E ISSN: 2583-049X

International Journal of Advanced Multidisciplinary Research and Studies

Volume 3, Issue 2, 2023

Evaluation of the Acute Flaccid Paralysis (AFP) Surveillance System in Punjab, Pakistan-2019

Author(s): Dr. Fawad Khurshid, Dr. Haram Saif, Dr. Muhammad Shah Rukh Khalil, Dr. Fayaz Sarwer, Dr. Muhammad Mohsan Watoo, Dr. Anzaar Ahmad, Dr. Ayaz Nasir



Pakistan is one of two countries where polio is still endemic in spite of enormous efforts. Pakistan started AFP surveillance system in 1995 and in 2000 additional technical support was provided to the system at all levels by WHO. Despite heavy circulation of polio virus in provinces KPK, Sindh and Baluchistan, Punjab has only 12 cases reported in 2019.Hence this system was evaluated in Punjab to identify any gaps.


Descriptive study was carried out in Punjab during February-2020.Literature and records were reviewed. In depth interviews of stakeholders were conducted using a semi-structured questionnaire. Updated CDC guidelines for evaluating public health surveillance system 2001 were used for evaluating the surveillance system.


Case definition was simple and system collects all necessary information. System had flexibility to collect information on other diseases like measles and Neonatal tetanus (NNT). Data quality was good and timeliness of all the performance indicators was excellent. Sensitivity was 100% as the system has picked up all the cases. Positive predictive value was 0.16%. System had the good acceptability in donor agency and the persons who are in the system. System was present in all districts, less involvement in private sector and representativeness was average. System operates without interruption showing good stability.


AFP surveillance system in Punjab is well developed. There is less involvement of private health sector. No full-time designated DSC is present in districts of Punjab. Routine immunization has no significant improvement. Environmental samples are still positive. It is recommended that there should be designated DSC in all districts of Punjab. Active surveillance sites should be increased in private sectors. Routine immunization should be improved. Actions taken for positive environmental samples need to be documented and communicated to higher level.

Keywords: AFP, Surveillance, Punjab, Evaluation

Pages: 191-195

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