# Updates on the polio surveillance action plan's key performance indicators: East and Southern African countries (January 2022 to December 2023)

## TL;DR

This study evaluates the progress of polio surveillance in East and Southern Africa from 2022 to 2023, showing improvements in case detection and sample handling.

## Contribution

The study provides updated insights into the effectiveness of the Global Polio Surveillance Action Plan in the ESA subregion.

## Key findings

- Male children were more likely to report AFP cases than female children with an 11% difference.
- There was a 2% increase in cases investigated within 11 days from 2022 to 2023.
- AFP surveillance quality indicators improved from 4.4 in 2022 to 4.7 in 2023.

## Abstract

The Global Polio Eradication Initiative (GPEI) partners are closely monitoring the progress of the implementation of key strategic activities of the polio eradication strategy for the years 2022-2026. This is being done using the Global Polio Surveillance Action Plan 2022-2024, which includes a set of indicators to track progress. All countries in the ESA sub-region have been informed about these key performance indicators, and the World Health Organization (WHO) is keeping a weekly eye on their implementation. We conducted a descriptive secondary analysis of field Acute Flaccid Paralysis (AFP) surveillance data compiled from 19 countries of East and Southern Africa for the period of January 2022 to December 2023. During the period, Seychelles did not report any AFP case, and therefore the country is excluded from the final analysis. A total of 18,078 AFP cases were detected, reported, and verified from nineteen countries in ESA and we found 8,049 females (44.5%) and 10,029 males (55.5%). This shows a male child was more likely to get AFP compared to a female child (11% difference, p < 0.0001). We noticed a significant increase in prompt AFP cases detection of 4% and an increased number of cases investigated within 11 days from the date of onset of paralysis from 7,790 (89%) in 2022 to 8,246 (91%) in 2023 (2% change, p < 0.0001). The two AFP surveillance quality indicators in the study period rose from 4.4 in 2022 to 4.7 in 2023 (0.3 increase, p < 0.0001). Of the 8,964 AFP stool samples assessed in 2023, 53% were delivered to the national polio laboratories within 72 hours compared to 52% of 8,666 AFP stool samples in 2022 (1% difference, p-value of 0.1838). There is an overall improvement in the Global Polio Surveillance Action Plan (GPSAP) indicators in the ESA subregion for the period of 1 January 2022 to 31 December 2023. We recommend utilizing innovative methods to improve case detections, providing tailored surveillance training to lower levels, and enhancing sample shipment and capacities to process samples timely.