India Progresses towards Polio Eradication

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Components of AFP Surveillance

The AFP surveillance network and case notification

Establishment and maintenance of reporting sites:

Reporting sites (RS) form the backbone of the AFP surveillance network, and include hospitals and other health facilities -- in the government or the private sector -- that are likely to see cases of AFP, as well as informers. Informers comprise pediatricians and other physicians practicing allopathic medicine, doctors of indigenous systems of medicine (Ayurvedic, homeopathic, Unnani), unlicensed practitioners (“quacks”), and others who are likely to see AFP cases. The RS are geographically well distributed to cover all areas in the country, to ensure that there is at least one RS in every block of every district. At present, 20,491 RUs and informers have been enrolled as RS, of which 9435 are RUs and 11,056 are informers. Both the RUs and the informers are expected to report AFP cases immediately; in addition, the RUs are visited at regular intervals by the District Immunization Officer (DIO) and the NPSP Surveillance Medical Officer (SMO) for active surveillance (“active case searches”) and are also required to submit a weekly AFP surveillance report to the DIO. This report (weekly “zero” report) is sent by the facility even if no AFP case was seen during that week, as a cross-check to ensure that all RUs are reporting all identified AFP cases. The active surveillance visits by SMO/DIO to major health facilities ensure that any missed or unreported AFP cases are detected for timely case investigation and stool collection. Each RU has a designated nodal officer responsible for reporting cases, transmitting surveillance reports and maintaining surveillance records. Both the SMO and DIO are involved in establishing and maintaining a sound reporting network, which functions according to established program guidelines. The SMO and the DIO regularly visit the RS in their area, providing support such as training, technical material, reporting forms, updates on the status of polio eradication in India and globally, and feedback on notified cases. The approach of repeated visits, giving feedback, solving problems and streamlining the surveillance process builds a high level of participation and programme ownership.

AFP case notification:

The Ministry of Health & Family Welfare, Government of India has instructed that all health facilities, clinicians and other practitioners are required to notify AFP cases immediately to the DIO, by the fastest means available. Because important activities including rapid case investigation with stool collection, outbreak response immunization, and active searches for additional cases in the community should occur early, immediate notification of AFP cases is essential.

©National Polio Surveillance Project, All Rights Reserved

©National Polio Surveillance Project, All Rights Reserved

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