20 April 2017 – In a small health facility in Sakhi Sarwar, a little town in Pakistan’s Punjab province, Dr Ujala Nayyar, WHO’s Surveillance Officer for Punjab, leans over a register to review all doctors’ appointments in recent months. She is checking every record to look for symptoms that could be signs of polio, like the sudden floppiness in arms, legs or any part of the body that indicates acute flaccid paralysis (AFP).
As she searches through the register, she checks if the doctor working at the clinic knows what the symptoms of polio are, and what they need to do if a child affected with AFP is brought in. This regular and detailed review of registers and the knowledge of hospital staff ensures optimal surveillance quality for polio eradication efforts.
Dr Nayyar and her team work with just one aim: to eradicate poliovirus. A network of 47,000 female health workers, religious leaders, traditional healers and more than 10,000 doctors helps her team identify paralyzed children in Punjab.
AFP can have several other causes in addition to polio, which means that every single case needs to be tested in a laboratory to confirm whether it was caused by polio or not. Approximately 800 stool samples of AFP cases are collected on a monthly basis and sent to the National Institute of Health for testing. This data enables the district surveillance team to identify where the poliovirus is circulating and vaccination campaigns need to be held in order to interrupt it.
A network of 47 Polio Eradication Officers in 36 districts of Punjab works relentlessly to ensure no paralysis case is missed.
Surveillance is one of the key activities of the polio eradication initiative in Pakistan. Many innovative approaches are being introduced to help detect where the virus is circulating, including surveillance reviews and regular AFP orientation sessions for medical officers and consultants on how to report AFP cases. ‘We have to be smart enough to run ahead of the virus to interrupt its circulation in Pakistan,’ says Dr Nayyar.
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