TABLE 1. National and subnational acute flaccid paralysis (AFP) surveillance indicators and number of confirmed wild poliovirus (WPV) and circulating vaccine-derived poliovirus (cVDPV) cases, by country, for all countries with poliovirus transmission during 2011–2016 or that were affected by the Ebola outbreak in West Africa within the World Health Organization (WHO) African Region and Eastern Mediterranean Region, 2015 and 2016*.
| WHO Region/Country | No. AFP cases (all ages) | Regional/National NPAFP rate† | Subnational areas with NPAFP rate ≥2§ (%) | Regional/National AFP cases with adequate specimens¶ (%) | Subnational areas with ≥80% adequate specimens (%) | Population in areas meeting both indicators** (%) | No. confirmed WPV cases* | No. confirmed cVDPV cases*,†† |
|---|---|---|---|---|---|---|---|---|
|
2015
| ||||||||
|
AFR (all 47 countries)§§
|
26,052
|
6.2
|
NA
|
90
|
NA
|
NA
|
0
|
18
|
|
Countries reporting WPV or cVDPV transmission during 2011–2016 and Ebola-affected countries (Guinea, Liberia, and Sierra Leone)
| ||||||||
| Angola |
414 |
3.8 |
100 |
95 |
100 |
100 |
0 |
0 |
| Cameroon |
619 |
5.6 |
100 |
83 |
80 |
67 |
0 |
0 |
| CAR |
81 |
3.9 |
71 |
80 |
43 |
34 |
0 |
0 |
| Chad |
433 |
6.6 |
100 |
87 |
78 |
87 |
0 |
0 |
| Cote d'Ivoire |
353 |
4.0 |
85 |
90 |
80 |
71 |
0 |
0 |
| DRC¶¶ |
2,117 |
6.0 |
100 |
74 |
9 |
6 |
0 |
0 |
| Equatorial Guinea |
9 |
2.9 |
43 |
22 |
0 |
0 |
0 |
0 |
| Ethiopia¶¶ |
1,179 |
2.8 |
82 |
76 |
45 |
29 |
0 |
0 |
| Gabon¶¶ |
61 |
8.6 |
100 |
33 |
0 |
0 |
0 |
0 |
| Guinea |
146 |
2.7 |
75 |
75 |
38 |
26 |
0 |
7 |
| Kenya |
619 |
3.1 |
89 |
85 |
74 |
68 |
0 |
0 |
| Liberia |
22 |
1.2 |
60 |
95 |
60 |
44 |
0 |
0 |
| Madagascar |
522 |
4.8 |
95 |
59 |
9 |
17 |
0 |
10 |
| Mali |
247 |
3.2 |
78 |
84 |
67 |
79 |
0 |
0 |
| Mozambique |
321 |
2.4 |
90 |
80 |
60 |
49 |
0 |
0 |
| Niger¶¶ |
214 |
2.1 |
63 |
61 |
0 |
0 |
0 |
0 |
| Nigeria |
13,970 |
17.1 |
100 |
98 |
100 |
100 |
0 |
1 |
| Republic of the Congo¶¶ |
117 |
5.3 |
100 |
78 |
45 |
29 |
0 |
0 |
| Sierra Leone |
41 |
1.5 |
50 |
79 |
25 |
23 |
0 |
0 |
| South Sudan |
331 |
6.5 |
100 |
94 |
90 |
90 |
0 |
0 |
|
EMR (all 21 countries)***
|
13,215
|
6.4
|
NA
|
90
|
NA
|
NA
|
74
|
2
|
|
Countries reporting WPV or cVDPV transmission during 2011–2016
| ||||||||
| Afghanistan |
2,738 |
18.9 |
100 |
93 |
94 |
94 |
20 |
0 |
| Iraq |
520 |
3.7 |
84 |
82 |
58 |
49 |
0 |
0 |
| Pakistan |
5,814 |
9.3 |
100 |
87 |
75 |
97 |
54 |
2 |
| Somalia |
281 |
5.4 |
100 |
96 |
100 |
100 |
0 |
0 |
| Syria††† |
236 |
3.1 |
57 |
85 |
71 |
43 |
0 |
0 |
| Yemen |
537 |
5.4 |
96 |
91 |
87 |
95 |
0 |
0 |
|
2016
| ||||||||
|
AFR (all 47 countries)§§
|
32,250
|
7.5
|
NA
|
90
|
NA
|
NA
|
4
|
1
|
|
Countries reporting WPV or cVDPV transmission during 2011–2016 and Ebola-affected countries (Guinea, Liberia, and Sierra Leone)
| ||||||||
| Angola |
396 |
3.5 |
94 |
94 |
100 |
84 |
0 |
0 |
| Cameroon |
871 |
7.9 |
100 |
85 |
90 |
82 |
0 |
0 |
| CAR¶¶ |
143 |
7.0 |
100 |
73 |
43 |
40 |
0 |
0 |
| Chad |
484 |
7.2 |
100 |
83 |
72 |
76 |
0 |
0 |
| Cote d'Ivoire |
371 |
4.2 |
85 |
93 |
85 |
74 |
0 |
0 |
| DRC¶¶ |
1,827 |
5.1 |
100 |
79 |
46 |
53 |
0 |
0 |
| Equatorial Guinea |
3 |
1.0 |
14 |
33 |
0 |
0 |
0 |
0 |
| Ethiopia¶¶ |
1,048 |
2.5 |
82 |
78 |
36 |
8 |
0 |
0 |
| Gabon¶¶ |
43 |
6.1 |
100 |
28 |
10 |
3 |
0 |
0 |
| Guinea |
1,065 |
20.1 |
100 |
87 |
88 |
85 |
0 |
0 |
| Kenya |
553 |
2.7 |
87 |
89 |
77 |
68 |
0 |
0 |
| Liberia |
69 |
3.5 |
87 |
75 |
47 |
40 |
0 |
0 |
| Madagascar |
788 |
7.6 |
95 |
85 |
77 |
81 |
0 |
0 |
| Mali |
307 |
3.8 |
89 |
89 |
78 |
96 |
0 |
0 |
| Mozambique |
426 |
3.3 |
100 |
82 |
50 |
65 |
0 |
0 |
| Niger¶¶ |
366 |
3.5 |
88 |
63 |
0 |
0 |
0 |
0 |
| Nigeria |
17,837 |
21.2 |
100 |
98 |
100 |
100 |
4 |
1 |
| Republic of the Congo |
82 |
3.7 |
82 |
82 |
73 |
78 |
0 |
0 |
| Sierra Leone |
68 |
2.6 |
100 |
76 |
50 |
45 |
0 |
0 |
| South Sudan |
323 |
6.3 |
90 |
91 |
80 |
70 |
0 |
0 |
|
EMR (all 21 countries)***
|
15,956
|
7.7
|
NA
|
90
|
NA
|
NA
|
33
|
1
|
|
Countries reporting WPV or cVDPV transmission during 2011–2016
| ||||||||
| Afghanistan |
2,903 |
20.0 |
100 |
92 |
97 |
99 |
13 |
0 |
| Iraq |
605 |
4.2 |
89 |
80 |
63 |
48 |
0 |
0 |
| Pakistan |
7,797 |
12.5 |
100 |
88 |
88 |
99 |
20 |
1 |
| Somalia |
316 |
5.9 |
100 |
99 |
100 |
100 |
0 |
0 |
| Syria††† |
303 |
3.9 |
71 |
79 |
43 |
28 |
0 |
0 |
| Yemen | 715 | 7.1 | 100 | 91 | 91 | 97 | 0 | 0 |
Abbreviations: AFR = African Region; CAR = Central African Republic; DRC = Democratic Republic of the Congo; Ebola = Ebola virus disease; EMR = Eastern Mediterranean Region; NA = not applicable; NPAFP = nonpolio AFP.
* Data as of February 12, 2017.
† Per 100,000 persons aged <15 years per year.
§ For all subnational areas regardless of population size.
¶ Standard WHO target is adequate stool specimen collection from ≥80% of AFP cases, assessed by timeliness and condition. In this analysis, timeliness was defined as two specimens collected ≥24 hours apart (≥1 calendar day in this data set), and both within 14 days of paralysis onset. Condition was defined as specimens arriving in good condition (reverse cold chain maintained and received without leakage or desiccation) in a WHO-accredited laboratory.
** Percent of the country’s population living in subnational areas which met both surveillance indicators (NPAFP rates of ≥2 per 100,000 persons aged <15 years per year and ≥80% of AFP cases with adequate specimens).
†† cVDPV was associated with two or more cases of AFP with genetically linked VDPVs. Guidelines for classification of cVDPV changed in 2015 and can be found at http://polioeradication.org/wp-content/uploads/2016/07/VDPV_ReportingClassification.pdf.
§§ Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cabo Verde, Central African Republic, Chad, Comoros, Congo, Cote d’Ivoire, Democratic Republic of Congo, Equatorial Guinea, Ethiopia, Eritrea, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Africa, South Sudan, Swaziland, Togo, Uganda, Tanzania, Zambia, and Zimbabwe.
¶¶ Stool adequacy dropped to <80% when stool condition was included with timeliness. Timeliness was defined as two specimens collected ≥24 hours apart (≥1 calendar day in this data set), and both within 14 days of paralysis onset. Condition was defined as specimens arriving in good condition (reverse cold chain maintained and received without leakage or desiccation) in a WHO-accredited laboratory.
*** Afghanistan, Bahrain, Djibouti, Egypt, Iran, Iraq, Jordan, Kuwait, Lebanon, Libya, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, Somalia, Sudan, Syria, Tunisia, United Arab Emirates, and Yemen.
††† The NPAFP rate for Syria is artificially low because of displaced populations and the lack of official data from areas not under government control.