Polio Surveillance in Afghanistan
Polio surveillance underpins Afghanistan's polio eradication programme. It provides the information needed to detect poliovirus, monitor virus circulation, and guide vaccination and outbreak response activities. Without a sensitive surveillance system, it would be impossible to identify where and how poliovirus continues to circulate. Afghanistan uses two complementary surveillance systems: Acute Flaccid Paralysis (AFP) surveillance and environmental surveillance, both of which are conducted nationwide by designated surveillance staff.
Acute Flaccid Paralysis (AFP) Surveillance
AFP surveillance is the gold standard for detecting suspected polio cases in children under 15 years of age. Afghanistan's surveillance network includes public and private health facilities, hospitals, physical rehabilitation centres, pharmacies, mid-level health workers, traditional healers, shrine keepers, and community volunteers. Every suspected AFP case is promptly reported, investigated, and laboratory tested to determine whether poliovirus is present. If poliovirus is detected, genetic analysis helps identify the origin of the virus and track transmission pathways, enabling targeted vaccination and outbreak response activities.
The AFP surveillance system consistently maintains high sensitivity and exceeds global performance targets. Regular monitoring of surveillance quality indicators helps ensure that suspected cases are detected, investigated, and tested in a timely manner.
Environmental Surveillance
Environmental surveillance complements AFP surveillance by testing sewage samples for wild polioviruses and vaccine-derived polioviruses. It helps detect virus circulation even when no paralytic cases have been reported, providing an early warning of transmission and helping guide programme response. Sample collection sites operate across all regions of the country and are regularly monitored to ensure the surveillance network remains effective.
Together, AFP and environmental surveillance enable the rapid detection of poliovirus transmission and provide the evidence needed to guide programme decisions and outbreak response.
Surveillance Quality
The Afghanistan Polio Eradication Initiative regularly reviews surveillance performance to assess case detection, investigation, specimen collection, documentation, data quality, and coordination among programme partners. Findings are used to strengthen staff capacity, supervision, community engagement, and surveillance quality, ensuring the system remains sensitive and responsive to poliovirus transmission.
Further Reading
Learn more about polio surveillance, global surveillance standards, and technical guidance through the resources below:
