Progress towards eradication of poliomyelitis in Ghana: A review of the Eastern Region of Ghana from 1997 to 2010

Poliomyelitis is a highly-infectious viral disease affecting children under 15 years. One in 200 infections leads to irreversible paralysis and in 5 to 10% of such case, patients die from paralyzed breathing muscles. Ghana is at the verge of polio certification and the only reported case of wild polio virus in the Eastern Region was in 2003. We reviewed AFP data in the Eastern-Region to assess the progress towards interruption of polio virus transmission and identified opportunities for surveillance improvement. We reviewed records and conducted secondary data analysis of all AFP cases reported to the Region from 1997 to 2010. We assessed data quality, calculated AFP surveillance indicators, and described AFP cases by person, place, time and polio vaccination status. Completeness of case-based-forms was 90%. Of 306 AFP-cases reported, one wild polio virus was recorded; 59.2% were males aged < 5 years; 26.5% had right lower limb paralysis; 14% occurred in October and 52.6% had received 4 doses of oral polio-vaccine. The non-polio AFP rate ranged from 0.12 to 4.3/100,000 population and stool adequacy from 60 to 100%. The period prevalence of non-polio entero-viruses was 8.5% (26/306). There is sustained progress towards interruption of polio virus transmission in the region. However, opportunity remains to improve the completeness of case-based forms and the non-polio AFP rate.