An Evaluation of the Acute Flaccid Paralysis (AFP) Surveillance System in Zvimba District, Mashonaland West Province; a Descriptive Cross Sectional Study

Background: In 2013, Zvimba district investigated 7 cases of AFP. Among the seven cases investigated, three had stool specimens collected more than 21 days after the onset of symptoms against a target of within 14 days. Only one of the seven cases had physical examination after 60 days from onset of symptoms. We therefore carried out this study to evaluate the AFP surveillance system in Zvimba district, Mashonaland West Province, Zimbabwe. Methods: A descriptive cross sectional study was conducted at 36 health facilities in Zvimba District, Zimbabwe. Structured questionnaires, checklist and AFP notification forms were used to collect data. Permission to proceed was sought and granted from the Mashonaland West Provincial Medical Director, Zvimba District Medical Officer and the Zimbabwe Health Studies Office. Results: Eighty-five percent of respondents were nurses. The median years in service was 7 years (Q1=4; Q3=10). Knowledge was good (83%). Ninety-six percent were willing to participate in the surveillance. Twenty four percent had ever completed an AFP form and eighty one percent reported that completion of the form was simple. All the 36 health centres in the district were accessible by road and had a cell phone and a working network reception. No form had laboratory results. Ninety nine percent perceived the AFP surveillance system as useful and 82% used data at local level. Conclusion: knowledge of health workers was good. The AFP surveillance system was useful, simple, stable, sensitive and representative. However the system was not timely. Completeness of data on the notification forms was also poor. Follow up physical examination on AFP cases was not done. Keywords: Acute flaccid paralysis, Polio, Surveillance, Zvimba district, Zimbabwe