JMIR Publications

ABSTRACT

Background:

Highly sensitive acute flaccid paralysis surveillance (AFP), which include immediate case investigation, and specimen collection are critical for reaching polio global eradication. In Yemen, the Acute Flaccid Paralysis Surveillance System (AFPSS) was launched in 1998 to achieve the polio eradication target. Although Yemen was certified as polio free country in 2009, the protracted war since 2015 put the country at risk for polio re-emergence

Objective:

to evaluate the performance of the Yemen AFPSS at both national and governorate levels and to assess the impact of the ongoing war on the performance

Methods:

Retrospective descriptive analysis was conducted on Yemen secondary AFP surveillance data for the years 2014 (before the war) and 2015-2017 (during the war). Data consisting of all children <15years reported as AFP. AFP surveillance performance was evaluated using WHO-specified AFP surveillance indicators

Results:

At the national level, all indicators were met before and after the war except for the “Lab results received ≤ 28 days” that was unmet since the war erupted. Furthermore, the “Stool specimens arriving at central level ≤3 days” was unmet after the war but only in 2017. At the governorate level, although the “Adequacy” and "Stool specimens arriving at laboratory in good condition” indicators were met before the war in all governorates, the first indicator was unmet in 9 (41%) governorates since the war erupted and the second was unmet in 9 governorates (41%) but only in 2017

Conclusions:

Findings showed that some of the AFP indicators was negatively impacted by eruption of the war due to closure of the Sana'a capital airport and postponement of samples during shipment to the reference laboratory under poor storage condition. To ensure rapid detection of any polio cases, improving specimens’ collection, storage, and transportation together with proper and timely specimens' shipment to the reference laboratory should be considered