Title : Analysis of acute flaccid paralysis surveillance data in Cote d'Ivoire from 2021 to 2023
Abstract:
Introduction:
Acute Flaccid Paralysis (AFP), a major symptom of poliomyelitis, is caused by the poliovirus. According to the WHO, in 2022, 21,143 cases of AFP were reported worldwide, with 30 cases (%) of wild poliovirus (WPV1) and 828 cases (%) of vaccine-derived poliovirus (cVDPV). In Africa, 5,588 AFP cases were reported, with 8 cases of WPV1 and 657 cases (%) of VDPV. In 2023, 2 cases of cVDPV2 were reported in Burkina Faso and 6 cases in Côte d'Ivoire (CIV). Surveillance data have not yet been analyzed; The objective of the study is to analyze AFP surveillance data from 2021 to 2023 in Côte d'Ivoire.
Methods:
This was a descriptive cross-sectional study conducted from February to April 2024, covering data from 2021 to 2023. The study population consisted of all AFP cases recorded in the DC-PEV surveillance database. The WHO target for the non-polio AFP rate in children under 15 years of age is 3/100,000. Data were extracted in Excel format and cleaned to search for duplicates, missing data, and outliers. EPI info version 7.2 software was used to perform the analyses and calculate means and frequencies, and QGIS version 3.10.7 software was used to create the maps.
Results:
A total of 2,486 AFP cases were reported in the various health districts in of the Côte d'Ivoire. Males were the most prevalent, with 1,348 (54%), and a sex ratio (male/female) of 1.18. Children aged 1 to 4 years were the most numerous, with 1,006 (40.47%), and the average age was 3.5 and SD 3.2. More than 4 doses of OPV (oral polio vaccine) were administered to 1,048 (42.16%) AFP cases, and 710 (28.56%) received 1 to 3 doses of OPV. Fever at the onset of paralysis was the most common symptom (74.38%). The stool samples sent to the laboratory were of good quality: 2,097 (84.35%), and 21% of stool samples were sent to the laboratory within 72 hours. Cell culture revealed 44 (1.77%) suspected polio enteroviruses and 284 (11.42%) non-polio enteroviruses (NPEVs). The rates of non-polio AFP (NPEVs) per 100,000 children under 15 years of age per year were 0.69/100,000 (2021), 0.64/100,000 (2022), and 0.78/100,000 (2023). The northern part of the country was most affected by cVDPVs, with the districts of Bouna (36.36%), Doropo (18.18%), and Kong (18.18%) respectively.
Conclusion:
The PFA database exists with good quality data and samples, children aged 1 to 4 and male were the most numerous. The detection rate of non-polio PFA per 100,000 children under 15 years per year did not reach the target of 3/100,000 according to WHO surveillance guidelines.
