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ISDS 2016 Conference Abstracts

Acute Flaccid Paralysis Surveillance system 
Evaluation, Oyo state, Nigeria; 2008-2014
Maureen O. Anyanwu*
Epidemiology and Medical statistics, Nigeria Field Epidemiology and Laboratory Training Programme/University of Ibadan,  
Ibadan/Abuja, Nigeria

Objective
We evaluated the AFP surveillance system in Oyo State to assess 

its attributes and determine if it was meeting its set objectives.

Introduction
In September, 2015, Nigeria was delisted from the list of polio 

endemic countries globally. To be certified polio free, the country 
must attain and maintain certification standard Acute Flaccid Paralysis 
(AFP) surveillance for additional two-years. In Oyo State, no case of 
Wild Polio Virus (WPV) has been reported since February, 2009.

Methods
We used the Centre for Disease Control and Prevention updated 

guidelines for evaluating public health surveillance system.  
We conducted a retrospective review of AFP surveillance data 
between 1st January, 2008 and 31st December, 2014. We conducted 
in-depth interviews with identified stakeholders. Semi-structured 
questionnaires were administered to Disease Surveillance and 
Notification Officers (DSNOs) and AFP focal persons. Univariate 
analysis was performed by calculating frequencies, means and 
proportions using Microsoft Excel 2010.

Results
The case definition of AFP and the tools for reporting are simple. 

Of the 897 AFP cases detected during the period under review  
(2008-2014), 20 (2.2%) were laboratory confirmed WPV. The 
sensitivity of the system between 2008 and 2014 measured by the 
Annualized Non-Polio AFP (NPAFP) rate was consistently above 
the target. of ≥ 2/100,000 population (Mean=3.96, Standard deviation 
(SD): 0.48). The mean NPAFP rate for underperforming LGAs during 
the review period was 1.6, SD: 0.31. The mean Stool adequacy and 
Timeliness were 91.43% (SD: 18.3) and 91.3% (SD: 20.3) above 
the target of ≥ 80% respectively. The mean Data quality was 90% 
(target is ≥ 90; SD: 3.8). Positive Predictive Value (PVP) was 2%  
(2008 -2009), and 0% in 2010-2014.

Conclusions
The Oyo State AFP surveillance system is simple, flexible, 

sensitive and meeting its set objectives. However, PVP was low and 
the system’s operating conditions are not stable. All the LGAs, at one 
point during the period under review did not meet the NPAFP and 
NPENT rates. We recommended that more logistic support should 
be provided for non-performing LGAs to improve case reporting, 
investigation, and response. DSNOs should be re -sensitized on 
reverse cold chain, so as to improve the NPENT rate

Keywords
Surveillance; Evaluation; Wild polio virus; Nigeria

Acknowledgments
Nigeria Field Epidemiology and laboratory Training Programme
African Field Epidemiology Network
Centre for Disease Control, Atlanta, USA
Oyo State Ministry of Health

*Maureen O. Anyanwu
E-mail: maureenanyanwu23@yahoo.com

Online Journal of Public Health Informatics * ISSN 1947-2579 * http://ojphi.org * 9(1):e92, 2017