+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

An evaluation of the sensitivity of acute flaccid paralysis surveillance for poliovirus infection in Australia



An evaluation of the sensitivity of acute flaccid paralysis surveillance for poliovirus infection in Australia



Bmc Infectious Diseases 9: 162



World Health Organization (WHO) targets for acute flaccid paralysis (AFP) surveillance, including the notification of a minimum rate of AFP among children, are used to assess the adequacy of AFP surveillance for the detection of poliovirus infection. Sensitive surveillance for poliovirus infection in both developed and developing countries is essential to support global disease eradication efforts. We applied recently developed methods for the quantitative evaluation of disease surveillance systems to evaluate the sensitivity of AFP surveillance for poliovirus infection in Australia. A scenario tree model which accounted for administrative region, age, population immunity, the likelihood of AFP, and the probability of notification and stool sampling was used to assess the sensitivity of AFP surveillance for wild poliovirus infection among children aged less than 15 years in Australia. The analysis was based on historical surveillance data collected between 2000 and 2005. We used a surveillance time period of one month, and evaluated the ability of the surveillance system to detect poliovirus infection at a prevalence of 1 case per 100 000 persons and 1 case per million persons. There was considerable variation in the sensitivity of AFP surveillance for poliovirus infection among Australian States and Territories. The estimated median sensitivity of AFP surveillance in Australia among children aged less than 15 years was 8.2% per month at a prevalence of 1 case per 100,000 population, and 0.9% per month at a prevalence of 1 case per million population. The probability that Australia is free from poliovirus infection given negative surveillance findings following 5 years of continuous surveillance was 96.9% at a prevalence of 1 case per 100,000 persons and 56.5% at a prevalence of 1 case per million persons. Given the ongoing risk of poliovirus importation prior to global eradication, long term surveillance is required to provide a high degree of confidence in freedom from poliovirus infection in Australia, particularly if a low prevalence of infection is assumed. Adherence to the WHO surveillance targets would considerably improve the sensitivity of surveillance for poliovirus infection in Australia.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 051485939

Download citation: RISBibTeXText

PMID: 19788763

DOI: 10.1186/1471-2334-9-162


Related references

A theoretical framework for evaluating the sensitivity of surveillance for detecting wild poliovirus: I. Factors affecting detection sensitivity in a person with acute flaccid paralysis. Journal of Infectious Diseases 175(Suppl. 1): S135-S140, 1997

Population sensitivity of acute flaccid paralysis and environmental surveillance for serotype 1 poliovirus in Pakistan: an observational study. Bmc Infectious Diseases 18(1): 176, 2018

Supplement 1. Global Poliomyelitis Eradication Initiative: Status Report || A Theoretical Framework for Evaluating the Sensitivity of Surveillance for Detecting Wild Poliovirus: I. Factors Affecting Detection Sensitivity in a Person with Acute Flaccid Paralysis. Journal of Infectious Diseases 175: S135-S140, 1997

The role of supplementary environmental surveillance to complement acute flaccid paralysis surveillance for wild poliovirus in Pakistan - 2011-2013. Plos One 12(7): E0180608, 2017

Eradication of wild poliovirus from the Americas: acute flaccid paralysis surveillance, 1988-1995. Journal of Infectious Diseases 175(Suppl. 1): S37-S42, 1997

Duration of poliovirus excretion and its implications for acute flaccid paralysis surveillance: a review of the literature. Journal of Infectious Diseases 175(Suppl. 1): S176-S182, 1997

Acute flaccid paralysis surveillance in bosnia and herzegovina: Recent isolation of two sabin like type 2 poliovirus. Journal of Medical Virology 89(9): 1678-1681, 2017

Surveillance of acute flaccid paralysis in Australia, 1995-97. Australian Paediatric Surveillance Unit. Journal of Paediatrics and Child Health 35(6): 536-540, 1999

Acute flaccid paralysis surveillance in Australia. Bulletin of the World Health Organization 79(12): 1169-1170, 2001

An acute flaccid paralysis surveillance-based serosurvey of poliovirus antibodies in Western Uttar Pradesh, India. Journal of Infectious Diseases 210(Suppl. 1): S234-S242, 2014

Annual report of the Australian National Poliovirus Reference Laboratory and summary of acute flaccid paralysis surveillance, 2001. Communicable Diseases Intelligence Quarterly Report 26(3): 419-427, 2002

Enhanced surveillance of acute flaccid paralysis following importation of wild poliovirus in Xinjiang Uygur Autonomous Region, China. Bmc Infectious Diseases 14: 113, 2014

Forewarning of poliovirus outbreaks in the Horn of Africa: an assessment of acute flaccid paralysis surveillance and routine immunization systems in Kenya. Journal of Infectious Diseases 210(Suppl. 1): S85-S90, 2014

The molecular characterization of poliovirus strains by the RT-PCR-RFLP assay and its use in the active surveillance for acute flaccid paralysis cases in Romania between 2001-2006. Roumanian Archives of Microbiology and Immunology 65(3-4): 120-130, 2008

Apparent improvement in surveillance for cases of acute flaccid paralysis in Australia. Australian and new Zealand Journal of Public Health 26(3): 281-282, 2002