Polio Eradication Initiative AfghanistanQuality AFP Surveillance<br />TAG Meeting Islamabad<br />March 24-25, 2011<br />
Pop <15 years<br />1400-56,000<br />56,001-144,000<br />144,001-381,000<br />381,001-1,225,000<br />Distribution of AFP ca...
Distribution of AFP cases by reporting source 2010-2011Community Based Surveillance System Afghansitan<br />2010<br />2011...
Surveillance system is reporting from each age group and Gender Overall Immunization status of NP AFP cases is improving <...
0-0.99<br />1-1.99<br />2-4.99<br />5+<br />Major AFP Surveillance Indicators 2009-2011 Afghanistan<br />Stool Adequacy  R...
% of SL<br />% of EV<br />AFP Cases with Stool Specimen Reaching RRL Within 3, 7 or 8+ days & % of SL, EV isolated in each...
B<br />a<br />d<br />a<br />k<br />h<br />s<br />h<br />a<br />n<br />K<br />u<br />n<br />d<br />u<br />z<br />B<br />a<b...
visit to 14 provinces in 5 Regions
Southern and S.-Eastern Region not visited for security reasons</li></li></ul><li>AFP Surveillance in insecure areas<br />
AFP Surveillance Key Indicators, by Province Southern region Afghanistan 2010- Mar 2011<br /> Data up to 12 Mar 2011<br />
Pop < 15 years <br /><100,000<br />100,000-<200,000<br />200,000-370,000<br />AFP Case<br />Roll On Mapping of Southern Re...
Managing AFP Surveillance in Difficult to access and insecure areas, Afghanistan 2010-Mar 2011<br />Identified 1-2 members...
Contacts having Polio Virus Isolates with their Index Cases, Afghanistan 2010<br /> Data up to 12 Mar 2011<br />
Surveillance Indicators: Selected insecure difficult to access Districts, Afghanistan 2010-Mar 2011<br />The case of 2011 ...
Managing AFP Surveillance in Difficult to access insecure areas, Afghanistan: <br />Areas of Surveillance Concern <br />Co...
AFP Surveillance: Benefits beyond Polio Eradication<br />Total Measles Cases Reported	  	= 2446 <br />Total specimens coll...
Summary AFP Surveillance Afghanistan, 2010<br />AFP cases are being reported by various sources, particularly the communit...
AFP Surveillance Afghanistan: Goals 2011<br />Improving surveillance in insecure or difficult to access areas and maintain...
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Afp surveillance Quality

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Afp surveillance Quality

  1. 1. Polio Eradication Initiative AfghanistanQuality AFP Surveillance<br />TAG Meeting Islamabad<br />March 24-25, 2011<br />
  2. 2. Pop <15 years<br />1400-56,000<br />56,001-144,000<br />144,001-381,000<br />381,001-1,225,000<br />Distribution of AFP cases by population density and by districts Afghanistan 2010-2011 (March)<br />2010<br />2011<br />Data up to 20 Mar 2011<br />
  3. 3. Distribution of AFP cases by reporting source 2010-2011Community Based Surveillance System Afghansitan<br />2010<br />2011<br />23 % of AFP cases are reported by various categories of community based reporting sites, including Mullah, Shrine Keepers, Pharmacists, CHWs. AFP cases from Nomads (03 cases in 2010) also reported <br />Data up to 20 Mar 2011<br />
  4. 4. Surveillance system is reporting from each age group and Gender Overall Immunization status of NP AFP cases is improving <br />
  5. 5. 0-0.99<br />1-1.99<br />2-4.99<br />5+<br />Major AFP Surveillance Indicators 2009-2011 Afghanistan<br />Stool Adequacy Rate by Region<br />Non Polio AFP Rate by Province<br />2009<br />2010<br />Detection within 7 days by Region<br />2011<br />
  6. 6. % of SL<br />% of EV<br />AFP Cases with Stool Specimen Reaching RRL Within 3, 7 or 8+ days & % of SL, EV isolated in each period, AFG 2010<br />60% of Specimens Reaching <br />within 3 days<br />94% of Specimens Reaching <br />within 7 days<br />Days<br />Data up to 20 Mar 2011<br />
  7. 7. B<br />a<br />d<br />a<br />k<br />h<br />s<br />h<br />a<br />n<br />K<br />u<br />n<br />d<br />u<br />z<br />B<br />a<br />l<br />k<br />h<br />T<br />a<br />k<br />h<br />a<br />r<br />S<br />a<br />r<br />i<br />P<br />u<br />l<br />S<br />a<br />m<br />a<br />n<br />g<br />a<br />n<br />P<br />a<br />r<br />w<br />a<br />n<br />K<br />a<br />p<br />i<br />s<br />a<br />L<br />a<br />g<br />h<br />m<br />a<br />n<br />K<br />a<br />b<br />u<br />l<br />N<br />a<br />n<br />g<br />a<br />r<br />h<br />a<br />r<br />H<br />i<br />r<br />a<br />t<br />F<br />a<br />r<br />a<br />h<br />Afghanistan international AFP surveillance review, 2010<br />Mission members and provinces visited,<br />Overall strong and good quality AFP system in reviewed areas:<br />High level awareness, timely case detection, investigation and documentation <br />Good coverage of population through community networks, Active Surveillance and ZERO-reporting<br />Tajikistan outbreak initiated rapid and effective measures to increase surveillance sensitivity<br />Practice of exclusion of non-AFP cases need improvement with tendency of inclusion<br />Based on these findings, the review team concludes that ongoing transmission of wild poliovirus in the reviewed areas is very unlikely to be missed<br /><ul><li>8 team members with polio field experience from Pakistan (6), WHO/EMRO (1)and WHO/HQ (1)
  8. 8. visit to 14 provinces in 5 Regions
  9. 9. Southern and S.-Eastern Region not visited for security reasons</li></li></ul><li>AFP Surveillance in insecure areas<br />
  10. 10. AFP Surveillance Key Indicators, by Province Southern region Afghanistan 2010- Mar 2011<br /> Data up to 12 Mar 2011<br />
  11. 11. Pop < 15 years <br /><100,000<br />100,000-<200,000<br />200,000-370,000<br />AFP Case<br />Roll On Mapping of Southern Region AFP cases 2010<br />Jul<br />Cum=123<br />New=28<br />Aug<br />Cum=177<br />New=26<br />Sep<br />Cum=188<br />New=11<br />Nov<br />Cum=230<br />New=17<br />Oct<br />Cum=213<br />New=25<br />Dec<br />Cum=251<br />New=21<br /> Data up to 20 Mar 2011<br />
  12. 12. Managing AFP Surveillance in Difficult to access and insecure areas, Afghanistan 2010-Mar 2011<br />Identified 1-2 members of community from each district like DSTs, are trained on surveillance. Conduct household survey and facilitate specimen collection and transportation. Also visit reporting volunteers<br />Orientation sessions for reporting volunteers in Helmand<br />Provision of Transportation cost to bring the AFP case to health facility for investigation and specimen collection <br />Collection of Samples from contacts of AFP cases in Ghor and Farah<br />Training sessions focus on search for AFP cases during house to house campaign<br />During 2010, 58% AFP cases of Southern Region reported from 13 HR district. <br /> Data up to 20 Mar 2011<br />
  13. 13. Contacts having Polio Virus Isolates with their Index Cases, Afghanistan 2010<br /> Data up to 12 Mar 2011<br />
  14. 14. Surveillance Indicators: Selected insecure difficult to access Districts, Afghanistan 2010-Mar 2011<br />The case of 2011 is from Daman Non-HRD<br />Data up to 20 Mar 2011<br />
  15. 15. Managing AFP Surveillance in Difficult to access insecure areas, Afghanistan: <br />Areas of Surveillance Concern <br />Compatible <br />High Risk Districts<br />Long arm NSL <br />
  16. 16. AFP Surveillance: Benefits beyond Polio Eradication<br />Total Measles Cases Reported = 2446 <br />Total specimens collected for lab = 1978<br />Total Lab confirmed = 1526<br />Supported Surveillance for influenza A/H1N1 in 2009<br />Reporting of other VPDs Measles and NNT<br />Strengthen Routine EPI by assisting mapping, district micro-planning, supervision during active surveillance and feed-back<br />Reporting and responding to epidemics/outbreak in coordination with DEWs<br />
  17. 17. Summary AFP Surveillance Afghanistan, 2010<br />AFP cases are being reported by various sources, particularly the community-based, most of the surveillance indicators are meeting the desired level at regional and provincial levels except in Kandahar, Helmand and Uruzgan provinces of Southern Region<br />International Surveillance Review held in 5 regions of the country concluded that transmission of poliovirus in reviewed areas is very unlikely to be missed.<br />Although AFP surveillance in selected security affected areas is constantly providing evidence of poliovirus circulation but needs extra efforts to achieve and maintain required standards<br />
  18. 18. AFP Surveillance Afghanistan: Goals 2011<br />Improving surveillance in insecure or difficult to access areas and maintaining standard surveillance<br />Internal Surveillance Reviews ( Southern Regions) <br />Strengthening the linkage between Focal Point & Reporting Sites.<br />Training of AFP Focal Points and Seminars for Reporting volunteers <br />Continue using AFP surveillance for other VPDs<br />
  19. 19. Thank You<br />

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