[Acute flaccid paralysis surveillance in Niger from 1998 to 2021].

Abstract

Introduction: Acute flaccid paralysis (AFP) caused by acute anterior poliomyelitis (AAP) remains endemic in some Asian and African countries, particularly Niger. Performance indicators defined by the WHO are used to evaluate the AFP surveillance system in affected countries. The objective of this study is to assess its outcomes in Niger from 1998 to 2021. The objective of this study is to assess its outcomes in Niger from 1998 to 2021.

Methodology: This is a cross-sectional study based on all secondary data from AFP case surveillance reported to the Directorate of Surveillance and Epidemic Response in Niger, over a 24-year period from 1998 to 2021.

Results: The sample included 9,659 patients of all ages and sexes. The sex ratio was 1.23, and 92.01% of patients were under 5 years old. The Maradi region ranked first among Niger's eight regions in terms of reported cases (32.27%). It hosts a large portion of the population from neighboring Nigeria, a country also endemic for AFP. More than half of the patients (66.59%) had received 1 to 10 doses of oral polio vaccine. From 1998 to 2021, 8,419 stool samples from 9,494 cases (88.70%) were usable upon arrival at the laboratory. Confirmed and compatible poliovirus cases accounted for 0.80% and 2.35%, respectively. Of the 276 patients who presented with paralysis, 71.73% suffered from paralysis in both limbs, and in 94.35% of the cases, the paralysis had progressed within 3 days.

Conclusion: This study allowed for an analysis of the performance of the active AFP surveillance system. In Niger, this surveillance is acceptable according to performance indicators, but there is still much progress to be made at both the population level and within the healthcare workforce.