Khaled Almoayed - Academia.edu (original) (raw)

Papers by Khaled Almoayed

JMIR public health and surveillance, Dec 6, 2019

Background: Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus er... more Background: Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus eradication. Objective: This study aimed to evaluate the performance of the AFP surveillance system in Yemen from 2010 to 2015, identify components that require strengthening, and compare the indicators by year and governorates. Methods: This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The World Health Organization (WHO) minimum performance standards were used to evaluate the performance of the AFP surveillance system. Results: A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for the nonpolio AFP rate of cases per 100,000 members of the population younger than 15 years of age, proportion of AFP cases reported within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which nonpolio enterovirus was isolated. However, the proportion of specimens that arrived at the central level within 3 days of the first sample collection and the proportion of stool specimens with results sent from the reference laboratory within 28 days of receipt did not reach targets in 2011 and 2015, respectively. Conclusions: The AFP surveillance system in Yemen has met most of the WHO indicator levels. Nevertheless, the evaluation showed areas of weakness regarding the arrival of specimens at the central level within 3 days of the first sample collection and delays in processing of the results and submitting feedback by the laboratory. Therefore, there is a need to strengthen the follow-up of specimens submitted to the laboratory.

BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is an essential strategy for poliovirus era... more BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is an essential strategy for poliovirus eradication. OBJECTIVE This study aimed to evaluate the performance of the AFP surveillance system in Yemen (2010-2015), identify components that require strengthening and compare the indicators by year and governorates. METHODS This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The WHO minimum performance standards were used to evaluate the performance of AFP surveillance system. RESULTS A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for non-polio AFP rate/100,000 population <15 years, proportion of AFP cases notified within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which non-polio enterovirus was isolated. However, the proportion of specimens arrived at the central level <3 days of 1st sample collection and the proportion of stool specimens with results sent from WHO reference laboratory <28 days of its receiving did not reach the target in 2011 and 2011 and 2015 respectively. CONCLUSIONS The AFP surveillance system in Yemen has met most WHO indicators. Nevertheless, the evaluation showed weakness points regarding to the specimens that arrived at the central level <3 days of 1st sample collection and the delay of processing the results and submitting feedback by EMRO laboratory. Therefore, there is a need to strengthen the follow up of specimens submitted to EMRO laboratory.

bioRxiv (Cold Spring Harbor Laboratory), Aug 25, 2022

The humanitarian crisis in Yemen led in 2016 to the biggest cholera outbreak documented in modern... more The humanitarian crisis in Yemen led in 2016 to the biggest cholera outbreak documented in modern history, with more than 2.5 million suspected cases to date. In late 2018, epidemiological surveillance showed that V. cholerae isolated from cholera patients had turned multi-drug resistant (MDR). We generated genomes from 260 isolates sampled in Yemen between 2018 and 2019 to identify a possible shift in circulating genotypes. 84% of V. cholerae isolates were serogroup O1 belonging to the seventh pandemic El Tor (7PET) lineage, sublineage T13-same as in 2016 and 2017-while the remaining 16% of strains were nontoxigenic and belonged to divergent V. cholerae lineages, likely reflecting sporadic gut colonisation by endemic strains. Phylogenomic analysis reveals a succession of T13 clones, with 2019 dominated by a clone that carried an IncC-type plasmid harbouring an MDR pseudocompound transposon (PCT). Identical copies of these mobile elements were found independently in several unrelated lineages, suggesting exchange and recombination between .

BMC Infectious Diseases

Background Yemen has faced one of the worst humanitarian crises in the world since the start of t... more Background Yemen has faced one of the worst humanitarian crises in the world since the start of the war in 2015. In 2020; 30 Vaccine Derived Polio Virus type 1 (VDPV1) isolates were detected in Saadah governorate. The aims are to characterize the outbreak and address the gaps predisposing the emergence and circulation of VDPV1 in Saadah governorate, Yemen. Method A retrospective descriptive study of confirmed cases of VDPV1 between January and December 2020 was performed. Surveillance staff collected data from patient cases, contacts, as well as stool specimens that shipped to WHO accredited polio labs. Data of population immunity was also reviewed. The difference in days between the date of sample collection, shipment, and receiving lab result was used to calculate the average of delayed days for lab confirmation. Results From January to December 2020, a total of 114 cases of acute flaccid paralysis (AFP) were reported from 87% (13/15) districts, and cVDPV1 was confirmed among 26% ...

International Journal of Infectious Diseases, 2020

Frontiers in Public Health, 2021

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save liv... more COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and in...

Frontiers in Public Health, 2021

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save liv... more COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and in...

Frontiers in Public Health, 2021

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save liv... more COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and in...

Frontiers in Public Health, 2021

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save liv... more COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and in...

JMIR Public Health and Surveillance, 2021

Background Rabies remains a neglected and poorly controlled disease throughout the developing wor... more Background Rabies remains a neglected and poorly controlled disease throughout the developing world, particularly in Africa and Asia, where most human rabies deaths occur. Objective This study aimed to describe the epidemiology of rabies exposures, its trend, and its geographical distribution in Yemen. Methods Cumulative data from a rabies surveillance system for the period 2011-2017 were obtained from the National Rabies Control Program as paper-based annual reports. Data included the number of persons bitten by a suspected rabid animal, their gender and age, and the result of the animal’s laboratory test. Human cases were defined as those exposed to rabies virus bitten by a suspected rabid animal, exposed to a confirmed rabid animal and then received postexposure prophylaxis (PEP), and deaths occurred after exposure to a confirmed rabid animal after having rabies symptoms during 2011-2017. Results From 2011 to 2017, a total of 76,049 persons were bitten by a suspected rabid animal...

BMC Infectious Diseases, 2022

Background The burden of seasonal influenza in conflict counties is exacerbated due to limited re... more Background The burden of seasonal influenza in conflict counties is exacerbated due to limited resource and collapse of health system. During 2018 /2019 season, two-fold increase in the incidence of influenza was reported in Yemen with 22% case fatality of severe acute respiratory infection (SARI). The aims are to analyze the influenza circulating viruses, positivity rate and risk factors for hospitalizing influenza associated-SARI. Methodology We used a retrospective analytical study based on surveillance data. All reported patients during 2018/2019 season, fulfilling the WHO cases definition for SARI or influenza like illness (ILI), and had laboratory result from the National Laboratory were included. Influenza positivity rate was calculated, all SARI and ILI patients with positive influenza were included for further analysis by univariate and multivariate binary logistic regression. Crude and adjusted Odds ratio (AOR), 95% confidence interval and P-value < 0.05 were used for s...

BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to id... more BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to identify high-risk areas, determine trends, and evaluate elimination activities. Since its launch, the NTSS had never been evaluated. OBJECTIVE This study aimed to assess the performance of NTSS and determine its strengths and weaknesses to recommend improvements. METHODS The US Centers for Disease Control and Prevention (CDC) guidelines were used for evaluating the NTSS. Stakeholders at the central, district, and facility levels were interviewed to rate the attributes of the NTSS. The percentage scores for attributes were ranked as poor (<60%), average (≥60% to <80%) and good (≥80%). RESULTS The overall usefulness score percentage was 38%, which indicates a poor performance. The performance of the NTSS was rated as average on flexibility (score percent: 68%) and acceptability (score percent: 64%) attributes and poor on stability (score percentage: 33%), simplicity (score percentage:...

International Journal of Infectious Diseases, 2014

Background: Poliomyelitis is still endemic in Pakistan. Province Balochistan has set up AFP surve... more Background: Poliomyelitis is still endemic in Pakistan. Province Balochistan has set up AFP surveillance system for immediate case investigation and specimen collection for detecting wild polio virus. The goal is polio eradication. The purpose of this evaluation is to identify the weaknesses and strengths of this system. Methods & Materials: CDC's updated guide lines for evaluation of public health surveillance system were followed and a descriptive study was carried out in March 2011 to evaluate the system's functioning in 2010. Literature was studied, records were reviewed in provincial health department, stakeholders were identified and information was obtained through a designed questionnaire based on system attributes by conducting in depth interviews and focus group discussions with the stakeholders. Results: AFP Surveillance is active meaning the staff visits hospitals frequently and also goes door to door to find cases. It is simple with an easily understandable case definition. System demonstrated its flexibility by incorporating information on measles and neonatal tetanus in 2009. Representativeness is average as system has limited integration with private sectors. All 29 districts submitted reports daily to the national level in the year 2010. However there is a gap in information sharing from district to provincial (subnational) level. Ninety percent of the reports are correctly filled. Information is shared with national & international health authority through electronic system within 24 hours. System sensitivity is 100%, whereas PVP is 5.6%. Conclusion: We recommend integration of AFP with private sectors and report sharing at provincial level. Data analysis at provincial level is necessary for policy making due to the securitycompromised situation.

The Lancet Microbe, 2021

HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific re... more HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.

JMIR public health and surveillance, Dec 6, 2019

Background: Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus er... more Background: Acute flaccid paralysis (AFP) surveillance is an essential strategy for poliovirus eradication. Objective: This study aimed to evaluate the performance of the AFP surveillance system in Yemen from 2010 to 2015, identify components that require strengthening, and compare the indicators by year and governorates. Methods: This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The World Health Organization (WHO) minimum performance standards were used to evaluate the performance of the AFP surveillance system. Results: A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for the nonpolio AFP rate of cases per 100,000 members of the population younger than 15 years of age, proportion of AFP cases reported within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which nonpolio enterovirus was isolated. However, the proportion of specimens that arrived at the central level within 3 days of the first sample collection and the proportion of stool specimens with results sent from the reference laboratory within 28 days of receipt did not reach targets in 2011 and 2015, respectively. Conclusions: The AFP surveillance system in Yemen has met most of the WHO indicator levels. Nevertheless, the evaluation showed areas of weakness regarding the arrival of specimens at the central level within 3 days of the first sample collection and delays in processing of the results and submitting feedback by the laboratory. Therefore, there is a need to strengthen the follow-up of specimens submitted to the laboratory.

BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is an essential strategy for poliovirus era... more BACKGROUND Acute Flaccid Paralysis (AFP) surveillance is an essential strategy for poliovirus eradication. OBJECTIVE This study aimed to evaluate the performance of the AFP surveillance system in Yemen (2010-2015), identify components that require strengthening and compare the indicators by year and governorates. METHODS This descriptive study was based on secondary analysis of AFP surveillance data reported during 2010-2015 from all Yemeni governorates. The WHO minimum performance standards were used to evaluate the performance of AFP surveillance system. RESULTS A total of 3019 AFP cases were reported between January 2010 and December 2015. At the national level, AFP surveillance achieved WHO targets throughout the evaluating period for non-polio AFP rate/100,000 population &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;15 years, proportion of AFP cases notified within 7 days, proportion of AFP cases investigated within 48 hours of notification, proportion of AFP cases with two adequate stool specimens, and proportion of stool specimens from which non-polio enterovirus was isolated. However, the proportion of specimens arrived at the central level &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;3 days of 1st sample collection and the proportion of stool specimens with results sent from WHO reference laboratory &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;28 days of its receiving did not reach the target in 2011 and 2011 and 2015 respectively. CONCLUSIONS The AFP surveillance system in Yemen has met most WHO indicators. Nevertheless, the evaluation showed weakness points regarding to the specimens that arrived at the central level &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt;3 days of 1st sample collection and the delay of processing the results and submitting feedback by EMRO laboratory. Therefore, there is a need to strengthen the follow up of specimens submitted to EMRO laboratory.

bioRxiv (Cold Spring Harbor Laboratory), Aug 25, 2022

The humanitarian crisis in Yemen led in 2016 to the biggest cholera outbreak documented in modern... more The humanitarian crisis in Yemen led in 2016 to the biggest cholera outbreak documented in modern history, with more than 2.5 million suspected cases to date. In late 2018, epidemiological surveillance showed that V. cholerae isolated from cholera patients had turned multi-drug resistant (MDR). We generated genomes from 260 isolates sampled in Yemen between 2018 and 2019 to identify a possible shift in circulating genotypes. 84% of V. cholerae isolates were serogroup O1 belonging to the seventh pandemic El Tor (7PET) lineage, sublineage T13-same as in 2016 and 2017-while the remaining 16% of strains were nontoxigenic and belonged to divergent V. cholerae lineages, likely reflecting sporadic gut colonisation by endemic strains. Phylogenomic analysis reveals a succession of T13 clones, with 2019 dominated by a clone that carried an IncC-type plasmid harbouring an MDR pseudocompound transposon (PCT). Identical copies of these mobile elements were found independently in several unrelated lineages, suggesting exchange and recombination between .

BMC Infectious Diseases

Background Yemen has faced one of the worst humanitarian crises in the world since the start of t... more Background Yemen has faced one of the worst humanitarian crises in the world since the start of the war in 2015. In 2020; 30 Vaccine Derived Polio Virus type 1 (VDPV1) isolates were detected in Saadah governorate. The aims are to characterize the outbreak and address the gaps predisposing the emergence and circulation of VDPV1 in Saadah governorate, Yemen. Method A retrospective descriptive study of confirmed cases of VDPV1 between January and December 2020 was performed. Surveillance staff collected data from patient cases, contacts, as well as stool specimens that shipped to WHO accredited polio labs. Data of population immunity was also reviewed. The difference in days between the date of sample collection, shipment, and receiving lab result was used to calculate the average of delayed days for lab confirmation. Results From January to December 2020, a total of 114 cases of acute flaccid paralysis (AFP) were reported from 87% (13/15) districts, and cVDPV1 was confirmed among 26% ...

International Journal of Infectious Diseases, 2020

Frontiers in Public Health, 2021

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save liv... more COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and in...

Frontiers in Public Health, 2021

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save liv... more COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and in...

Frontiers in Public Health, 2021

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save liv... more COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and in...

Frontiers in Public Health, 2021

COVID-19 pandemic has underscored the need for a well-trained public health workforce to save liv... more COVID-19 pandemic has underscored the need for a well-trained public health workforce to save lives through timely outbreaks detection and response. In Yemen, a country that is entering its seventh year of a protracted war, the ongoing conflict severely limited the country's capacity to implement effective preparedness and response measures to outbreaks including COVID-19. There are growing concerns that the virus may be circulating within communities undetected and unmitigated especially as underreporting continues in some areas of the country due to a lack of testing facilities, delays in seeking treatment, stigma, difficulty accessing treatment centers, the perceived risks of seeking care or for political issues. The Yemen Field Epidemiology Training Program (FETP) was launched in 2011 to address the shortage of a skilled public health workforce, with the objective of strengthening capacity in field epidemiology. Thus, events of public health importance can be detected and in...

JMIR Public Health and Surveillance, 2021

Background Rabies remains a neglected and poorly controlled disease throughout the developing wor... more Background Rabies remains a neglected and poorly controlled disease throughout the developing world, particularly in Africa and Asia, where most human rabies deaths occur. Objective This study aimed to describe the epidemiology of rabies exposures, its trend, and its geographical distribution in Yemen. Methods Cumulative data from a rabies surveillance system for the period 2011-2017 were obtained from the National Rabies Control Program as paper-based annual reports. Data included the number of persons bitten by a suspected rabid animal, their gender and age, and the result of the animal’s laboratory test. Human cases were defined as those exposed to rabies virus bitten by a suspected rabid animal, exposed to a confirmed rabid animal and then received postexposure prophylaxis (PEP), and deaths occurred after exposure to a confirmed rabid animal after having rabies symptoms during 2011-2017. Results From 2011 to 2017, a total of 76,049 persons were bitten by a suspected rabid animal...

BMC Infectious Diseases, 2022

Background The burden of seasonal influenza in conflict counties is exacerbated due to limited re... more Background The burden of seasonal influenza in conflict counties is exacerbated due to limited resource and collapse of health system. During 2018 /2019 season, two-fold increase in the incidence of influenza was reported in Yemen with 22% case fatality of severe acute respiratory infection (SARI). The aims are to analyze the influenza circulating viruses, positivity rate and risk factors for hospitalizing influenza associated-SARI. Methodology We used a retrospective analytical study based on surveillance data. All reported patients during 2018/2019 season, fulfilling the WHO cases definition for SARI or influenza like illness (ILI), and had laboratory result from the National Laboratory were included. Influenza positivity rate was calculated, all SARI and ILI patients with positive influenza were included for further analysis by univariate and multivariate binary logistic regression. Crude and adjusted Odds ratio (AOR), 95% confidence interval and P-value < 0.05 were used for s...

BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to id... more BACKGROUND The Neonatal Tetanus Surveillance System (NTSS) in Yemen was established in 2009 to identify high-risk areas, determine trends, and evaluate elimination activities. Since its launch, the NTSS had never been evaluated. OBJECTIVE This study aimed to assess the performance of NTSS and determine its strengths and weaknesses to recommend improvements. METHODS The US Centers for Disease Control and Prevention (CDC) guidelines were used for evaluating the NTSS. Stakeholders at the central, district, and facility levels were interviewed to rate the attributes of the NTSS. The percentage scores for attributes were ranked as poor (<60%), average (≥60% to <80%) and good (≥80%). RESULTS The overall usefulness score percentage was 38%, which indicates a poor performance. The performance of the NTSS was rated as average on flexibility (score percent: 68%) and acceptability (score percent: 64%) attributes and poor on stability (score percentage: 33%), simplicity (score percentage:...

International Journal of Infectious Diseases, 2014

Background: Poliomyelitis is still endemic in Pakistan. Province Balochistan has set up AFP surve... more Background: Poliomyelitis is still endemic in Pakistan. Province Balochistan has set up AFP surveillance system for immediate case investigation and specimen collection for detecting wild polio virus. The goal is polio eradication. The purpose of this evaluation is to identify the weaknesses and strengths of this system. Methods & Materials: CDC's updated guide lines for evaluation of public health surveillance system were followed and a descriptive study was carried out in March 2011 to evaluate the system's functioning in 2010. Literature was studied, records were reviewed in provincial health department, stakeholders were identified and information was obtained through a designed questionnaire based on system attributes by conducting in depth interviews and focus group discussions with the stakeholders. Results: AFP Surveillance is active meaning the staff visits hospitals frequently and also goes door to door to find cases. It is simple with an easily understandable case definition. System demonstrated its flexibility by incorporating information on measles and neonatal tetanus in 2009. Representativeness is average as system has limited integration with private sectors. All 29 districts submitted reports daily to the national level in the year 2010. However there is a gap in information sharing from district to provincial (subnational) level. Ninety percent of the reports are correctly filled. Information is shared with national & international health authority through electronic system within 24 hours. System sensitivity is 100%, whereas PVP is 5.6%. Conclusion: We recommend integration of AFP with private sectors and report sharing at provincial level. Data analysis at provincial level is necessary for policy making due to the securitycompromised situation.

The Lancet Microbe, 2021

HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific re... more HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.