title: An epidemiological analysis of acute flaccid paralysis and its surveillance system in Iraq, 1997-2011.
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.
authors.affiliation: School of Medicine, Faculty of Medical Sciences, University of Duhok, Duhok, Kurdistan Region, Iraq. jagar.jasem@osumc.edu.
authors.forename: Jagar A
authors.initials: JA
authors.lastname: Jasem
authors.forename: Kawa
authors.initials: K
authors.lastname: Marof
authors.forename: Adnan
authors.initials: A
authors.lastname: Nawar
authors.forename: Yosra
authors.initials: Y
authors.lastname: Khalaf
authors.forename: Faisal
authors.initials: F
authors.lastname: Al-Hamdani
authors.forename: Sagvan
authors.initials: S
authors.lastname: Ali
authors.forename: Andre C
authors.initials: AC
authors.lastname: Kalil
authors.forename: K M Monirul
authors.initials: KM
authors.lastname: Islam
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007493:Iraq / Q000453:epidemiology; D008297:Male; D010243:Paralysis / Q000453:epidemiology*; D011051:Poliomyelitis / Q000453:epidemiology*; D017955:Poliovirus; D018571:Sentinel Surveillance