Evaluation of acute flaccid paralysis surveillance system in the River Nile State - Northern Sudan, 2021

BACKGROUND: One of the four main elements of the worldwide polio eradication strategy is acute flaccid paralysis surveillance (AFP). This system is based on (acute flaccid paralysis (AFP) cases reported and tested at World Health Organization (WHO) accredited laboratories. To measure and monitor performance, indicators were created. The current study aims to evaluate the system components, performance, and efficiency in River Nile State, Northern Sudan, and their compliance with World Health Organization (WHO) requirements for it to be adopted as a good system; its results can be used to certify whether a country is polio-free or not. MATERIAL AND METHODS: A facility-based retrospective descriptive study was conducted in the River Nile State, Northern Sudan, from Jan 2017 to Dec 2020. This study included all reporting sites/units, workers who reported acute flaccid paralysis (AFP) cases, and officers at the locality level. A total of 50 health institutions were visited for surveillance, and interviews with 59 health workers who were part of the AFP surveillance system were undertaken. The data were collected from participants using a pre-tested questionnaire designed and constructed by the World Health Organization (WHO) framework, and the data were analyzed using the SPSS version (22). RESULTS: The River Nile State’s AFP surveillance system was of high quality in terms of the infrastructure that had been put in place and the effectiveness of the system’s operations, as evidenced by the following statistics: from 2017 to 2020, the reported non-polio acute flaccid paralysis (AFP) cases were at a mean rate of 4.02 per 100,000 children under the age of 15; the majority of AFP reported cases were under 10 years; and males made up 73.3% of reported cases; The completeness of reports and surveillance documents exceeded 80%, and active surveillance was applied in 80% of reporting sites. CONCLUSION: Despite the fact that the surveillance system is capable of detecting cases, Sudan continues to report cases of imported polio from other countries, highlighting the need to strengthen surveillance systems and eradication efforts in these countries.