1 / HEALTH SERVICES DELIVERY
1.4 / DISEASE CONTROL PROGRAMME
1.4.2.d.6 / Communicable Diseases Control: Immunisable Diseases Control
Poliomyelitis Eradication Initiative
A / Focal Point / Epidemiology Unit
B / Implementing Agencies / Epidemiological Unit
Provincial Director of Health Services
Deputy Provincial Director of Health Services
C / Target Areas & Beneficiaries / Institutional Staff, Public Health Staff and the Community
Project Summary:
Sri Lanka is on the verge of eradicating poliomyelitis after achieving and maintaining a high immunization coverage and established AFP (Acute Flaccid Paralysis) surveillance. Most of the standard WHO indicators of Polio Surveillance have been met and to improve existing AFP surveillance practices and to sustain the achieved targets it is necessary to conduct following activities.
  • Routine Immunization with OPV
  • National and Sub National Immunization Days
  • Mopping up immunization
  • Enhanced AFP Surveillance.
  • Review meetings at National, Provincial and Regional level
  • Consultative Meetings of Virologists, Epidemiologists, Physicians, Paediatricians and Neurologists

1. Justification:

Sri Lanka is on the verge of eradicating poliomyelitis after achieving and maintaining a high immunization coverage and established AFP surveillance. Most of the standard WHO indicators of Polio Surveillance have been met and it is important to improve the existing AFP surveillance activities throughout the country. As the neighbouring country India is continuing to isolate wild polio virus from the community there is a risk of importation of wild polio virus to Sri Lanka and outbreak of polio. It is necessary to strengthen the AFP surveillance activities in Sri Lanka

2. Important Assumptions/Risks/Conditions:

  • Government of Sri Lanka will continue to procure vaccine
  • EPI programme will continue to maintain its high standard
  • Vaccine acceptance by the community will be 100%

3. Project Objective:

Objective / Indicators / Means of Verification
Eradication of Poliomyelitis / No cases of polio occurring in the country and in the South East Asia for 3 consecutive years / AFP surveillance
IMMR
MRI data on AFP

4. Project Output/Product

Outputs / Indicators / Means of Verification
All children immunized with OPV / Immunization coverage / Review data at Epidemiological Unit quarterly and annually, EPI reviews
National and Sub-National Immunization Days continued / Immunization coverage at national and sub-national immunization day / Review data at Epidemiological Unit quarterly and annually, EPI reviews
Surveillance enhanced / Non polio AFP rate in children < 15 yrs. of age. (Target >/= 1/100,000)
Completeness and timeliness of reporting
Reported AFP cases investigated within 48 hrs. of report (Target >/= 80%)
Reported AFP case with stools specimens collected within 14 days of onset and follow-up examination at least 60 days after onset of paralysis / Quarterly review by NCCPE and NPEC
Monthly quarterly and annually review
Laboratory surveillance strengthened / Specimens of stools arriving at National Laboratory (MRI) within 03 days of being collected (Target> 80%)
Specimens of stools with a turn around time <28 days (Target>80%)
Stool specimens from which non-polio enterovirus was isolated (Target> 10%) / Monthly quarterly and annually review

5. Related Projects:

Project No. / Project Title
Immunization with OPV (EPI
National Immunization Days
Sub National Immunization Days
Immunization of children following an AFP case
Mopping-up immunization
Quarterly Meetings of National Polio Expert Committee
Quarterly Meetings of National Committee for Certification of Polio Eradication Quarterly review of AFP surveillance activities at Regional Epidemiologists conferences
Consultative Meetings of Virologists, Epidemiologists, Physicians, Paediatricians and Neurologists
Supervisory Visits

6. Relevant Agencies to be Coordinated:

WHO, UNICEF, Ministry of Health

7. Monitoring & Evaluation:

1. Who? Epidemiologist /National Committee for Certification of Polio

Eradication/Regional Certification Committee

2. When? Monthly /Quarterly /Annually

3. What actions to be taken based on results of monitoring & evaluation?

Continuous review with regional / national level

8. Activities:

Activities / Expected Results / Process Indicators
1 / Continue Immunization programme with OPV (EPI) / 100% coverage / Immunization coverage
2 / Organize National Immunization Days / 100% coverage / Immunization coverage
3 / Organize Sub National Immunization Days / 100% coverage / Immunization coverage
4 / Conduct Mopping-up immunization / 100% coverage / Immunization coverage
5 / Organize Quarterly Meetings of National Polio Expert Committee / To improve AFP surveillance / 4 meetings/year
6 / Carryout Quarterly review of AFP surveillance activities at Regional Epidemiologists conferences / To improve AFP surveillance / 4 meetings/year
7 / Organize Quarterly Meetings of National Committee for Certification of Polio Eradication / To get experts help on diagnosing doubtful AFP cases / 4 meetings/year
8 / Conduct Consultative Meetings of Virologists, Epidemiologists, Physicians, Paediatricians and Neurologists / To review AFP surveillance activities / 4 meetings/year
9 / Supervisory Visits / To improve AFP surveillance