AVADAR (Auto-Visual AFP Detection and Reporting): demonstration of a novel SMS-based smartphone application to improve acute flaccid paralysis (AFP) surveillance in Nigeria

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Abstract

Background

Eradication of polio requires that the acute flaccid paralysis (AFP) surveillance system is sensitive enough to detect all cases of AFP, and that such cases are promptly reported and investigated by disease surveillance personnel. When individuals, particularly community informants, are unaware of how to properly detect AFP cases or of the appropriate reporting process, they are unable to provide important feedback to the surveillance network within a country.

Methods

We tested a new SMS-based smartphone application (App) that enhances the detection and reporting of AFP cases to improve the quality of AFP surveillance. Nicknamed Auto-Visual AFP Detection and Reporting (AVADAR), the App creates a scenario where the AFP surveillance network is not dependent on a limited number of priority reporting sites. Being installed on the smartphones of multiple health workers (HWs) and community health informants (CHIs) makes the App an integral part of the detection and reporting system.

Results

Results from two phases of tests conducted in Nigeria point to the effectiveness of the App in the surveillance of AFP.

Conclusion

We posit that appropriate use of the App can soon bring about a worldwide eradication of poliomyelitis.

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Most cited references 4

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Progress Toward Polio Eradication - Worldwide, 2015-2016.

Michelle Morales-Olmedo, Rudolf H. Tangermann, Steven G F Wassilak (2016)

In 1988, the World Health Assembly resolved to eradicate poliomyelitis. Wild poliovirus (WPV) transmission persists in only two countries (Afghanistan and Pakistan) after the removal of Nigeria from the list of countries with endemic polio in September 2015.* Indigenous WPV type 2 has not been detected since 1999 and was declared eradicated by the Global Commission for the Certification of Poliomyelitis Eradication in September 2015.(†) Since November 2012, when the last case of WPV type 3 was detected in Nigeria, WPV type 1 has been the sole circulating type of WPV (1). This report summarizes global progress toward polio eradication during 2015-2016 and updates previous reports (2). In 2015, 74 WPV cases were reported in two countries (Afghanistan and Pakistan), a decrease of 79% from the 359 WPV cases reported in 2014 in nine countries; 12 WPV cases have been reported in 2016 (to date), compared with 23 during the same period in 2015 (3). Paralytic polio caused by circulating vaccine-derived poliovirus (cVDPV) remains a risk in areas with low oral poliovirus vaccine (OPV) coverage. Seven countries, including Pakistan, reported 32 cVDPV cases in 2015 (4). In four of these countries, ≥6 months have passed since the most recent case or isolate. One country (Laos) with VDPV transmission in 2015 has reported three additional cVDPV cases in 2016 to date. Encouraging progress toward polio eradication has been made over the last year; however, interruption of WPV transmission will require focus on reaching and vaccinating every missed child through high quality supplementary immunization activities (SIAs) and cross-border coordination between Afghanistan and Pakistan (5,6).

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An evaluation of the sensitivity of acute flaccid paralysis surveillance for poliovirus infection in Australia

Rochelle E Watkins, P Martin, Heath A. Kelly … (2009)

Background World Health Organization (WHO) targets for acute flaccid paralysis (AFP) surveillance, including the notification of a minimum rate of AFP among children, are used to assess the adequacy of AFP surveillance for the detection of poliovirus infection. Sensitive surveillance for poliovirus infection in both developed and developing countries is essential to support global disease eradication efforts. We applied recently developed methods for the quantitative evaluation of disease surveillance systems to evaluate the sensitivity of AFP surveillance for poliovirus infection in Australia. Methods A scenario tree model which accounted for administrative region, age, population immunity, the likelihood of AFP, and the probability of notification and stool sampling was used to assess the sensitivity of AFP surveillance for wild poliovirus infection among children aged less than 15 years in Australia. The analysis was based on historical surveillance data collected between 2000 and 2005. We used a surveillance time period of one month, and evaluated the ability of the surveillance system to detect poliovirus infection at a prevalence of 1 case per 100 000 persons and 1 case per million persons. Results There was considerable variation in the sensitivity of AFP surveillance for poliovirus infection among Australian States and Territories. The estimated median sensitivity of AFP surveillance in Australia among children aged less than 15 years was 8.2% per month at a prevalence of 1 case per 100,000 population, and 0.9% per month at a prevalence of 1 case per million population. The probability that Australia is free from poliovirus infection given negative surveillance findings following 5 years of continuous surveillance was 96.9% at a prevalence of 1 case per 100,000 persons and 56.5% at a prevalence of 1 case per million persons. Conclusion Given the ongoing risk of poliovirus importation prior to global eradication, long term surveillance is required to provide a high degree of confidence in freedom from poliovirus infection in Australia, particularly if a low prevalence of infection is assumed. Adherence to the WHO surveillance targets would considerably improve the sensitivity of surveillance for poliovirus infection in Australia.

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Community Awareness and Sensitization on Acute Flaccid Paralysis Case Reporting in a Northern State of Nigeria

OI Musa, TM Akanda, GA Salaudeen … (2009)

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Author and article information

Contributors

Faisal M. B. Shuaib: faisalshuaib@yahoo.com

Philip F. Musa: musa@uab.edu

Sisay Tegegne Gashu: gashutegegns@who.int

Chima Onoka: chimaonoka@gmail.com , chima.onoka@nphcda.gov.ng

Salihu Abdullahi Ahmed: salihua@who.int

Murtala Bagana: murtala.bagana@nphcda.gov.ng

Michael Galway: Michael.Galway@gatesfoundation.org

Fiona Braka: brakaf@who.int

Ticha Johnson Muluh: tichaj@who.int

Richard Banda: bandari@who.int

Godwin Akpan: akpang@who.int

Ajiboye Tunji: ajiboyet@who.int

Umar Kabo Idris: umar.idris@ehealthnigeria.org

Journal

Journal ID (nlm-ta): BMC Public Health

Journal ID (iso-abbrev): BMC Public Health

Title: BMC Public Health

Publisher: BioMed Central (London )

ISSN (Electronic): 1471-2458

Publication date (Electronic): 13 December 2018

Publication date PMC-release: 13 December 2018

Publication date Collection: 2018

Volume: 18

Issue : Suppl 4 Issue sponsor : Publication of this supplement has been supported by the WHO Nigeria. The articles have undergone the journal's standard peer review process for supplements. The Supplement Editors declare that they have no competing interests and that they have did not oversee peer review for their own papers.

Electronic Location Identifier: 1305

Affiliations

[1 ]National Primary Health Care Agency, Abuja, Nigeria

[2 ]ISNI 0000000106344187, GRID grid.265892.2, The University of Alabama at Birmingham, ; Birmingham, USA

[3 ]World Health Organization country Representative Office, Abuja, Nigeria

[4 ]ISNI 0000 0000 8990 8592, GRID grid.418309.7, Bill and Melinda Gates Foundation, ; St. NW, Washington DC, USA

[5 ]EHealth Africa, Nigeria office, Kano, Abuja Nigeria

[6 ]Novel-T, Geneva, Switzerland

Article

Publisher ID: 6187

DOI: 10.1186/s12889-018-6187-x

PMC ID: 6291924

PubMed ID: 30541508

SO-VID: c2bc374c-46e8-4174-b25b-9f4a33706c41

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

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ScienceOpen disciplines: Public health

Keywords: polio,acute flaccid paralysis,avadar,surveillance,technology,smartphone

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ScienceOpen disciplines: Public health

Keywords: polio, acute flaccid paralysis, avadar, surveillance, technology, smartphone

AVADAR (Auto-Visual AFP Detection and Reporting): demonstration of a novel SMS-based smartphone application to improve acute flaccid paralysis (AFP) surveillance in Nigeria

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Abstract

Background

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Conclusion

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Global Health Next Generation Network

Most cited references 4

Progress Toward Polio Eradication - Worldwide, 2015-2016.

An evaluation of the sensitivity of acute flaccid paralysis surveillance for poliovirus infection in Australia

Community Awareness and Sensitization on Acute Flaccid Paralysis Case Reporting in a Northern State of Nigeria

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