[Poliomyelitis eradication in areas with armed conflict: the case of Afghanistan]

The aim of this study was to describe fieldwork to erradicate poliomyelitis from Afghanistan and particularly from the Mazar Region. From 1997-1999, 365 cases of acute flaccid paralysis were detected. Of these, 216 cases (59.2%) were classified as poliomyelitis. The rate of acute flaccid paralysis improved from 0.1 in 1997 to 0.8 in 1999. Fieldwork in the Mazar region revealed under-notification and the need to improve surveillance methods. However, massive use of the services of traditional healers and extreme transport difficulties reduced the efficacy of the interventions. The case of Afghanistan suggests that epidemiological surveillance systems are feasible in countries with armed conflict, although such systems require considerable resources.