JMIR Publications

ABSTRACT

Background:

Acute flaccid paralysis surveillance played a major role in the global eradication of polio. The World Health Organization adopted this method to monitor the progress towards poliomyelitis eradication. The Expanded Program of Immunization in Jordan has routinely collected acute flaccid paralysis data since 1999, which then attained a polio-free certification. Yet, because of wars in neighboring countries, such as Syria and Iraq, there is a risk of polio outbreaks to occur.

Objective:

To evaluate the Acute flaccid paralysis surveillance system in Jordan from 2016 to 2020 and identify areas for improvement.

Methods:

This was a retrospective descriptive study that used data from the Acute flaccid paralysis surveillance system in Jordan between January of 2016 and December of 2020. The World Health Organization standard indicators were used to evaluate the performance of the surveillance system.

Results:

A total of 483 cases of non-polio acute flaccid paralysis were reported. Most of them (n= 478 or 99%) were below 15 years of age, and among those, 55.6% were below 5 years old, and 58% were male. At the national level, the surveillance achieved all the World Health Organization indicators throughout the evaluating period, except for two indicators: the proportion of stool specimens from which non-polio enterovirus was isolated in 2016 and 2017 and the non-polio acute flaccid paralysis detection rate per 100,000 of the population under 15 years of age in 2020. At a sub-national level (governorates level), the proportion of stool specimens from which non-polio enterovirus was isolated, as an indicator, was not achieved most of the time. This was frequently observed in each of all evaluation years of 2016 to 2020. Moreover, most indicators were not achieved at the governorate level in 2020.

Conclusions:

There are some gaps that need improvement in the Acute flaccid paralysis surveillance system in Jordan, especially at the governorate level. The lower performance during 2020 could be referred to the COVID-19 crisis and the lockdown during the pandemic. Similar challenges are possible in the future and proper preparation is required.