Early effects of the COVID-19 pandemic on the acute flaccid paralysis surveillance in East and Southern African countries

Pan Afr Med J. 2021 Jun 24:39:147. doi: 10.11604/pamj.2021.39.147.28884. eCollection 2021.

Abstract

Introduction: the World health organisation (WHO) African Region reported the first confirmed COVID-19 case caused by the SARS-CoV-2 on 25th February 2020, and the first case for the East Southern Africa (ESA) sub-region was on 5th March 2020. Almost all countries in the ESA sub region implemented the WHO-recommended preventive measures variably after the notification of community transmission of the COVID-19 disease. This resulted in the disruption of the outpatient, immunization surveillance, and the related supply chain activities.

Methods: a comparative analysis study design of secondary acute flaccid paralysis (AFP) surveillance data received from the East and Southern Africa sub-region countries to evaluate the effect of the COVID-19 pandemic in the AFP field surveillance for the same time period of March to December 2019 and 2020.

Results: we observed that 52.4% of second stool samples were received in the laboratory within 72 hours from March to December 2019, and only 48.1% in the same period of 2020. A 4.3% decline with a p-value of <0.0001 (95% CI, ranges from 2.326% to 6.269%). Similarly, we noted a 4.7% decline in the number of reported AFP cases in the ESA sub-region for March to December 2020 compared to the same period in 2019, a p-value of less than 0.001 (95% CI ranges from 2.785 to 6.614). For the percentage of stool adequacy, we observed a 3.37% decline for April in 2020 compared to April 2019 with a p-value of less than 0.001 (95% CI ranges from 2.059 to 4.690).

Conclusion: we observed a decline in the core AFP surveillance (non polio) NP-AFP rate, and percentage of stool adequacy in countries severely affected by the COVID-19 disease. These countries implemented stringent transmission prevention measures such as lock-down and international transportation restrictions.

Keywords: COVID-19 pandemic; lockdown; poliovirus; social distancing; surveillance.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Africa, Eastern / epidemiology
  • Africa, Southern / epidemiology
  • COVID-19*
  • Central Nervous System Viral Diseases / diagnosis*
  • Central Nervous System Viral Diseases / epidemiology
  • Child
  • Child, Preschool
  • Feces / virology*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Myelitis / diagnosis*
  • Myelitis / epidemiology
  • Neuromuscular Diseases / diagnosis*
  • Neuromuscular Diseases / epidemiology
  • Population Surveillance / methods*

Supplementary concepts

  • acute flaccid myelitis