[P2-14] Epidemiology of Acute Flaccid Paralysis in PAKISTAN
An Acute Flaccid Paralysis (AFP) surveillance network is established in the whole province of Punjab with all government & selective private health facilities expanding over 3,500 health facilities. All AFP patients of less than 15 years of age are taken into the system and investigated. From 2011-2015, AFP cases investigated were 2632, 2407, 2300, 2466, 3025 respectively. Out of these confirmed Poliomyelitis cases by stool culture the number have reduced during 2011 to 2015 from 9 to 2 while Poliomyelitis Compatible cases were 2 & 1 in 2011 & 2012. Gullian Barre syndrome is leading differential diagnosis among reported AFP cases from 2011- 2016 with 38%, 38%, 41%, 37%, 34% and 20% respectively, followed by a high incidence of Traumatic neuritis with 12%, 13%, 13%, 15%, 15% & 13% in 2016. Childhood hemiplegia and CVA is third most diagnosed in AFP illness with 10%, 11%, 9%, 8%, 8%&6%.Transeverse Myelitis is persistently 1% with 2% in year 2015.
Residual Paralysis in Poliomyelitis cases is 100% , in GBS cases at 60 day follow up average is 17-20%, traumatic neuritis residual weakness is 8%-11%, and for childhood hemiplegia & CVA residual weakness is between 4% -7%.
Poliomyelitis cases were provisional diagnosed as of GBS in 43%, Traumatic neuritis 20%, acute Childhood hemiplegia 9% & meningoencephalitis 6%. Only one case was actually diagnosed of Poliomyelitis.
Conclusion: GBS is the leading cause of AFP followed by TN, TM and Poliomyelitis.
Residual Paralysis in Poliomyelitis cases is 100% , in GBS cases at 60 day follow up average is 17-20%, traumatic neuritis residual weakness is 8%-11%, and for childhood hemiplegia & CVA residual weakness is between 4% -7%.
Poliomyelitis cases were provisional diagnosed as of GBS in 43%, Traumatic neuritis 20%, acute Childhood hemiplegia 9% & meningoencephalitis 6%. Only one case was actually diagnosed of Poliomyelitis.
Conclusion: GBS is the leading cause of AFP followed by TN, TM and Poliomyelitis.