Table 2.
Acute Flaccid Paralysis Surveillance, Afghanistan, 1997–June 2013
| Year | No. of AFP Cases | Met Specimen Standards, %a | Nonpolio AFP Rate per 100 000 Children Aged <15 yb |
|---|---|---|---|
| 1997 | 28 | 46.4 | 0.1 |
| 1998 | 122 | 48.4 | 0.7 |
| 1999 | 231 | 51.9 | 0.7 |
| 2000 | 253 | 49.4 | 1.1 |
| 2001 | 214 | 73.8 | 1.7 |
| 2002 | 335 | 79.7 | 2.3 |
| 2003 | 600 | 88.2 | 4.0 |
| 2004 | 687 | 90.8c | 4.5 |
| 2005 | 827 | 91.7 | 5.3 |
| 2006 | 989 | 89.2 | 6.2 |
| 2007 | 1116 | 91.8 | 6.9 |
| 2008 | 1383 | 92.2d | 8.2 |
| 2009 | 1477 | 92.5 | 8.8 |
| 2010 | 1572 | 92.6 | 9.2 |
| 2011 | 1830 | 92.1 | 10.5 |
| 2012 | 1829 | 92.3 | 9.9 |
| 2013 | 1879 | 93.0 | 9.9 |
Abbreviation: AFP, acute flaccid paralysis.
Quality of AFP surveillance is evaluated by 3 key indicators established by the World Health Organization (WHO): sensitivity of reporting (target: nonpolio AFP rate of ≥2 cases per 100 000 children aged <15 years; completeness of stool specimen collection (target: 2 adequate stool specimens from ≥80% of all persons with AFP); and proportion of stool specimens processed in a WHO-accredited laboratory.
United Nations population figures used to calculate rates.
In 2004, the global community changed the target for the sensitivity of reporting from 1 to 2 cases per 100 000 children aged <15 years, and the second indicator was modified to “the completeness and timeliness of stool specimen collection”—at least 80% of AFP cases with 2 adequate stool specimens collected >24 hours apart, both within 14 days of paralysis onset and shipped on ice or frozen packs to a WHO-accredited laboratory and arriving at the laboratory in good condition.
In 2008, the third indicator, the proportion of stools and specimens processed in a WHO accredited laboratory, was added as a separate measure of surveillance quality.