Key result
The AFP surveillance system in Yemen met most WHO performance targets from 2010 to 2015, consistently achieving a nonpolio AFP detection rate of >2 cases per 100,000 children under 15 years of age.
Why the study?
Acute flaccid paralysis surveillance is essential for poliovirus eradication, prompting an evaluation of Yemen's surveillance system performance from 2010 to 2015 to identify components requiring strengthening.
Observational (n=3,019)
Yes
The AFP surveillance system in Yemen generally met WHO performance standards between 2010 and 2015, though logistical challenges caused delays in specimen transport and laboratory reporting.
Surveillance gaps in Yemen warrant targeted strengthening; leaves open whether improvements can sustain eradication amid ongoing conflict.
BACKGROUND: Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus eradication. OBJECTIVE: This study aimed to evaluate the performance of the AFP surveillance system in Yemen from 2010 to 2015, identify components that require strengthening, and compare the indicators by year and governorates. METHODS: This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The World Health Organization (WHO) minimum performance standards were used to evaluate the performance of the AFP surveillance system. RESULTS: A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for the nonpolio AFP rate of cases per 100,000 members of the population younger than 15 years of age, proportion of AFP cases reported within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which nonpolio enterovirus was isolated. However, the proportion of specimens that arrived at the central level within 3 days of the first sample collection and the proportion of stool specimens with results sent from the reference laboratory within 28 days of receipt did not reach targets in 2011 and 2015, respectively. CONCLUSIONS: The AFP surveillance system in Yemen has met most of the WHO indicator levels. Nevertheless, the evaluation showed areas of weakness regarding the arrival of specimens at the central level within 3 days of the first sample collection and delays in processing of the results and submitting feedback by the laboratory. Therefore, there is a need to strengthen the follow-up of specimens submitted to the laboratory.
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Almoayed et al. (2019) conducted an observational in Acute flaccid paralysis (n=3,019). Acute Flaccid Paralysis Surveillance System vs. WHO minimum performance standards was evaluated on Performance indicators of the AFP surveillance system (e.g., nonpolio AFP detection rate). The AFP surveillance system in Yemen met most WHO performance targets from 2010 to 2015, consistently achieving a nonpolio AFP detection rate of >2 cases per 100,000 children under 15 years of age.
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