ArticleBMC public health2023
Evaluation of the Acute flaccid paralysis surveillance indicators in Zambia from 2015-2021: a retrospective analysis.
Article in BMC public health, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 17 citations in OpenAlex.
- Ethiopia towards polio eradication: insights from acute flaccid paralysis surveillance data analysis 2016 to 2023.The Pan African medical journal · 2026Article
- Spatiotemporal and clinical characterisation of acute flaccid paralysis in Uganda, 2016-2023.BMJ public health · 2026Article
- Evaluation of surveillance performance and determinants for priority vaccine-preventable diseases in Niger State, Nigeria: A CDC 2001 Guideline-based multilevel analysis.PLOS global public health · 2026Article
- A review on health system-based surveillance for acute flaccid paralysis: technological advancements, challenges, and outlooks.Journal of health, population, and nutrition · 2025Review
- Article
- Surveillance of Acute Flaccid Paralysis (AFP) in Greece: 2008-2024.Pathogens (Basel, Switzerland) · 2025Article
- Deep learning model meets community-based surveillance of acute flaccid paralysis.Infectious Disease Modelling · 2025Article
- Community-Based Surveillance of Acute Flaccid Paralysis: A Review on Detection and Reporting Strategy.Journal of epidemiology and global health · 2025Review
- Tracking acute flaccid paralysis in Niger: a half-decade epidemiological portrait (2016-2021).BMC infectious diseases · 2025Article
- The evolution, facilitators, barriers, and additional activities of acute flaccid paralysis surveillance platform in polio eradication programme Bangladesh: a mixed-method study.Global health action · 2024Article
- Evaluation of the Intensive Acute Flaccid Paralysis Surveillance System in Ghana: Post the Switch from tOPV to bOPV.Tropical medicine and infectious disease · 2024Article
- Article
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Authors and funding
16 authors at 7 institutions in 4 countries.
Funding
Abstract
backgroundThe resurgence of poliovirus infection in previously polio free regions and countries calls for renewed commitment to the global polio eradication efforts including strengthening of Acute Flaccid Paralysis (AFP) surveillance systems. Zambia is one of the countries substantially at risk for the importation of poliovirus infection from neighbouring countries including Malawi, Mozambique, and Democratic Republic of the Congo (DRC). This study describes a seven-year AFP surveillance, assesses the surveillance indicators, and highlights areas for improvement.
methodsWe conducted retrospective analysis of the routinely collected AFP surveillance data from January 2015 to December 2022. The AFP surveillance indicators performance was assessed using the World Health Organisation's recommended minimum AFP surveillance indicators performance.
resultsCumulatively, a total of 1715 AFP cases were reported over the study period. More than half, 891 (52%) of reported cases were aged < 5 years with 917 (53.5%) of males. More than half, 1186 (69.2%) had fever at onset, 718 (41.9%) had asymmetric paralysis and 1164 (67.9%) had their paralysis progressed within 3 days of onset. The non-polio AFP rate ranges from 3.4 to 6.4 per 100,000 children < 15 years old and stool adequacy ranging from 70.9% to 90.2% indicating sensitive surveillance with late detection of cases. The percentage of cases with early stool collection, timely transportation was above the World Health Organisation (WHO) minimum of 80% but with declining proportion of stools arriving in the laboratory in optimal condition. Completeness of 60-days follow-up evaluation was suboptimal ranging from 0.9% to 28.2%.
conclusionThe AFP surveillance system in Zambia is doing well. However, additional efforts are needed to improve early detection of cases; stool sample collection, transportation and monitoring to ensure arrival in good condition in the laboratory; and improve 60-days follow-up evaluation for evidenced-based classification of inadequate AFP cases and proper care.
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