2000
http://www.journals.uchicago.edu/CID/journal/issues/v35n11/020580/brief/020580.abstract.html
Clinical Infectious Diseases 2002;35:000
© 2002 by the Infectious Diseases Society of America. All rights reserved.
1058-4838/2002/3511-00XX$15.00
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| MAJOR ARTICLE |
Predictors of
Virologically Confirmed Poliomyelitis in
India, 19982000
Kathryn A. Kohler,1 W. Gary Hlady,2 Kaushik Banerjee,2,3 Paul Francis,2 Sunita Durrani,2 and Patrick L. F. Zuber1
1Global
Immunization Division, National Immunization
Program, Centers for Disease
Control and Prevention, Atlanta,
Georgia; and 2National Polio
Surveillance Project and 3Southeast
Asia Regional Office, World Health
Organization, New Delhi, India
Received 24 April 2002; revised 16 July 2002; electronically published 12 November 2002.
| As we progress toward eradication of polio, a
growing proportion of cases of acute flaccid paralysis
(AFP) reported are due to causes other than polio. AFP
surveillance data from India for 19982000
were analyzed to determine the sensitivity and
specificity of signs and symptoms present at initial
case investigation and of residual weakness (which is
used to classify AFP cases) for virologically
confirmed poliomyelitis. Sensitivity was highest for age of
<5 years (93%97%)
and residual weakness (74%96%).
Residual weakness was more sensitive among children
aged <5 years. Cases of AFP in patients aged <5
years who have fever and asymmetrical paralysis are
most likely to be confirmed as poliomyelitis. In
countries with suboptimal surveillance for AFP, these results
may help to prioritize investigation of AFP cases.
The high sensitivity of residual weakness demonstrates the
importance of 60-day follow-up examination for all patients
with AFP, particularly those for whom the initial
case investigation was inadequate or delayed.
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