Forewarning of Poliovirus Outbreaks in the Horn of Africa: An Assessment of Acute Flaccid Paralysis Surveillance and Routine Immunization Systems in Kenya

Background. Although the Horn of Africa region has successfully eliminated endemic poliovirus circulation, it remains at risk for reintroduction. International partners assisted Kenya in identifying gaps in the polio surveillance and routine immunization programs, and provided recommendations for im...

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Bibliographic Details
Published in:	The Journal of infectious diseases 2014-11, Vol.210 (suppl_1), p.S85-S90
Main Authors:	Walker, Allison Taylor, Sodha, Samir, Warren, Wick C., Sergon, Kibet, Kiptoon, Shem, Ogange, John, Ahmeda, Abdi Hassan, Eshetu, Messeret, Corkum, Melissa, Pillai, Satish, Scobie, Heather, Mdodo, Rennatus, Tack, Danielle M., Halldin, Cara, Appelgren, Kristie, Kretsinger, Katrina, Bensyl, Diana M., Njeru, Ian, Kolongei, Titus, Muigai, Juliet, Ismail, Amina, Okiror, Samuel O.
Format:	Article
Language:	eng
Subjects:	Adolescent AFRICAN REGION Animals Bacillus Calmette Guerin vaccine Child Child, Preschool Disease Outbreaks Epidemiological Monitoring Female Health care facilities Health surveillance Humans Infant Infant, Newborn Kenya - epidemiology Male Paralysis Paralysis - epidemiology Paralysis - prevention & control Poliomyelitis Poliomyelitis - epidemiology Poliomyelitis - prevention & control Poliovirus Poliovirus vaccines Poliovirus Vaccines - administration & dosage Poliovirus Vaccines - supply & distribution Surveillance Toxoid vaccines Vaccination Vaccination - statistics & numerical data
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Summary:	Background. Although the Horn of Africa region has successfully eliminated endemic poliovirus circulation, it remains at risk for reintroduction. International partners assisted Kenya in identifying gaps in the polio surveillance and routine immunization programs, and provided recommendations for improved surveillance and routine immunization during the health system decentralization process. Methods. Structured questionnaires collected information about acute flaccid paralysis (AFP) surveillance resources, training, data monitoring, and supervision at provincial, district, and health facility levels. The routine immunization program information collected included questions about vaccine and resource availability, cold chain, logistics, health-care services and access, outreach coverage data, microplanning, and management and monitoring of AFP surveillance. Results. Although AFP surveillance met national performance standards, widespread deficiencies and limited resources were observed and reported at all levels. Deficiencies were related to provider knowledge, funding, training, and supervision, and were particularly evident at the health facility level. Conclusions. Gap analysis assists in maximizing resources and capacity building in countries where surveillance and routine immunization lag behind other health priorities. Limited resources for surveillance and routine immunization systems in the region indicate a risk for additional outbreaks of wild poliovirus and other vaccine-preventable illnesses. Monitoring and evaluation of program strengthening activities are needed.
ISSN:	0022-1899 1537-6613