Eradication of Poliomyelitis in Ethiopia: Virological and Acute Flaccid Paralysis Surveillance

*Corresponding author: Fax: +251-1-774722, E-mail: Berhane12 @yahoo.com In Ethiopia, as in other Third World countries, poliomyelitis is a major public health problem affecting mainly preschool children (1). A study conducted at a major pediatric hospital in Addis Ababa demonstrated an increase in new cases between 1971 and 1981. Eighty-nine percent of the cases with residual paralysis were 2-year-old children. There was no seasonal variation. A study in 1979 involving over a quarter of a million school age children in Addis Ababa indicated a prevalence of 2.7/1,000, with an estimated annual incidence of 7.8/100,000 (2). Another study, conducted from February to July in 1993, indicated that the prevalence among children aged 5-9 years was 7.3/1,000 (3). Other school and institutional based studies revealed a higher prevalence (4). The key to evaluating the status of polio eradication is combining epidemiological and laboratory investigations of acute flaccid paralysis (AFP) among infants and children (5). Table 1 shows AFP cases reported in 1998-2001 and vaccination history. One important criterion of proper AFP surveillance is the minimum detection of at least one AFP case among 100,000 children under 15 years of age. Given that the corresponding population is about 30 million in Ethiopia, the number of expected AFP cases is 300. The AFP surveillance indicators are shown in Table 2. From 1997 to 2001, Ethiopia made remarkable progress. However, the rate of collection of two stool specimens within 14 days after onset of paralysis remains unsatisfactorily low. Table 3 shows the record of specimens sent to National