ABSTRACT
Main objective of the study is to highlight the major cause of AFP and% of GBS represents the AFP during the study period. Retrospective analytical study. This study was conducted in AJK, for the duration of three years from January 2011 to December 2013. Retrospective analysis of AFP cases reported during 2011-2013. Primarily the AFP cases investigated through history and clinical examination. Principal cause of AFP [Acute flaccid Paralysis] cases were investigated through specific tests like serum electrolytes, CSF [cerebrospinal fluid], electromyogram and viral culture from stool sample to exclude poliovirus. All the cases reported from AJK and taken on the line list labeling as GBS were included in the study during 2011-2013. Three years data analysis shows more than 50% GBS cases presenting AFP and the numbers are increasing every year. Most of the GBS and even AFP belong to 6-59 months age group. More than 55% GBS cases recover completely and this proportion increased from 2011-2013. Data analysis revealed GBS is a major cause of AFP in AJK and needs not to be overlooked to keep poliovirus transmission ceased here. AFP surveillance system is huge resource and this is a high time to study all the causes responsible for acute flaccid paralysis to strengthen polio eradication efforts and to develop understanding for prevention and control, to avoid acute flaccid paralysis related morbidity and mortality amongst children in Pakistan
ABSTRACT
Main objective of the study is to analyse sensitivity of the surveillance system, required to keep poliovirus circulation ceased in AJK. Retrospective analysis of AFP cases reported during the study period. This study included all the AFP cases reported during the study period in AJK from Jan. 2011 to Dec. 2013. Historical data is used to analyse AFP surveillance for detecting poliovirus infection in children age <15 years in the study area based on few assumptions that all the results are negative and adequate information were available to make ultimate diagnosis of each AFP case reported in the area during study period. Surveillance sensitivity analysed using AFP surveillance criteria recommended by WHO and variable used in AFP surveillance system. Surveillance sensitivity is analysed based on two indicators "non polio AFP rate" and stool adequacy. Sensitivity level analysed in AFP cases aged 6-59 months for >/= 7 OPV doses including routine and SIAs revealed 6/10 districts have high sensitivity. Long absence of Polio virus in the area, creeping up of boredom among health human resource, Clinician's failure to notify all AFP cases resulting in down going Surveillance sensitivity