Polio eradication initiative in Africa: influence on other infectious disease surveillance development.
BACKGROUND
The World Health Organization (WHO) and partners are collaborating to eradicate poliomyelitis. To monitor progress, countries perform surveillance for acute flaccid paralysis (AFP). The WHO African Regional Office (WHO-AFRO) and the U.S Centers for Disease Control and Prevention are also involved in strengthening infectious disease surveillance and response in Africa. We assessed whether polio-eradication initiative resources are used in the surveillance for and response to other infectious diseases in Africa.


METHODS
During October 1999-March 2000, we developed and administered a survey questionnaire to at least one key informant from the 38 countries that regularly report on polio activities to WHO. The key informants included WHO-AFRO staff assigned to the countries and Ministry of Health personnel.


RESULTS
We obtained responses from 32 (84%) of the 38 countries. Thirty-one (97%) of the 32 countries had designated surveillance officers for AFP surveillance, and 25 (78%) used the AFP resources for the surveillance and response to other infectious diseases. In 28 (87%) countries, AFP program staff combined detection for AFP and other infectious diseases. Fourteen countries (44%) had used the AFP laboratory specimen transportation system to transport specimens to confirm other infectious disease outbreaks. The majority of the countries that performed AFP surveillance adequately (i.e., non polio AFP rate = 1/100,000 children aged <15 years) in 1999 had added 1-5 diseases to their AFP surveillance program.


CONCLUSIONS
Despite concerns regarding the targeted nature of AFP surveillance, it is partially integrated into existing surveillance and response systems in multiple African countries. Resources provided for polio eradication should be used to improve surveillance for and response to other priority infectious diseases in Africa.
Nsubuga
Peter
P
Division of International Health, Epidemiology Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. pnsubuga@cdc.gov
McDonnell
Sharon
S
Perkins
Bradley
B
Sutter
Roland
R
Quick
Linda
L
White
Mark
M
Cochi
Stephen
S
Otten
Mac
M
D000349:Africa / Q000453:epidemiology; D003140:Communicable Disease Control / Q000458:organization & administration*; D003141:Communicable Diseases / Q000145:classification; D004196:Disease Outbreaks / Q000517:prevention & control*; D006292:Health Priorities; D006801:Humans; D017589:Immunization Programs / Q000458:organization & administration; D011051:Poliomyelitis / Q000517:prevention & control*; D011159:Population Surveillance / Q000379:methods*; D011635:Public Health Administration / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D018511:Systems Integration; D014944:World Health Organization