Hong Kong Med J 2005;11:164-73 | Number 3, June 2005
Surveillance of acute flaccid paralysis in Hong Kong: 1997 to 2002
RMK Lam, THF Tsang, KY Chan, YL Lau, WL Lim, TH Lam, NK Leung
Centre for Health Protection, Department of Health, Hong Kong
OBJECTIVES. To describe the characteristics of patients reported with acute flaccid paralysis between 1997 and 2002, and to evaluate the performance of the acute flaccid paralysis surveillance system using indicators recommended by the World Health Organization.
DESIGN. Retrospective study.
SETTING. Department of Health, Hong Kong.
PARTICIPANTS. Children aged younger than 15 years who were reported to the Department of Health between 1997 and 2002 with acute flaccid paralysis.
MAIN OUTCOME MEASURES. The prevalence of urinary symptoms was assessed using telephone interview. The urinary symptoms investigated were as listed in a validated Chinese version of Urogenital Distress Inventory Short Form (UDI-6). The impact on quality of life was quantified using a validated Chinese version of Incontinence Impact Questionnaire Short Form (IIQ-7).
RESULTS. Of 120 children with acute flaccid paralysis reported between 1997 and 2002, 42% were younger than 5 years of age. None of the cases were acute poliomyelitis or polio-compatible. A neurological cause was identified in 67.5% of cases, of which the most common was Guillain- Barré syndrome (42%), followed by transverse myelitis (15%). All except one of the performance indicators consistently met World Health Organization requirements and thus demonstrated the effectiveness of the acute flaccid paralysis surveillance programme. The acute flaccid paralysis notification rate consistently exceeded 1.0 per 100 000 population below 15 years of age. The requirement for adequate stool investigation was the single indicator that did not satisfy World Health Organization requirements. This highlighted the importance of maintaining physicians’ awareness of acute flaccid paralysis surveillance.
CONCLUSION. Hong Kong should remain vigilant for acute flaccid paralysis. The effective surveillance system and its evaluation may serve as a model for surveillance of other infectious diseases.
Key words: Evaluation studies; Guillain-Barre syndrome; Paralysis; Poliomyelitis; Sentinel surveillance
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