الفهرس 
AcknowledgmentOnly 14 pages are availabe for public view
 |  | from | 126 |  |  |
| | | from | 126 | | |
Abstract
Introduction : Poliomyelitis is a highly infectious disease caused by poliovirus that affect the gastro-intestinal tract and can invade the central nervous system causing various degrees of paralysis. WHO declared Egypt as polio-free country in 2006. AFP surveillance remains the gold standard of poliovirus surveillance and all efforts should be made to maintain it at high level of performance and improve it when necessary. Aim of the study : The specific objectives of this study were to measure the annual incidence of reported AFP cases in Dakahlia Governorate during the study period, describe the seasonal and geographical variations of AFP, identify Factors associated with AFP, and to find out the differential diagnosis of AFP cases. Population and methods: This record-based descriptive study was carried out in Dakahlia Governorate, including all the 599 AFP cases reported in the last nine years starting from January 2009 to December 2017. It was conducted to highlight the epidemiological pattern of AFP as a surveillance tool for polio in Dakahlia Governorate (Egypt) in the past decade. Results: The non-polio AFP rate/ 100,000 children under 15 years reported by Dakahlia health directorate was at least 2.8/100,000 every year. The majority (97.7%) of cases were notified within 7 days from onset of the disease, and 97.6% of cases were investigated within 48 hours of reporting. Specimens were collected within 14 days of onset of paralysis in 96.8% of cases, majority of specimens 99.0% were sent to the central laboratory within 3 days of the 1st stool specimen, and 97.3% of specimens were adequate specimens. Follow-up after 60 days was completed in 99.8% of cases. Large number of AFP cases were reported by general and fever hospitals in Dakahlia governorate. Private health facilities have made significant contributions in AFP case notification and reporting. Cases reported by PHC and insurance facilities are relatively lower. Assessing the contribution of each health facility is critical for evidence based decision-making on subsequent planning of active case search visits. This is getting greatest attention in settings where health facilities are massively expanding while the number of health workers for visiting increasing numbers of health facilities for surveillance is still limited. Discussion: This study showed high levels of surveillance performance in Dakahlia governorate. The surveillance of AFP cases in Dakahlia, Egypt had succeeded to establish the absence of WPV transmission in this locality. Routine immunization coverage with OPV has to be high as it is because this will help prevent the re-introduction of wild poliovirus in the community. Conclusion: AFP surveillance system was effective over the 9 years period between 2009 and 2017 in Dakahlia governorate; meeting the WHO surveillance performance indicators at this subnational level.