Sensitivity of poliomyelitis surveillance in India

To estimate the sensitivity of poliomyelitis surveillance in India.

A comparison of two sets of data obtained from lameness surveys and routine surveillance system.

Lameness surveys were undertaken by the Ministry of Health and Family Welfare in 1981, 1989 and 1992 using 30-cluster sampling technique. These data were compared with the number of polio cases reported through routine surveillance system.

Based on the 1981 survey which was undertaken near the initiation of routine immunization with oral polio vaccine (OPV) in India, poliomyelitis incidence was estimated at 25 cases per 100,000 population. Subsequent studies in 1989 and 1992 estimated a decrease in incidence rates to 15.7 and 6.3 cases per 100,000 population, respectively. Comparing the number of reported cases with the survey estimates provided a measure of the sensitivity of (completeness of reporting) surveillance; the sensitivity increased from 8% in 1981, to 20% in 1989, to 32% in 1992.

The results are encouraging when compared with the global estimates of 10% reporting in 1993. Nevertheless, there is a need for further improvement in the completeness of reporting of poliomyelitis cases to detect all the cases of acute flaccid paralysis to allow epidemiological investigations and effective follow-up action which is critical to interrupt wild virus transmission.