Conference abstract

Acute flaccid paralysis case investigation report Bekwai Municipality, Ghana

Pan African Medical Journal - Conference Proceedings. 2017:3(38).17 Dec 2017.
doi: 10.11604/pamj-cp.2017.3.38.148

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Keywords: Acute flaccid paralysis (AFP) surveillance, polio, surveillance system
Oral presentation

Acute flaccid paralysis case investigation report Bekwai Municipality, Ghana

Kingsley Atuahene Ampratwum1,&, Dennis Laryea1, Akoto Osei1, Opoku-Amankwaah1

1Ghana Health Service, Bekwai Municipal Health Directorate, Ghana

&Corresponding author
Kingsley Atuahene Ampratwum, Ghana Health Service, Bekwai Municipal Health Directorate, Ghana

Abstract

Introduction: globally, 3 countries (Pakistan, Afghanistan and Nigeria) reporting cases Nigeria had 2 confirmed cases - August 2016. In Ghana, no case of polio since 2000 Acute Flaccid Paralysis (AFP) surveillance- ensures that all conditions that look like paralytic polio are picked. This has been one major indicator of our disease surveillance system, indicating its sensitivity to detect polio if it occurs. This AFP case (GHA-ASH-BEK-2016-01) was notified by a Medical Officer from Akomaa SDA Hospital, Kortwia, near Bekwai in the Ashanti Region of Ghana. This study was to look into the timeliness of the municipal surveillance system in relation to this case, and also assess the case for risk factors, in any, and to get laboratory reports.

Methods: standard case definition used; any child under 15 years of age with acute flaccid paralysis or any person with paralytic illness at any age in whom the clinician suspects poliomyelitis. AFP case investigation form was used to collect data. Client folder, local laboratory investigations report and Road to health records book reviewed, while caretaker was interviewed. Amansie Central district, the resident district of case, was also involved. Two stool samples were taken day 6 and 7 post paralysis to the laboratory for testing.

Results: case was a 17-month old non-schooling, resident in Ntebene, a farming community, Amansie Central District who had begun complementary feeding. He had eaten food prepared by his mother food at home only. The entire household of 6 (3 under 15) drink from a borehole. There was no history of travel for the past 40 days, except the current one at Assanso, on 9th August which resulted in hospitalization. There was an onset of paralysis of both lower limbs - 10/8/16, with fever. Only 2 doses of OPV are documented in the child health records health card, corroborated by mother, though was regular at CWC. The Full Blood Count test revealed high White Blood Count title value. (WBC 15.0X109/L, Lymphocyte 68%). Sixty days post paralysis, there was no residual paralysis. Laboratory results for poliomyelitis negative. None of 3 other children in household had signs and symptoms suggestive of AFP.

Conclusion: the investigations was timely and indicates a sensitive district surveillance system. Polio was ruled out. Risk factors included incomplete routine polio vaccination and use of pit latrine in the community.