فهرست نشریات علمی دسترسی آزاد ایران

Background: Following the widespread use of poliovirus vaccine in the mid-1950s, the incidence of poliomyelitisdeclined rapidly in many industrialized countries. The aim of this study was to determine the surveillance ofpoliomyelitis and acute flaccid paralysis (AFP) in Fars Province, southern Iran to detect poliovirus wherever itmay circulate.Methods: From 1995 to 2006, in a cross-sectional study, all patients over 15 years of age with flaccid paralysisin Fars Province of Iran were enrolled. The surveillance medical officers visited every AFP case, took clinicalhistories, and performed clinical examinations. Two stool samples were collected from each reported case within14 days of the onset of paralysis and sent to WHO-accredited laboratories for poliovirus isolation and intra-typicdifferentiation. AFP cases from which stool sample of wild poliovirus was isolated were classified as confirmedpoliomyelitis. Those AFP cases whose cultures for poliovirus were negative were referred to an expert panel.Whenever possible, nerve conduction velocity tests, electromyography, and other diagnostic modalities such asbrain and vertebral MRI were performed along with a detailed neurological examination at least three weeks afterthe onset of paralysis.Results: The non-polio AFP rate was 227 (mean: 18.91 per year). Only one case of poliomyelitis was reported inthe first year of surveillance. Other 226 cases had non-polio AFP. The most common cause of paralysis amongthese patients was Guillain-Barre syndrome (66%).Conclusion: The non-polio AFP rate is almost in agreement with the estimated incidence of AFP in the populationaged 0-15 years worldwide. Routine coverage with three doses of OPV with supplementary immunizationactivities has reportedly reached over 95% of all target children. The existing system must be closely monitoredand actively supported to maintain and constantly improve performance.