Evaluation of the acute flaccid paralysis (AFP) surveillance system in Mwenezi district, Masvingo, 2018: a descriptive study

OBJECTIVES: Poliomyelitis is an infectious disease caused by the polio virus which affects mostly young children below the age of 15 years. For surveillance children with acute flaccid paralysis (AFP) are tracked. In Zimbabwe every district should report two cases per 100,000 population of children under the age of 15 years old. In 2017, Mwenezi district failed to detect any AFP cases. We therefore evaluated the AFP surveillance system in Mwenezi district. We conducted a surveillance system evaluation using the updated Centers for Disease Control guidelines for evaluating public health surveillance systems. We interviewed health workers in Mwenezi district and looked at AFP records from January to December 2017. RESULTS: The main reasons for failure to report a case in 2017 were the vastness of the district with bad road networks as well as lack of a dedicated vehicle to carry out EPI outreach activities. About a quarter, 24%, of the health workers did not know the specimen that is used in AFP diagnosis. The AFP surveillance system in Mwenezi district was performing poorly due to lack of active search of cases in the community caused by disruption of EPI outreach activities.