Jpn. J. Infect. Dis., 57, 72-73, 2004
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Laboratory and Epidemiology Communications
Regional Distribution of Acute Flaccid Paralysis Cases in Ethiopia in 2000-2002
Berhane Beyene*, Ayele Gebremarian1,
Tilhun Teka1, Zenebe Melaku1, Bekure Tsegaye1,
Damene Alieyu2, Oyewole Femi2 and Almaz G/senbet3
National Polio Laboratory, Ethiopian Health and Nutrition Research
Institute, 1National Polio Expert
Committee, Pediatric Department, Addis Ababa University Medical
School, 2World Health Organization/EPI
and
3Disease Prevention and Control
Department, Ministry of Health of Ethiopia, Addis Ababa, Ethipia
Communicated by Hiroshi Yoshikura
(Accepted March 9, 2004)
*Corresponding author: Mailing address: National Polio Laboratory, Ethiopian Health and Nutrition Research Institute, P.O. Box 1242, Addis Ababa, Ethiopia. Fax: +251-1-757722, E-mail: Berhane12@yahoo.com
The polio eradication initiative in Ethiopia started in 1996. We examined the performance of acute flaccid paralysis (AFP) surveillance in Ethiopia by region. The criteria of good AFP surveillance are the detection of at least one AFP case per 100,000 children under 15 years of age, timely collection of stool specimens from AFP patients, and timely transport of specimens on ice to a laboratory for diagnosis.
Table 1 shows the total number of AFP cases reported by region in 2000 - 2002. All the regions satisfied the detection rate criteria in 2001 and 2002. Polio-compatible cases in most regions sharply decreased in 2001, and remained at the same level in 2002. This reflects a switch from clinical to virological case classification (1). Under the new scheme, cases with no or inadequate stool specimens, no follow-up, or with residual paralysis on 60-day follow-up, are reviewed by an Expert Group for the purpose of classification. The Expert Group classifies such cases as polio-compatible or cases to be discarded.
Table 2 shows the frequency of cases in which stool specimens were collected more than 14 days after the onset of paralysis and the frequency of residual paralysis among such cases. A large variation among regions was noted. In general, in 2002 data, stool specimens were not collected in time in 15 - 50% of the total AFP cases, and in 20 - 100% of such cases, residual paralysis developed, suggesting that in adequate stool specimen collection is a potential problem in Ethiopia.
The authors thank Mr. Tesfaye Bedada, WHO Data Manager; the officers of Disease Prevention and Control Department of Ministry of Health Surveillance; surveillance officers of WHO; and personnel from the 11 regions and 71 zones in Ethiopia who provided us with the original surveillance information.
REFERENCE
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