학술논문

Faster Detection of Poliomyelitis Outbreaks to Support Polio Eradication.
Document Type
Journal Article
Source
Emerging Infectious Diseases. Mar2016, Vol. 22 Issue 3, p449-456. 8p. 1 Chart, 1 Graph, 2 Maps.
Subject
*ACUTE flaccid paralysis
*POLIO prevention
*MICROBIAL virulence
*PREVENTION of epidemics
*CLUSTER analysis (Statistics)
*COMPARATIVE studies
*EPIDEMIOLOGY
*RESEARCH methodology
*MEDICAL cooperation
*MUSCLE hypotonia
*PARALYSIS
*POLIO
*RESEARCH
*RESEARCH funding
*TIME
*EVALUATION research
*EARLY diagnosis
*DISEASE eradication
*DIAGNOSIS
POLIO diagnosis
Language
ISSN
1080-6040
Abstract
As the global eradication of poliomyelitis approaches the final stages, prompt detection of new outbreaks is critical to enable a fast and effective outbreak response. Surveillance relies on reporting of acute flaccid paralysis (AFP) cases and laboratory confirmation through isolation of poliovirus from stool. However, delayed sample collection and testing can delay outbreak detection. We investigated whether weekly testing for clusters of AFP by location and time, using the Kulldorff scan statistic, could provide an early warning for outbreaks in 20 countries. A mixed-effects regression model was used to predict background rates of nonpolio AFP at the district level. In Tajikistan and Congo, testing for AFP clusters would have resulted in an outbreak warning 39 and 11 days, respectively, before official confirmation of large outbreaks. This method has relatively high specificity and could be integrated into the current polio information system to support rapid outbreak response activities. [ABSTRACT FROM AUTHOR]