title: Evaluation of acute flaccid paralysis in hamadan, iran from 2002 to 2009.
abstract: OBJECTIVE
  To achieve a polio-free certification in Iran, a nationwide active surveillance program for acute flaccid paralysis (AFP) was set up following World Health Organization guidelines. This article describes the results of an eight-year surveillance of AFP in Hamadan, in the west of Iran.
  
  
  METHODS
  A standard set of minimum core variables were collected. All cases of non-polio AFP in children aged <15 years old were reported. Two stool specimens were collected within 14 days of the onset of paralysis.
  
  
  RESULTS
  During the eight-year survey, 88 AFP cases aged <15 years old were reported. About 40% (35/88) of cases were aged ≤5 years, 56% (49/88) were boys, 19 (21.6%) had fever at the onset of paralysis, 74 (84.0%) had complete paralysis within four days of onset, and 22 (24.7%) had asymmetric paralysis. More than one AFP case was detected per 100,000 children aged <15 years old in all years. The risk of AFP in patients aged <5 years old was almost double that of older patients. Guillain-Barré Syndrome was the major leading cause of AFP (66/88). Adequate stool specimens were collected from 85% of AFP patients. All stool specimens were tested virologically, but no wild polioviruses were detected.
  
  
  CONCLUSIONS
  The active surveillance of non-polio AFP was efficient over the last eight years and exceeded 1.0 case per 100,000 children aged <15 years old. Nonetheless, there was a decreasing trend in the detection of AFP cases during the last two years and should be the focus of the policymakers' special attention, although AFP cases were still above the target level.
authors: Research Center for Health Sciences, Department of Epidemiology & Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran.
authors: Jalal
authors: J
authors: Poorolajal
authors: Shadi
authors: S
authors: Ghasemi
authors: Leila Nezamabadi
authors: LN
authors: Farahani
authors: Atefeh Sadat
authors: AS
authors: Hosseini
authors: Seyyed Jalal
authors: SJ
authors: Bathaei
authors: Ali
authors: A
authors: Zahiri