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  • 1.
    Tesfaye, Brook
    et al.
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Sowe, Alieu
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Kisangau, Ngina
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Ogange, John
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Ntoburi, Stephen
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Nekar, Irene
    Polio Surge Consultant, African Field Epidemiology Network, Nairobi, Kenya.
    Muitherero, Charles
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Camara, Yaya
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Gathenji, Carolyne
    Horn of Africa Polio Eradication Coordination Office, Nairobi, Kenya.
    Langat, Daniel
    Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya.
    Sergon, Kibet
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Limo, Hilary
    Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya.
    Nzunza, Rosemary
    Kenya Medical Research Institute, Center for Virus Research, Ministry of Health, Nairobi, Kenya.
    Kiptoon, Shem
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    Kareko, David
    Division of Disease Surveillance and Response, Ministry of Health, Nairobi, Kenya.
    Onuekwusi, Iheoma
    World Health Organization, Kenya Country Office, United Nations Office in Nairobi (UNON), Gigiri Complex, Block U, Nairobi, Kenya.
    An epidemiological analysis of Acute Flaccid Paralysis (AFP) surveillance in Kenya, 2016 to 20182020In: BMC Infectious Diseases, E-ISSN 1471-2334, Vol. 20, no 1, article id 611Article in journal (Refereed)
    Abstract [en]

    Background: The poliovirus has been targeted for eradication since 1988. Kenya reported its last case of indigenous Wild Poliovirus (WPV) in 1984 but suffered from an outbreak of circulating Vaccine-derived Poliovirus type 2 (cVDPV2) in 2018. We aimed to describe Kenya's polio surveillance performance 2016-2018 using WHO recommended polio surveillance standards.

    Methods: Retrospective secondary data analysis was conducted using Kenyan AFP surveillance case-based database from 2016 to 2018. Analyses were carried out using Epi-Info statistical software (version 7) and mapping was done using Quantum Geographic Information System (GIS) (version 3.4.1).

    Results: Kenya reported 1706 cases of AFP from 2016 to 2018. None of the cases were confirmed as poliomyelitis. However, 23 (1.35%) were classified as polio compatible. Children under 5 years accounted for 1085 (63.6%) cases, 937 (55.0%) cases were boys, and 1503 (88.1%) cases had received three or more doses of Oral Polio Vaccine (OPV). AFP detection rate substantially increased over the years; however, the prolonged health workers strike in 2017 negatively affected key surveillance activities. The mean Non-Polio (NP-AFP) rate during the study period was 2.87/ 100,000 children under 15 years, and two adequate specimens were collected for 1512 (88.6%) AFP cases. Cumulatively, 31 (66.0%) counties surpassed target for both WHO recommended AFP quality indicators.

    Conclusions: The performance of Kenya's AFP surveillance system surpassed the minimum WHO recommended targets for both non-polio AFP rate and stool adequacy during the period studied. In order to strengthen the country's polio free status, health worker's awareness on AFP surveillance and active case search should be strengthened in least performing counties to improve case detection. Similar analyses should be done at the sub-county level to uncover underperformance that might have been hidden by county level analysis.

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