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Surveillance of acute flaccid paralysis in Hong Kong: 1997 to 2002
R M K Lam1, T H F Tsang, K Y Chan
1Centre for Health Protection, Department of Health, Hong Kong.
Insights
This study evaluated Hong Kong's acute flaccid paralysis surveillance system, finding it effective in identifying non-polio causes like Guillain-Barre syndrome, though stool investigations need improvement.
Area of Science:
- Public Health
- Epidemiology
- Infectious Disease Surveillance
Background:
- Acute flaccid paralysis (AFP) surveillance is crucial for detecting infectious neurological diseases.
- The World Health Organization (WHO) provides guidelines for evaluating AFP surveillance systems.
Purpose of the Study:
- To characterize patients with AFP reported in Hong Kong from 1997-2002.
- To assess the performance of the AFP surveillance system against WHO indicators.
Main Methods:
- Retrospective study of children under 15 years reported with AFP.
- Analysis of surveillance data and performance indicators.
Main Results:
- 120 children reported with AFP; none were polio-related.
- Guillain-Barre syndrome (42%) and transverse myelitis (15%) were common neurological causes.
- The surveillance system met most WHO performance indicators, demonstrating effectiveness, except for adequate stool investigation.
Conclusions:
- Hong Kong's AFP surveillance system is effective and can serve as a model for other infectious diseases.
- Vigilance for AFP is essential, and physician awareness of surveillance protocols must be maintained.
Objectives:
To describe the characteristics of patients reported with acute flaccid paralysis between 1997 and 2002, and to evaluate the performance of the acute flaccid paralysis surveillance system using indicators recommended by the World Health Organization.
Design:
Retrospective study.
Setting:
Department of Health, Hong Kong.
Participants:
Children aged younger than 15 years who were reported to the Department of Health between 1997 and 2002 with acute flaccid paralysis.
Results:
Of 120 children with acute flaccid paralysis reported between 1997 and 2002, 42% were younger than 5 years of age. None of the cases were acute poliomyelitis or polio-compatible. A neurological cause was identified in 67.5% of cases, of which the most common was Guillain-Barre syndrome (42%), followed by transverse myelitis (15%). All except one of the performance indicators consistently met World Health Organization requirements and thus demonstrated the effectiveness of the acute flaccid paralysis surveillance programme. The acute flaccid paralysis notification rate consistently exceeded 1.0 per 100 000 population below 15 years of age. The requirement for adequate stool investigation was the single indicator that did not satisfy World Health Organization requirements. This highlighted the importance of maintaining physicians' awareness of acute flaccid paralysis surveillance.
Conclusion:
Hong Kong should remain vigilant for acute flaccid paralysis. The effective surveillance system and its evaluation may serve as a model for surveillance of other infectious diseases.
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