform virologic testing of stool specimens to determine whether the paralysis Goal of AFP surveillance. achieving and maintaining elimination. The urgent need for such a system is underscored by ongoing efforts to restructure the International Health Regulations (IHR) (8) as a framework for containment of global public health risks. Network laboratories process stool samples from AFP cases to perform virus isolation, serotyping, intratypic differentiation, and genomic sequencing. Department of Health and Human Services. New York, NY: UNICEF, World Health Organization, United Nations Population Fund. Number of AFP cases investigated within 48 hours of detection.   |  44 (96%) countries had participated in a proficiency testing program through the National Public Health Laboratory in South Africa (7). † High-quality (i.e., certification-standard) AFP surveillance requires 1) detection of at least one case of nonpolio AFP per 100,000 population aged (1). § Consisting of WHO, UNICEF, the United Nations Foundation, the American Red Cross, the International Federation of Red Cross/Red Crescent Societies, A WHO region is certified polio-free after a period of 3 years without isolation of wild poliovirus from an AFP case, in the presence of high-quality AFP Building national AFP surveillance capacity (including investigation and documentation of AFP cases, community investigation and search for additional cases, transport of specimens to the laboratory under reverse cold chain conditions, as well as rapid data handling and linkage with laboratory results) h… These are the Non-Polio Acute Flaccid Paralysis (NP-AFP) rate and the proportion The 2003 outbreak of SARS, the threat of influenza pandemics, and the importance of early detection of and Discover everything Scribd has to offer, including books and audiobooks from major publishers. surveillance for AFP, which is an innovative approach developed to suit the exacting requirements for detecting every single poliomyelitis case, taking action and thereby eradicating polioviruses, even in areas where little health infrastructure is in place. to country resources and program goals (e.g., measles elimination Since 2000, the AFP surveillance program has been coordinated at the Victorian Infectious Diseases Reference Laboratory and is conducted in collaboration with the Australian Paediatric Surveillance Unit (APSU). surveillance†. Other Diseases. Measles laboratories have used much of the polio laboratory infrastructure; they are often housed at the same institutions and use similar systems for specimen transport, data management, communication, 53 WHO. other resources used to implement Integrated Disease Surveillance and Response (IDSR), a strategy adopted in 1998 by AFP screening alone is not effective for surveillance; Patients with chronic hepatitis B: a special population. Globally, more than two thirds of countries with AFP surveillance have used that infrastructure, or applied it as a model, for measles surveillance (Table). 30333, U.S.A. CDC. Persons using assistive technology might not be able to fully access information in this file. Harare, Zimbabwe; June 15--17, 2004. A standard case definition of a suspected case of Poliomyelitis was circulated among the medical profession in 1988 as a strategy for polio In addition, measles funds support approximately 80 international and national staff members (e.g., epidemiologists, surveillance officers, data managers, and laboratory coordinators) and fund diagnostic kits and laboratory equipment. with adequate stool specimens tested in 86% of all AFP cases (Table). The four steps of surveillance are: finding and reporting children with acute flaccid paralysis (AFP) transporting stool samples for analysis response to outbreaks of other infectious diseases highlight the need for a more comprehensive global disease detection system. In the Region of the Americas, the AFP surveillance system has been expanded or used as a model to fully implement case-based measles surveillance with laboratory confirmation of suspected cases. AFP Surveillance For the Polio Eradication program, crucial that AFP surveillance should not miss poliomyelitis cases Case definition has to catch as many cases as possible even those that are not polio: High sensitivity Low specificity All geographic areas to be covered, up to district All AFP cases investigated and polio excluded Alpha Fetoprotein (AFP): Alpha fetoprotein (AFP) is the most widely used biomarker for HCC surveillance, but this test has a sensitivity of only 47 to 64% and a specificity of 82 to 95% for detecting HCC among persons with HCV infection. 7. An AFP tumor marker test checks the level of this protein. Use of trade names and commercial sources is for identification only and does not imply endorsement by the U.S. Department of Adoption of the global polio eradication goal in 1988 required implementation of AFP surveillance in We evaluated the quality of the AFP surveillance using the WHO guidelines for minimum performance standards [19–22].Data analysis Introduction: Côte d'Ivoire's status as a polio-free country requires high quality surveillance of acute flaccid paralysis. Any child under 15 years of age with AFP* or any person of any age with paralytic illness if polio is suspected DOWNLOADS  |  1. all countries and territories, including areas affected by conflict and other obstacles. Contact GPO for current prices. <> 1600 Clifton Rd, MailStop E-90, Atlanta, GA In certain countries of the Africa Region, AFP surveillance provides a functional infrastructure, trained personnel, and AFP is defined by the acute onset of weakness or paralysis with reduced muscle tone in children. transportation, communication, and meetings), and $51 million was used to pay approximately 2,700 international and national staff members who supported and conducted AFP surveillance and vaccination activities (Table). Disclaimer During 2003, of the more than $98 million provided for AFP surveillance by Acute flaccid paralysis (AFP) surveillance is the gold standard for poliomyelitis control and prevention. MMWR SEARCH  |  and reported the results locally and to regional networks as needed. AFP surveillance systems across the world, as we’ve discussed, aren’t perfect, but in general, they’re characterized by high quality, active surveillance visits, extensive additional staff, often funded by WHO, and lab facility support, often constructed by the Polio Eradication Initiative. <15 years, 2) testing of two adequate stool specimens from at least 80% of AFP cases, and 3) testing of all specimens in WHO-accredited laboratories. AFP surveillance, or finding and reporting children with acute flaccid paralysis (AFP), is fundamental in detecting polio cases. Start Free Trial Cancel anytime. During 2003, approximately 35,000 AFP cases were reported globally, The GPEI has developed and maintained AFP surveillance as the primary means of monitoring the impact of polio eradication activities, enabling prompt poliovirus detection and outbreak response throughout the world. Our study aims to determine the prevalence of non-poliovirus enteroviruses found in the surveillance of Acute Flaccid Paralysis (AFP) in Côte d'Ivoire and to study their distribution according to individual characteristics and associated factors. Acute Flaccid Paralysis Surveillance At present, two thirds of countries with AFP systems have adapted their systems for surveillance of measles and other vaccine-preventable diseases. 7. Users should not rely on this HTML document, but are referred to the electronic PDF version and/or Save or instantly send your ready documents. 5. This approach has been instrumental in the successful interruption of endemic measles virus transmission of 42 (91%) of 46 countries had completed surveillance assessments, 35 (76%) had adopted IDSR technical guidelines, and UNICEF, World Health Organization, United Nations Population Fund. Acute flaccid paralysis (AFP) surveillance is key for global polio eradication. It is the process of detecting and investigating (including stool sample collection) of all AFP cases in children below 15 years of age. Laboratory surveillance for wild and vaccine-derived polioviruses. AFP surveillance is the intelligence network that underpins the entire eradication initiative. Acute Flaccid Paralysis or AFP is a clinical syndrome, which refers to a collection of signs and symptoms, instead of a diagnosis. Expansion of AFP surveillance systems has increased the responsibilities of SMOs in dozens of countries. It is used to demonstrate the presence or absence of poliovirus and for certification of a country as polio-free [ 9, 10 ]. References12 and hospitals. Number of polio compatible10. AFP is defined by the acute onset of weakness or paralysis with reduced muscle tone in children. As poliomyelitis is eradicated, AFP surveillance systems in these and other countries might be further expanded and adapted The most obvious way to maintain and expand existing AFP and measles <15 years with timely collection of specimens indicates that surveillance Reporting to NOCS7 5. vaccination and education. Expanded Program on Immunization (EPI) confirmation, strong international commitment and funding for control/elimination, and continued focus on using surveillance data for targeted control activities. surveillance activities, especially at the district level. genetic characterization of measles viruses. %���� Objectives of Surveillance8 6. 5. However, the extent of the Canadian International Development Agency, and CDC. For assistance, please send e-mail to: mmwrq@cdc.gov. • AFP is a notifiable disease as per GoI guidelines • AFP reporting helps Patient, Clinician & Nation • PE programme is based on quality AFP Surveillance & Your role is critical. To promote quality AFP surveillance, SMOs maintain links to clinicians and (Minimum Rate = 10%). WHO This presentation contains • Current Epidemiology • Impact & future strategy in regard to current epidemiology • What is AFP Surveillance • Why AFP Surveillance • Role of Medical Officer & DIO in AFP Surveillance • Surveillance for cases of acute flaccid paralysis (AFP) is a key strategy adopted for the eradication of polio. All MMWR HTML versions of articles are electronic conversions from ASCII text stream The WHO has devised a set of performance indicators to ensure that AFP surveillance is properly maintained. Measles. A non-Polio AFP rate of 1/100,000 should be adopted as the benchmark for adequacy of AFP surveillance in India as per Kerala data, a State, which has been free of Polio for more than three years. paralysis (AFP) cases in children aged <15 years and 2) deploy a network versus mortality reduction) (Table). A WHO-sponsored laboratory accreditation program monitors laboratory performance; in 2003, AFP surveillance in all six WHO regions met or exceeded performance standards, and 96% of Reported by: Immunization, Vaccines, and Biologicals Dept, WHO, Geneva, Switzerland. application/pdf Easily fill out PDF blank, edit, and sign them. MMWR 2004;53:990--3. The network's primary roles are serologic confirmation of suspected measles cases and External technical and funding support for AFP surveillance is provided by Wkly Epidemiol Rec partnership¶. In 2003, SMOs and polio/measles laboratory workers assisted in the detection and investigation of outbreaks of severe acute SMOs conducted field and case investigations, collected samples, shipped them to laboratories, and organized outbreak response measures in coordination with local and regional health data weekly to WHO. the Regional Committee of the WHO Regional Office for the Africa Region to strengthen all infectious disease How ever it also encompasses points that has come out of the experience of conducting AFP This report describes the status of global AFP surveillance, including its resulted from poliovirus infection. In: Proceedings of the Fifth Annual Meeting of the Integrated Disease Surveillance is sensitive enough to detect polio and allows comparison of AFP reporting completeness among and within countries (Table). 3 … BMC Public Health 2002;2:1--6. Since 2000, the AFP surveillance program has been coordinated at the Victorian Infectious Diseases Reference Laboratory and is conducted in collaboration with the Australian Paediatric Surveillance Unit (APSU). This active search identifies areas with NT cases and enables prioritizing areas for intervention through laboratories were fully accredited by WHO. Infectious Agent4 2. DISCLAIMER  |  AFP and measles surveillance systems have the potential to serve as a foundation for a global network of public Part II: Assessment of AFP Surveillance at the FACILITY level Number of times visited by province level for active surveillance in last year Approx interval between active case searches (give range in weeks or months) Has a nodal Since the 1988 World Health Assembly resolution to eradicate poliomyelitis, the number of countries where polio It allows detecting poliovirus (PV) reintroductions from endemic countries. Acute flaccid paralysis (AFP) is defined … AFP detection rate substantially increased over the years; however, the prolonged health workers strike in 2017 negatively affected key surveillance activities. Symptoms of Acute Flaccid Paralysis 3.1 What is 'acute flaccid paralysis' (AFP) surveillance? 2004;79:229--34. U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800. 3BEST PRACTICES IN ACTIVE SURVEILLANCE POLICY  |  of pages found at these sites. Div of Viral and Rickettsial Diseases, National Center for Infectious Diseases; Global Immunization Div, National Immunization Program, CDC. 58 0 obj As part of the eradication strategy, a global network GOAL OF AFP SURVEILLANCE  IDENTIFICATION OF ALL RESERVOIRS OF CIRCULATING WILD POLIO VIRUS  (THAT COULD BE POLIO) BY DOCUMENTING ALL SUCH CASES,IT IS POSSIBLE TO SHOW THAT NONE OF THESE “POLIO-LIKE” CASES WERE CAUSED BY THE POLIO VIRUS,AND THAT POLIO IS NO LONGER PRESENT OR EXISTING. In the Americas, in 2003, blood specimens were tested in 95% of suspected measles cases (Table). To date, diseases that have been successfully monitored by systems modeled after AFP and measles surveillance systems share common traits: well-defined case of syndromic presentation, relative ease of specimen collection for laboratory into HTML. Any disease eradication initiative relies on sensitive and timely surveillance. All cases identified are tested to As of the end of 2003, a total of 196 of 214 countries and territories operated AFP surveillance systems* and reported For many developed countries, the AFP surveillance system is integrated into existing disease Nitro Pro 8 (8. Countries with fewer public health resources receive external funding for polio eradication and to support a network of surveillance medical officers (SMOs). ---progress towards poliomyelitis eradication, 1995--1997, Bangladesh. Therefore, adding the two biomarkers to a regular surveillance program such as AFP and ultrasound can help physicians identify HCC tumors earlier in at risk patients. and reporting of results. AFP-L3 and DCP can alert about early development of HCC before it can be detected by imaging modalities and is useful for identifying patients at risk for HCC [7-11]. Nsubuga P, McDonnell S, Perkins B, et al. Progress towards global eradication of (5). Featherstone D, Brown D, Sanders R. Development of the Global Measles Laboratory Network. of diseases that are prone to epidemics. The mean Non-Polio (NP-AFP) rate during the … Clinical Features10 8. The WHO, in order to achieve eradication, recommended that countries conduct surveillance for cases of AFP which allows new cases to be identified where none had been before and can detect importations of wild polioviruses (WPVs). neonatal deaths (6); however, current reporting captures <5% of NT cases. Active surveillance (with visits to health facilities) is a critical strategy of AFP surveillance systems for highly sensitive and timely detection of cases. poliomyelitis, 2003 and January--April 2004. Most network laboratories routinely test measles-negative sera for rubella and processed approximately 65,000 serum specimens from suspected measles cases in 2003 (Table). As of June 2004, a total surveillance systems. 3) The quality of 3) Such surveillance is especially challenging for polio eradication, because only one of every 200 poliovirus infections results in clinically apparent paralytic disease. Health and Human Services.References to non-CDC sites on the Internet are AFP surveillance programs [18, 24]. The Integrated Disease Surveillance and Response (IDSR) framework makes surveillance and laboratory data more usable, helping public health managers and decision-makers improve detection and response to the leading causes of coalition§. An original paper copy of this issue can be obtained from the Superintendent of Documents, Wkly Epidemiol Rec 1998;73:19--24. Management11 9. the informal health sector (e.g., traditional healers, communities, and community informants). Measles program activities, including surveillance, have been supported by the Measles Initiative, which is supported by an international In 57 countries, neonatal tetanus (NT) is a major public health problem, causing 14% of all Only 18 member states do not report AFP cases to WHO: Canada, Comoros, Denmark, Finland, France, Iceland, Japan, Luxembourg, Mauritius, Monaco, Netherlands, Reunion, San Marino, Saint Helena, Seychelles, Sweden, United Kingdom, and United States. Complete (AFP) Surveillance Form online with US Legal Forms. Progress toward measles elimination---Region of the Americas. 37. surveillance system was established to 1) identify acute flaccid reporting systems is to phase in reporting of other diseases that support integration of surveillance activities. ACCESSIBILITY, Morbidity and Mortality Weekly Report the partnership, $47 million was used for surveillance activity costs (e.g., operation of the laboratory network, 2019-06-28T08:17:10Z World Health Organization, Regional Office for Africa. Three of the six WHO regions have been certified as polio-free. Much more than documents. respiratory syndrome (SARS), cholera, dengue, Rift Valley fever, shigellosis, hemorrhagic fevers, meningitis, and malaria. To ensure that paralytic polio cases will be detected if they occur, countries conduct surveillance for all AFP by using a standard case definition. 1 Acknowledgement This national AFP surveillance guide line is adopted basically from the AFRO surveillance field guideline. Purpose of AFP surveillance AFP surveillance helps to detect reliably areas where poliovirus transmission is occurring. Polio eradication initiative in Africa: influence on other infectious disease surveillance development. Maternal and neonatal tetanus elimination by 2005: strategies for It is the Nitro Pro 8 (8. more nonpolio AFP cases per 100,000 population aged As incidence of measles has declined to low levels, countries have shifted AFP is the manifestation of a wide spectrum of clinical diseases and is not nationally notifiable in the United States. specialized laboratories (Figure) (3). 3.2. World Health Organization (WHO) targets for acute flaccid paralysis (AFP) surveillance, including the notification of a minimum rate of AFP among children, are used to assess the adequacy of AFP surveillance for the detection of poliovirus infection. 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