RESUMO
Objective: The surveillance of acute flaccid paralysis [AFP] is a key strategy for monitoring the progress of poliomyelitis eradication and is a sensitive measure for detecting potential cases of poliomyelitis and poliovirus infection. This study was conducted to describe the characteristics of patients reported with AFP, and to evaluate the performance of the surveillance system in Kurdistan province, western Iran, using indicators recommended by the World Health Organization [WHO]
Methods: This observational study was conducted from January 2000 to December 2010 at the Kurdistan Center for Disease Control and the Department of Pediatrics. All children who fulfilled the WHO definition for AFP were included in our study. The stool samples of all the children were sent for poliovirus isolation. All the patients were evaluated for 60 days after the onset of symptoms to identify the signs of residual weakness
Findings: One-hundred thirty nine children aged <15 years were reported to the Center for Diseases Control with AFP. In 138 [99%] stool samples no poliovirus was isolated. None of the patients was diagnosed as having acute poliomyelitis or polio-compatible paralysis. Guillain-Barre syndrome was the most frequent final diagnosis [79 cases] followed by Transverse Myelitis [7 cases] and Encephalitis [6 cases]. By detecting 1.3 to 3.6 [mean 3.2] AFP cases per 100 000 population in Kurdistan during the study period, we achieved the WHO target for AFP surveillance. All performance indicators but one consistently met the WHO requirements and therefore demonstrated the effectiveness of the AFP surveillance program in Kurdistan
Conclusion: The effective surveillance system in Kurdistan and its evaluation may serve as a model for the surveillance of other infectious diseases
RESUMO
We studied the safety of a trivalent inactivated surface antigen [split virion, inactivated] influenza vaccine, Begrivac[registered sign] [Novartis Company], widely used in health care workers in Kurdistan. A longitudinal follow-up study was performed in Sanandaj city, west of Iran, recruiting 936 people. A questionnaire was completed for each participant, and all symptoms or abnormal physical findings were recorded. In part 1 of the study, the post-vaccination complaints were headache [5.3%], fever [7.9%], weakness [9.6%], chills [10.1%], sweating [10.5%], arthralgia [20.2%], and malaise [21.5%]. Swelling of the injection site was seen in 267 [30.3%] participants, and pruritus of the injection site was seen in 290 [32.9%] participants. Redness and induration were also reported in 42.5% of the participants. Local reactions were mainly mild and lasted for 1-2 days. No systemic reactions were reported in the second part of the study. None of the participants experienced any inconvenience. We concluded that local adverse reactions after the trivalent inactivated split influenza vaccine, Begrivac[registered sign], in health care workers were far more common than expected. Continuous surveillance is needed to assess the potential risks and benefits of newly produced influenza vaccines