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Published in: BMC Infectious Diseases 1/2014

Open Access 01-12-2014 | Research article

An epidemiological analysis of acute flaccid paralysis and its surveillance system in Iraq, 1997-2011

Authors: Jagar A Jasem, Kawa Marof, Adnan Nawar, Yosra Khalaf, Faisal Al-Hamdani, Sagvan Ali, Andre C Kalil, KM Monirul Islam

Published in: BMC Infectious Diseases | Issue 1/2014

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Abstract

Background

Acute flaccid paralysis surveillance (AFP) is an essential strategy of the WHO’s Polio Eradication Initiative. This is the first study conducted to estimate the incidence, etiology, distribution, and surveillance performance of AFP in Iraq.

Methods

Surveillance data about the AFP cases under the age of 15 years reported from Iraq during January 1997 to December 2011 were depended in the current study.

Results

A total of 4974 cases of AFP were reported from Iraq during the study period, with an annual incidence of 2.5/100,000 population. Guillain-Barré syndrome represented more than half of the reported cases (N = 2611, 52.5%), followed by traumatic neuritis (N = 715, 14.4%), and other CNS infections (N = 292, 5.9%). Poliomyelitis accounted for 166 (3.3%) of cases, the last reported case being in January 2000. Surveillance performance showed that all, but two, indicators were below the required WHO recommended levels.

Conclusions

AFP surveillance remains the gold standard method for poliomyelitis detection. It witnessed dramatic changes over the last two decades. This has raised people’s and clinicians’ awareness to the importance of promptness in notifying suspected cases and timely transportation of stool specimens to the National Poliovirus Laboratory in Baghdad, or alternatively having more than one laboratory for poliovirus detection in the country, all of which are very useful measures to increase the surveillance performance in the country.
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Literature
1.
go back to reference Behrman RE, Kliegman RM, Jenson H: Nelson’s Textbook of Pediatrics. 2004, Philadelphia. UAS: Saunders Behrman RE, Kliegman RM, Jenson H: Nelson’s Textbook of Pediatrics. 2004, Philadelphia. UAS: Saunders
2.
go back to reference Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL: Harrison's Principles of Internal Medicine. 2005, New York, USA: McGraw-Hill Medical Publishing Division Kasper DL, Fauci AS, Longo DL, Braunwald E, Hauser SL, Jameson JL: Harrison's Principles of Internal Medicine. 2005, New York, USA: McGraw-Hill Medical Publishing Division
3.
go back to reference Nathanson N, Kew OM: From emergence to eradication: the epidemiology of poliomyelitis deconstructed. Am J Epidemiol. 2010, 172 (11): 1213-1229. 10.1093/aje/kwq320.CrossRefPubMedPubMedCentral Nathanson N, Kew OM: From emergence to eradication: the epidemiology of poliomyelitis deconstructed. Am J Epidemiol. 2010, 172 (11): 1213-1229. 10.1093/aje/kwq320.CrossRefPubMedPubMedCentral
5.
go back to reference WHO, Iraqi Ministry of Health: Accute flaccid paralysis field manual: For communicable diseases surveillance staff, republic of Iraq. 2009, Baghdad, Iraq: Iraqi Ministry of Health WHO, Iraqi Ministry of Health: Accute flaccid paralysis field manual: For communicable diseases surveillance staff, republic of Iraq. 2009, Baghdad, Iraq: Iraqi Ministry of Health
8.
go back to reference Apostol LN, Suzuki A, Bautista A, Galang H, Paladin FJ, Fuji N, Lupisan S, Olveda R, Oshitani H: Detection of non-polio enteroviruses from 17 years of virological surveillance of acute flaccid paralysis in the Philippines. J Med Virol. 2012, 84 (4): 624-631. 10.1002/jmv.23242.CrossRefPubMedPubMedCentral Apostol LN, Suzuki A, Bautista A, Galang H, Paladin FJ, Fuji N, Lupisan S, Olveda R, Oshitani H: Detection of non-polio enteroviruses from 17 years of virological surveillance of acute flaccid paralysis in the Philippines. J Med Virol. 2012, 84 (4): 624-631. 10.1002/jmv.23242.CrossRefPubMedPubMedCentral
9.
go back to reference Muscat M, Fiore L, Busuttil R, Gilles HM: Surveillance of wild polioviruses in patients with acute flaccid paralysis in Malta during 1998 and 1999. Eur J Epidemiol. 2000, 16 (11): 1057-1060. 10.1023/A:1010848925903.CrossRefPubMed Muscat M, Fiore L, Busuttil R, Gilles HM: Surveillance of wild polioviruses in patients with acute flaccid paralysis in Malta during 1998 and 1999. Eur J Epidemiol. 2000, 16 (11): 1057-1060. 10.1023/A:1010848925903.CrossRefPubMed
10.
go back to reference Persu A, Baicus A, Stavri S, Combiescu M: Non-polio enteroviruses associated with acute flaccid paralysis (AFP) and facial paralysis (FP) cases in Romania, 2001-2008. Roum Arch Microbiol Immunol. 2009, 68 (1): 20-26.PubMed Persu A, Baicus A, Stavri S, Combiescu M: Non-polio enteroviruses associated with acute flaccid paralysis (AFP) and facial paralysis (FP) cases in Romania, 2001-2008. Roum Arch Microbiol Immunol. 2009, 68 (1): 20-26.PubMed
11.
go back to reference Samoilovich EO, Feldman EV, Yermalovich MA, Protas II, Titov LP: Vaccine-associated paralytic poliomyelitis and other diseases with acute flaccid paralysis syndrome in Belarus. Cent Eur J Public Health. 2003, 11 (4): 213-218.PubMed Samoilovich EO, Feldman EV, Yermalovich MA, Protas II, Titov LP: Vaccine-associated paralytic poliomyelitis and other diseases with acute flaccid paralysis syndrome in Belarus. Cent Eur J Public Health. 2003, 11 (4): 213-218.PubMed
12.
go back to reference Fiore L, Buttinelli G, Fiore S, Donati V, Di Lonardo A: Surveillance of acute flaccid paralysis in Italy, 1997-2001. Ann Ig. 2002, 14 (4 Suppl 5): 73-80.PubMed Fiore L, Buttinelli G, Fiore S, Donati V, Di Lonardo A: Surveillance of acute flaccid paralysis in Italy, 1997-2001. Ann Ig. 2002, 14 (4 Suppl 5): 73-80.PubMed
13.
go back to reference Alwan A: Health in Iraq—the current situation, our vision for the future and areas of work: Baghdad. 2004, Iraq: Iraqi Ministry of Health Alwan A: Health in Iraq—the current situation, our vision for the future and areas of work: Baghdad. 2004, Iraq: Iraqi Ministry of Health
14.
go back to reference Cetorelli V: The impact of the Iraq war on neonatal polio immunisation coverage: a quasi-experimental study. J Epidemiol Community Health. 2013, doi: 10.1136/jech-2013-203174 Cetorelli V: The impact of the Iraq war on neonatal polio immunisation coverage: a quasi-experimental study. J Epidemiol Community Health. 2013, doi: 10.1136/jech-2013-203174
15.
go back to reference Anonymous: The deteriorating health situation in Iraq. Lancet. 2007, 369 (9576): 1834- Anonymous: The deteriorating health situation in Iraq. Lancet. 2007, 369 (9576): 1834-
16.
go back to reference Frankish H: Health of the Iraqi people hangs in the balance. Lancet. 2003, 361 (9358): 623-625. 10.1016/S0140-6736(03)12619-0.CrossRefPubMed Frankish H: Health of the Iraqi people hangs in the balance. Lancet. 2003, 361 (9358): 623-625. 10.1016/S0140-6736(03)12619-0.CrossRefPubMed
18.
go back to reference Chao A, Tsay PK, Lin SH, Shau WY, Chao DY: The applications of capture-recapture models to epidemiological data. Stat Med. 2001, 20 (20): 3123-3157. 10.1002/sim.996.CrossRefPubMed Chao A, Tsay PK, Lin SH, Shau WY, Chao DY: The applications of capture-recapture models to epidemiological data. Stat Med. 2001, 20 (20): 3123-3157. 10.1002/sim.996.CrossRefPubMed
19.
go back to reference Lam RM, Tsang TH, Chan KY, Lau YL, Lim WL, Lam TH, Leung NK, National Committee for the Certification of Wild Poliovirus Eradication: Surveillance of acute flaccid paralysis in Hong Kong: 1997 to 2002. Hong Kong Med J. 2005, 11 (3): 164-173.PubMed Lam RM, Tsang TH, Chan KY, Lau YL, Lim WL, Lam TH, Leung NK, National Committee for the Certification of Wild Poliovirus Eradication: Surveillance of acute flaccid paralysis in Hong Kong: 1997 to 2002. Hong Kong Med J. 2005, 11 (3): 164-173.PubMed
20.
go back to reference Whitfield K, Kelly H: Using the two-source capture-recapture method to estimate the incidence of acute flaccid paralysis in Victoria, Australia. Bull World Health Organ. 2002, 80 (11): 846-851.PubMedPubMedCentral Whitfield K, Kelly H: Using the two-source capture-recapture method to estimate the incidence of acute flaccid paralysis in Victoria, Australia. Bull World Health Organ. 2002, 80 (11): 846-851.PubMedPubMedCentral
21.
go back to reference Brenner H: Use and limitations of the capture-recapture method in disease monitoring with two dependent sources. Epidemiology. 1995, 6 (1): 42-48. 10.1097/00001648-199501000-00009.CrossRefPubMed Brenner H: Use and limitations of the capture-recapture method in disease monitoring with two dependent sources. Epidemiology. 1995, 6 (1): 42-48. 10.1097/00001648-199501000-00009.CrossRefPubMed
22.
go back to reference Dhole TN, Ayyagari A, Chowdhary R, Shakya AK, Shrivastav N, Datta T, Prakash V: Non-polio enteroviruses in acute flaccid paralysis children of India: vital assessment before polio eradication. J Paediatr Child Health. 2009, 45 (7–8): 409-413.CrossRefPubMed Dhole TN, Ayyagari A, Chowdhary R, Shakya AK, Shrivastav N, Datta T, Prakash V: Non-polio enteroviruses in acute flaccid paralysis children of India: vital assessment before polio eradication. J Paediatr Child Health. 2009, 45 (7–8): 409-413.CrossRefPubMed
23.
go back to reference Duintjer Tebbens RJ, Pallansch MA, Cochi SL, Wassilak SG, Linkins J, Sutter RW, Aylward RB, Thompson KM: Economic analysis of the global polio eradication initiative. Vaccine. 2010, 29 (2): 334-343. 10.1016/j.vaccine.2010.10.026.CrossRefPubMed Duintjer Tebbens RJ, Pallansch MA, Cochi SL, Wassilak SG, Linkins J, Sutter RW, Aylward RB, Thompson KM: Economic analysis of the global polio eradication initiative. Vaccine. 2010, 29 (2): 334-343. 10.1016/j.vaccine.2010.10.026.CrossRefPubMed
Metadata
Title
An epidemiological analysis of acute flaccid paralysis and its surveillance system in Iraq, 1997-2011
Authors
Jagar A Jasem
Kawa Marof
Adnan Nawar
Yosra Khalaf
Faisal Al-Hamdani
Sagvan Ali
Andre C Kalil
KM Monirul Islam
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2014
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/1471-2334-14-448

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