KMID : 1038520110330010001
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Epidemiology and Health 2011 Volume.33 No. 1 p.1 ~ p.0
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Evaluation of Acute Flaccid Paralysis in Hamadan, Iran from 2002 to 2009
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Poorolajal Jalal
Ghasemi Shadi Farahani Leila Nezamabadi Hosseini Atefeh Sadat Bathaei Seyyed Jalal Zahiri Ali
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Abstract
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OBJECTIVES: To achieve a polio-free certification in Iran, a nationwide active surveillance program for acute flaccid paralysis (AFP) was set up following World Health Organization guidelines. This article describes the results of an eight-year surveillance of AFP in Hamadan, in the west of Iran.
METHODS: A standard set of minimum core variables were collected. All cases of non-polio AFP in children aged <15 years old were reported. Two stool specimens were collected within 14 days of the onset of paralysis.
RESULTS: During the eight-year survey, 88 AFP cases aged <15 years old were reported. About 40% (35/88) of cases were aged ¡Â5 years, 56% (49/88) were boys, 19 (21.6%) had fever at the onset of paralysis, 74 (84.0%) had complete paralysis within four days of onset, and 22 (24.7%) had asymmetric paralysis. More than one AFP case was detected per 100,000 children aged <15 years old in all years. The risk of AFP in patients aged <5 years old was almost double that of older patients. Guillain-Barre Syndrome was the major leading cause of AFP (66/88). Adequate stool specimens were collected from 85% of AFP patients. All stool specimens were tested virologically, but no wild polioviruses were detected.
CONCLUSION: The active surveillance of non-polio AFP was efficient over the last eight years and exceeded 1.0 case per 100,000 children aged <15 years old. Nonetheless, there was a decreasing trend in the detection of AFP cases during the last two years and should be the focus of the policymakers¡¯ special attention, although AFP cases were still above the target level.
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KEYWORD
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Paralysis, Poliomyelitis, Population surveillance, Guillain-Barre syndrome, Iran
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