TABLE 1. National and subnational acute flaccid paralysis surveillance indicators and number of confirmed wild poliovirus and circulating vaccine-derived poliovirus cases, by country, for all countries with poliovirus transmission during 2011–2017 and those that were affected by the Ebola virus disease outbreak in West Africa — World Health Organization African Region and Eastern Mediterranean Region, 2016–2017*.
| WHO Region/Country | No. of AFP cases (all ages) | Regional/National NPAFP rate† | % Subnational areas with NPAFP rate ≥2§ | % Regional or national AFP cases with adequate specimens¶ | % Subnational areas with ≥80% adequate specimens | % Population living in areas meeting both indicators** | No. of confirmed WPV cases* | No. of confirmed cVDPV cases*,†† |
|---|---|---|---|---|---|---|---|---|
|
2016
| ||||||||
|
AFR (all 47 countries)§§
|
31,759 |
7.4 |
NA |
92 |
NA |
NA |
4 |
1 |
| Angola |
392 |
3.5 |
94 |
94 |
100 |
84 |
—¶¶ |
—¶¶ |
| Cameroon |
868 |
7.8 |
100 |
87 |
90 |
82 |
— |
— |
| Central African Republic*** |
143 |
7.0 |
100 |
73 |
29 |
25 |
— |
— |
| Chad |
484 |
7.2 |
87 |
85 |
65 |
78 |
— |
— |
| Côte d'Ivoire |
371 |
4.2 |
85 |
94 |
85 |
74 |
— |
— |
| DRC*** |
1,819 |
5.1 |
100 |
78 |
50 |
56 |
— |
— |
| Equatorial Guinea |
3 |
0.6 |
0 |
0 |
0 |
0 |
— |
— |
| Ethiopia*** |
1,048 |
2.5 |
82 |
79 |
46 |
9 |
— |
— |
| Gabon*** |
43 |
6.1 |
100 |
26 |
10 |
3 |
— |
— |
| Guinea |
1,061 |
20.1 |
100 |
88 |
88 |
85 |
— |
— |
| Kenya |
554 |
2.8 |
89 |
89 |
79 |
70 |
— |
— |
| Liberia |
69 |
3.6 |
100 |
75 |
53 |
43 |
— |
— |
| Madagascar |
791 |
7.6 |
96 |
86 |
77 |
80 |
— |
— |
| Mali |
307 |
3.8 |
89 |
90 |
78 |
96 |
— |
— |
| Mozambique |
425 |
3.2 |
90 |
82 |
40 |
59 |
— |
— |
| Niger*** |
366 |
3.5 |
75 |
62 |
13 |
3 |
— |
— |
| Nigeria |
17,867 |
20.7 |
97 |
99 |
97 |
99 |
4 |
1 |
| Republic of the Congo |
82 |
3.6 |
83 |
82 |
67 |
78 |
— |
— |
| Sierra Leone |
68 |
2.6 |
100 |
77 |
50 |
45 |
— |
— |
| South Sudan |
323 |
6.3 |
90 |
91 |
80 |
70 |
— |
— |
|
EMR (all 21 countries)†††
|
15,951 |
7.6 |
NA |
90 |
NA |
NA |
33 |
1 |
| Afghanistan |
2,905 |
20.1 |
100 |
92 |
97 |
100 |
13 |
— |
| Iraq |
605 |
4.2 |
90 |
81 |
58 |
44 |
— |
— |
| Pakistan |
7,848 |
12.6 |
100 |
87 |
88 |
99 |
20 |
1 |
| Somalia |
316 |
5.9 |
100 |
99 |
100 |
100 |
— |
— |
| Syria |
246 |
3.2 |
57 |
81 |
64 |
33 |
— |
— |
| Yemen |
715 |
7.1 |
100 |
91 |
100 |
100 |
— |
— |
|
2017
| ||||||||
|
AFR§§
|
30,889 |
7.1 |
NA |
92 |
NA |
NA |
— |
22 |
| Angola |
411 |
3.6 |
94 |
97 |
100 |
84 |
— |
— |
| Cameroon |
973 |
8.9 |
100 |
85 |
90 |
82 |
— |
— |
| Central African Republic |
167 |
8.3 |
100 |
80 |
43 |
48 |
— |
— |
| Chad*** |
702 |
10.2 |
100 |
79 |
52 |
62 |
— |
— |
| Côte d'Ivoire |
334 |
3.6 |
60 |
91 |
75 |
58 |
— |
— |
| DRC*** |
2,113 |
5.8 |
100 |
79 |
46 |
42 |
— |
22 |
| Equatorial Guinea |
12 |
3.7 |
57 |
17 |
14 |
0 |
— |
— |
| Ethiopia |
1,096 |
2.6 |
73 |
86 |
100 |
90 |
— |
— |
| Gabon*** |
51 |
6.9 |
100 |
59 |
50 |
35 |
— |
— |
| Guinea |
453 |
8.4 |
100 |
87 |
100 |
100 |
— |
— |
| Kenya |
463 |
2.2 |
66 |
84 |
72 |
53 |
— |
— |
| Liberia |
81 |
4.1 |
100 |
82 |
60 |
76 |
— |
— |
| Madagascar |
701 |
6.6 |
100 |
93 |
96 |
99 |
— |
— |
| Mali |
256 |
3.1 |
100 |
88 |
89 |
95 |
— |
— |
| Mozambique |
374 |
2.9 |
100 |
86 |
70 |
80 |
— |
— |
| Niger*** |
681 |
6.4 |
100 |
70 |
0 |
0 |
— |
— |
| Nigeria |
15,967 |
18.5 |
97 |
98 |
97 |
99 |
— |
— |
| Republic of the Congo |
118 |
5.5 |
83 |
84 |
58 |
66 |
— |
— |
| Sierra Leone*** |
75 |
2.8 |
100 |
77 |
75 |
77 |
— |
— |
| South Sudan |
388 |
7.3 |
90 |
85 |
70 |
67 |
— |
— |
|
EMR†††
|
19,035 |
9.0 |
NA |
88 |
NA |
NA |
22 |
74 |
| Afghanistan |
3,090 |
21.3 |
100 |
94 |
100 |
100 |
14 |
— |
| Iraq |
699 |
4.8 |
95 |
87 |
79 |
74 |
— |
— |
| Pakistan |
10,196 |
16.3 |
100 |
86 |
100 |
100 |
8 |
— |
| Somalia |
345 |
6.3 |
100 |
99 |
100 |
100 |
— |
— |
| Syria*** |
348 |
3.6 |
57 |
70 |
57 |
28 |
— |
74 |
| Yemen | 713 | 7.0 | 100 | 82 | 70 | 68 | — | — |
Abbreviations: AFP = acute flaccid paralysis; AFR = African Region; cVDPV = circulating vaccine-derived poliovirus; DRC = Democratic Republic of the Congo; Ebola = Ebola virus disease; EMR = Eastern Mediterranean Region; NA = not available; NPAFP = nonpolio AFP; WHO = World Health Organization; WPV = wild poliovirus.
* Data current as of February 22, 2018.
† 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. For 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. Good condition was defined as arrival of specimens in a WHO-accredited laboratory with reverse cold chain maintained and without leakage or desiccation.
** Percentage of the country’s population living in subnational areas which met both surveillance indicators (NPAFP rates ≥2 per 100,000 persons aged <15 years per year and ≥80% of AFP cases with adequate specimens).
†† cVDPV was associated at least one case of AFP with evidence of transmission and genetically linked. Guidelines for classification of cVDPV can be found at http://polioeradication.org/wp-content/uploads/2016/09/Reporting-and-Classification-of-VDPVs_Aug2016_EN.pdf.
§§ Algeria, Angola, Benin, Botswana, Burkina Faso, Burundi, Cameroon, Cabo Verde, Central African Republic, Chad, Comoros, Côte d’Ivoire, Democratic Republic of the Congo, Equatorial Guinea, Eritrea, Ethiopia, Gabon, Gambia, Ghana, Guinea, Guinea-Bissau, Kenya, Lesotho, Liberia, Madagascar, Malawi, Mali, Mauritania, Mauritius, Mozambique, Namibia, Niger, Nigeria, Rwanda, Republic of the Congo, Sao Tome and Principe, Senegal, Seychelles, Sierra Leone, South Africa, South Sudan, Swaziland, Togo, Uganda, Tanzania, Zambia, and Zimbabwe.
¶¶ Dashes indicate that no confirmed cases were found.
*** Stool adequacy dropped to <80% when stool condition was included with timeliness.
††† 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.