Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov 1;210 Suppl 1(0 1):S85-90.
doi: 10.1093/infdis/jiu149.

Forewarning of poliovirus outbreaks in the Horn of Africa: an assessment of acute flaccid paralysis surveillance and routine immunization systems in Kenya

Allison Taylor Walker  1 , Samir Sodha  1 , Wick C Warren  1 , Kibet Sergon  2 , Shem Kiptoon  2 , John Ogange  2 , Abdi Hassan Ahmeda  2 , Messeret Eshetu  3 , Melissa Corkum  4 , Satish Pillai  1 , Heather Scobie  1 , Rennatus Mdodo  1 , Danielle M Tack  1 , Cara Halldin  1 , Kristie Appelgren  1 , Katrina Kretsinger  1 , Diana M Bensyl  1 , Ian Njeru  5 , Titus Kolongei  5 , Juliet Muigai  5 , Amina Ismail  5 , Samuel O Okiror  3
Affiliations

Forewarning of poliovirus outbreaks in the Horn of Africa: an assessment of acute flaccid paralysis surveillance and routine immunization systems in Kenya

Allison Taylor Walker et al. J Infect Dis. .

Abstract

Background: Although the Horn of Africa region has successfully eliminated endemic poliovirus circulation, it remains at risk for reintroduction. International partners assisted Kenya in identifying gaps in the polio surveillance and routine immunization programs, and provided recommendations for improved surveillance and routine immunization during the health system decentralization process.

Methods: Structured questionnaires collected information about acute flaccid paralysis (AFP) surveillance resources, training, data monitoring, and supervision at provincial, district, and health facility levels. The routine immunization program information collected included questions about vaccine and resource availability, cold chain, logistics, health-care services and access, outreach coverage data, microplanning, and management and monitoring of AFP surveillance.

Results: Although AFP surveillance met national performance standards, widespread deficiencies and limited resources were observed and reported at all levels. Deficiencies were related to provider knowledge, funding, training, and supervision, and were particularly evident at the health facility level.

Conclusions: Gap analysis assists in maximizing resources and capacity building in countries where surveillance and routine immunization lag behind other health priorities. Limited resources for surveillance and routine immunization systems in the region indicate a risk for additional outbreaks of wild poliovirus and other vaccine-preventable illnesses. Monitoring and evaluation of program strengthening activities are needed.

Keywords: decentralization; polio; program review; routine immunization; surveillance.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. All authors: No reported conflicts.

Figures

Figure 1
Figure 1
Geographic areas of Kenya selected for the acute flaccid paralysis surveillance and Expanded Program on Immunization review, 2012.
See this image and copyright information in PMC

References

    1. [Accessed 14 November 2013];Global Polio Eradication Initiative. 2013 http://apps.who.int/immunization_monitoring/en/diseases/poliomyelitis/af....
    1. World Health Organization. Field guide for supplementary activities aimed at achieving polio eradication. Geneva: World Health Organization; 1997. Expanded Programme on Immunization.
    1. [Accessed 4 December 2013];Kenya Open-Source Government Data. 2013 https://www.opendata.go.ke/Health-Sector/Vol-II-Table-14-Population-by-m....
    1. WHO and UNICEF working group for monitoring national immunization coverage. Data Update: A Summary of Global Immunization Coverage through 2012. UNICEF and WHO; Oct, 2013.
    1. Kenya National Bureau of Statistics (KNBS) and ICF Macro. Kenya demographic and health survey 2008–09. Calverton, Maryland: KNBS and ICF Macro; 2010.

Substances