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Muhammad Hakim

Muhammad Hakim

Post Graduate Resident at College of Physician and Surgeons-Pakistan

Title: Evaluation of Acute Flaccid Paralysis (AFP) Surveillance System in Khyber Agency Federally Administrated Tribal Areas (FATA) Pakistan – 2015.

Biography

Biography: Muhammad Hakim

Abstract

Introduction: FATA has set up of AFP surveillance system for immediate case investigation and specimen collection for detecting wild polio virus. The goal is polio eradication. Khyber Agency shares borders with Afghanistan and Peshawar due to which remains a major reservoir of polio virus and has contributed 76 cases in 2014. The purpose of this evaluation is to identify the weaknesses and strengths of this system to formulate recommendations.

Methodology: CDC’s updated guide lines for evaluation of public health surveillance system were followed and a descriptive study was carried out in May 2015 to evaluate the system’s functioning in 2014. Literature was studied, records were reviewed in Khyber Agency health department, stakeholders were identified and information was obtained through a designed questionnaire based on system attributes by conducting in depth interviews with the stakeholders.

Results: System was found simple; stable and flexible. Representativeness was average. Sensitivity was 100% while predictive value positive was 48.10%.Cases with adequate stools were 128 (81%). Completeness and timeliness of report files were 26 (86.66%).Case investigations within 48 hours of report 156(98.73%). Stool specimens collected within 14 days of paralysis onset 128(81.01%). Percentage of AFP cases with 60 days follow-up by 90 days after onset 58(36.70%).

Conclusion: AFP surveillance system in reality is not achieving as envisioned objectives due to the security compromised situation. The system needs improvement in logistics planning, data management, data quality including completeness and analysis. High sensitivity was due to the broad case definition to avoid missing any case. Regular field /desk reviews of system are required. Refresher training for health practitioner and community involvement were recommended.