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Afghanistan Polio Eradication Initiative Surveillance Update Week 18 ( Ending on Saturday 9 May 2009 ) National Surveillance Office May 12, 2009.

Published byEvan Hudson Modified over 9 years ago

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Presentation on theme: "Afghanistan Polio Eradication Initiative Surveillance Update Week 18 ( Ending on Saturday 9 May 2009 ) National Surveillance Office May 12, 2009."— Presentation transcript:

1 Afghanistan Polio Eradication Initiative Surveillance Update Week 18 ( Ending on Saturday 9 May 2009 ) National Surveillance Office May 12, 2009

2 AFP Case Classification Afghanistan 2009 Year 2009 Reported AFP cases 486 Confirmed 7 Compatible 1 Discarded 408 Pending 70 ^ Data up to 9 May 09 ^ 56 Adequate AFP cases pending lab results 11 Inadequate AFP case pending 60 days follow 3 Inadequate AFP case pending ERC

3 Confirmed Polio cases & Compatibles Afghanistan 07-09 Province No. polio cases 2008 Date of Last Polio case 2008 No. polio cases 2009 Date of Last polio case 2009 P1P3P1P3P1P3P1P3 Farah1110-02-08 15-04-08 ---- Hirat1026-09-08---- Hilmand7001-12-082-02-03-09- Kandahar10215-10-0825-04-084-19-04-09- Uruzgan5014-10-08---- Zabul1002-09-08---- Nangarhar0327-11-08---- Nuristan001-30-03-09- 2007 NSL1=06 NSL3=11 Comp=02 NSL1=25 NSL3=06 Comp=3 2008 NSL1 NSL3 Compatible Polio cases are placed by village 2009 Recent NSL1 from Panjawai District of Kandahar Province, onset is 19 Apr, age 36m, 1 OPV dose NSL1=7 NSL3=0 Comp=1 Data up to 9 May 09

4 2008 NSL1=25 NSL3=06 2004 NSL1= 2 NSL3= 2 1999 NSL1= 45 NSL3= 18 P1 & P3 Poliovirus Isolates Afghanistan 1999, 04, 07-09 2007 NSL1=06 NSL3= 11 NSL1=7 NSL3=0 2009 NSL1 NSL3 Data up to 9 May 09

5 Distribution of P1 & P3 by Month & District 07-09 Mar Feb JanAprMayJun 2007 2008 NSL1=0 NSL3=0 NSL1=0 NSL3=0 NSL1=1 NSL3=0 NSL1=1 NSL3=1 NSL1=0 NSL3=0 NSL1=2 NSL3=0 NSL1=2 NSL3=0 NSL1=1 NSL3=1 NSL1=1 NSL3=0 NSL1=0 NSL3=2 NSL1=1 NSL3=1 NSL1=3 NSL3=0 2009 NSL1 NSL3 NSL1=3 NSL3=0 NSL1=1 NSL3=0 NSL1=2 NSL3=0 Data up to 9 May 09 NSL1=1 NSL3=0 NSL1=0 NSL3=0

6 Distribution of P1 & P3 by Month & District 07-08 Sep Aug JulOctNovDec 2007 2008 NSL1=0 NSL3=3 NSL1=0 NSL3=1 NSL1=0 NSL3=1 NSL1=2 NSL3=1 NSL1=0 NSL3=3 NSL1=0 NSL3=1 NSL1=2 NSL3=1 NSL1=2 NSL3=0 NSL1=6 NSL3=0 NSL1=6 NSL3=0 NSL1=0 NSL3=1 NSL1=1 NSL3=0 NSL1 NSL3 Data up to 9 May 09

7 List Of Confirmed Polio Cases Afghanistan 2009 NoEpidProvinceDistrictDonsetProgFeverAsymSexAgeRoutineSIAs Dlast OPV Dstool 1Dstool2HcaseLabRCluster 1AFG/08/09/007KANDAHAR SHAH WALI KOT 16-01-09YYYM1800- 21-01-0922-01-09NNSL1A-3A 2AFG/08/09/010KANDAHARDaman27-01-09YYYM120324-11-0801-02-0902-02-09NNSL1A-3A 3AFG/08/09/017*KANDAHARPanjwai21-01-09YYNF80102-06-200814-02-0915-02-09NNSL1A-3A 4AFG/08/09/020HILMANDNadiali06-02-09YYYM110114-04-0817-02-0918-02-09YNSL1A-3A 5AFG/08/09/027HILMANDKajaki02-03-09YYYM90104-08-0811-03-0912-03-09YNSL1A-3A 6AFG/06/09/040NURISTANBARGI MATAL30-03-09YYYF2431315-03-0906-04-0907-04-09NNSL1B-4A 7AFG/08/09/063KANDAHARPANJWAYI19-04-09YYYM360102-02-0721-04-0922-04-09YNSL1A-3A *Confirmed by contact Data up to 9 May 09

8 List Of Compatible Polio Cases Afghanistan 2009 No Epid Province District Donset Prog Fever Asym Sex Age Routine SIAs Dlast OPV Dstool 1 Dstool2 Hcase LabR 1AFG/08/09/023HILMAND NAWAI BARAK ZAI 09-01-09YYYM80123-11-0823-02-0924-02-09YNVI Data up to 9 May 09

9 Polio Virus Isolates By Type & Month, Afghanistan 05-09 2005 tOPV mOPV1 mOPV3 sNID NID 2006 2007 Short interval additional dose NSL1 NSL3 2008 2009 Data up to 9 May 09

10 Afghanistan & Pakistan P1 isolates by genetic cluster 2009 Pakistan ProvinceA-3AA-3DB-4APEND Baluchistan000 NWFP012 Sindh100 Islamabad000 Punjab001 Total113 Afghanistan ProvinceA-3AA-3DB-4APEND Helmand200 Kandahar400 Farah000 Uruzgan000 Zabul000 Herat000 Nuristan010 Total610 A-3D A-3A Data up to 2 May 09 PEND B-4A

11 Afghanistan & Pakistan P3 isolates by genetic cluster 2009 Cluster B-1C PAK DistrictDonset Sialkot11 Jan Charsada11 Jan Charsada19 Jan Khi Baldia11 Feb Khi Baldia25 Feb Kambar09 Apr Cluster B-1C AFG DistrictDonset Data up to 2 May 09

12 Regional Reference Lab Update Afghanistan 2009 Data up to 9 May 09 *AFG/08/09/017 (Index case EV but 1 contact is NSL1) Month of onsetCases Cases under process Negative cases NPEV positive (excl PV/NPEV) NPEV % Within 28 days Positive cases CultureITD Wild (incl W/V) Vaccine (excl W/V) Jan11900892118%100%27 Feb10800901312%100%14 Mar133001041814%100%29 Apr 412027717%95%05 Week 1 Apr 361027617%97%02 Week 2 Apr 2913010414%55%11 Week 3 Apr 19180015% 00 Week 4 Apr total125340641814%73%18 May 66------- Week 1 Total AFP cases 4914003477014%92%628 ( 5.70 %) Contacts2612501863212%90%1*17 ( 6.51 %)

13 AFP Cases Labeled As Hot & Pending in Lab, Afghanistan 2009 Hot by criteria=AFP cases have (Fever + rapid progress+ Asymmetric paralysis + Age <48 month) Data up to 9 May 09 EPIDDONSETDistrictProvinceSexAgeDoses Date of last OPV Site of paralysis Dstool2 (or 1) Hot by field Hot by criteria Provincial diagnoses AFG/06/09/05017-04-09BATI KOTNANGARHARF241613-04-09Right leg 21-04-09YES Viral Neuropathy AFG/07/09/02922-04-09SAROBIPAKTIKAM4512-04-09 Right arm Right leg 26-04-09YES Hemiplegia due infection. AFG/08/09/06918-04-09MUSA QALAHILMANDM9212-04-09 Right leg27-04-09YES Traumatic Neuritis AFG/08/09/07119-04-09KANDAHAR F24116-03-09 Left arm Left leg 27-04-09YES Hemiplegia due to infection AFG/08/09/07219-04-09DAMANKANDAHARM36312-04-09 Right leg29-04-09YES Infective Monoplegia AFG/08/09/07325-04-09KANDAHAR F361803-04-09 Right arm Right leg 03-05-09YES Hemiplegia due to Infection AFG/08/09/07424-04-09ARGHISTANKANDAHARM181313-04-09Left leg 30-04-09YES Traumatic Neuritis

14 AFP Cases Pending ERC, Afghanistan EPIDDONSETDistrictProvinceSexAgeDoses Dstool2 (or 1) AsymProgreFever Lab result 60d follow up result AFG/01/09/02221-01-09TALUQANTAKHARM174516-02-09NOYESNONVIRES WEAK AFG/06/09/03314-02-09JALAL ABADNANGARHARF181519-03-09YES NVIRES WEAK AFG/03/09/04420-02-09KUSHKHIRATM591115-03-09NOYESNONVIRES WEAK Data up to 9 May 09

15 AFP Cases Pending Classification >90 days, Afghanistan EPIDDONSETDistrictProvinceSexAgeDoses Dstool2 (or 1) AsymProgressFever Lab result Days since onset Reason for not being classified AFG/01/09/02221-01-09TALUQANTAKHARM174516-02-09NOYESNONVI108PEND ERC Data up to 9 May 09

16 Reported AFP Cases, Comparison By Month, Afghanistan 0 6 -09 @ of 2/100,0000 <15 year @ of 1/100,0000 <15 year 2006 2007 2008 Data up to 9 May 09 2009

17 AFP Cases By Week Of Onset Afghanistan 2009 Week (Sun-Sat) Expected 2= Two cases/100,000 <15 yrs Good AFP= GBS or T. Myelitis, T. Neuritis Data up to 9 May 09 Region AFP Cases 2009 Week Number 9101112131415161718 Expect “2” Reported Good AFP 01-Mar14-Mar21-Mar22-Mar 04-Apr 11-Apr 18-Apr25-Apr26-Apr27-Apr Badakhshan 10 142 0112110110 Central 63 8935 76148810320 Eastern 30 5214 4243444100 Northeastern 39 8723 10244663520 Northern 47 6828 7654544001 South East 34 3212 3322123220 Southern 58 7534 3597656700 Western 55 6941 3623533400 Afghanistan 336 486189 373128293633 2371

18 Population Density Map Afghanistan 2009 Pakistan Uzbakistan Turkmanistan Iran Tajikistan China Dot=10 Persons/Sq Km

19 Non-Polio AFP Rate by Province, Afghanistan per 100,000 under 15 years (Annualized) 2009 2008 2007 0-0.99 1-2.99 3-4.99 5+ Data up to 2 May 09

20 % of AFP cases reported within 7 days of paralysis onset by region Afghanistan 07-09 Data up to 9 May 09

21 Proportion of Adequate Stools By Region Afghanistan 07-09 Data up to 9 May 09

22 AFP Cases with Stool Specimen Reaching The RRL Within 3 and 7 Days of 2 nd Specimen Collection By Region, Afghanistan 07-09 Within 3 days Within 7 days Data up to 9 May 09

23 Percentage of Entero -Virus and SL isolation Afghanistan 07-09 Entero Virus SL Percentage EV % by month 07-09 Data up to 9 May 09

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