Community-Based Surveillance of Acute Flaccid Paralysis: A Review on Detection and Reporting Strategy.

Abstract

Polio is a highly contagious viral disease that primarily affects children under 15, often leading to permanent paralysis, known as acute flaccid paralysis (AFP). AFP surveillance is essential for the eradication of polio, with community-based surveillance (CBS) playing a pivotal role in detecting and reporting cases. CBS improves the timeliness and accuracy of AFP detection, but challenges such as underreporting, delays, and low community awareness persist. Strategies involving use of mobile applications, awareness campaigns, and improvements in healthcare infrastructure were implemented to improve CBS of AFP. While numerous case studies from various countries illustrate the implementation of CBS, a comprehensive synthesis of these studies across diverse contexts is limited. This paper examines state-of-the-art CBS approaches for AFP, analyzing progress, challenges, and potential solutions. A targeted literature review of English-language studies published between 2004 and 2024 was conducted, focusing on the roles of communities, technological integration, and practical recommendations, while excluding studies that lacked methodological rigor or direct relevance. The review revealed that CBS has significantly advanced the global fight against polio by increasing community awareness, enabling earlier detection, and improving the reporting of AFP cases. However, issues such as security concerns, delayed reporting, low levels of community awareness, and underutilization of technology persist. This review recommends strengthening organizational structures, improving healthcare access, raising community awareness, and using technology for more efficient AFP surveillance. The implication of this work is beyond polio as it offers a comprehensive framework for integrating disease surveillance, technology and community involvement to strengthen public health strategies and build robust health systems.