Evaluation of Acute Flaccid Paralysis (AFP) Surveillance System in Sukkur Division - Sindh Province, Pakistan, 2016
Bibliographic record
Abstract
Background: Pakistan is among three countries in the world with ongoing wild poliovirus transmission. Pakistan established an AFP Surveillance system in 1995 and in 2000 further technical strengthening was provided to system at all levels by WHO. Sindh reported 8 confirmed cases of poliomyelitis in 2016 and 3 cases were from Larkana Division. An adjacent division, Sukkur, is a big reservoir for poliovirus and an intersection between three provinces. Objective: The evaluation was conducted to identify the gaps in the surveillance system and suggest recommendations for improvement. Methods: A descriptive study was conducted during November-December 2016. The study setting was Sukkur Division. Quantitative and qualitative attributes of the system were assessed using Updated CDC Guidelines for Evaluating Public Health Surveillance Systems, 2001. A desk review of literature, departmental reports and records was undertaken. Major stakeholders were identified and interviewed using a semi-structured questionnaire. Sensitivity and PPV were calculated by using WHO estimates of Sindh Province for previous year. Results: Case definition used was simple and gathered all essential information. System demonstrated its flexibility by incorporating information on other diseases like measles and neonatal-tetanus (NNT). The System captured all cases from 3 districts of the Sukkur Division. Data quality is good with 90% of the reports being completely and correctly filled and timeliness of data sharing was excellent with 85% reports reaching the provincial level weekly. Representativeness is average as system has limited coverage of private sector. System sensitivity is 100%, whereas PVP is 0.087%. System functions showing good stability without any disruption. Conclusions: Polio is marked for eradication hence the system is fulfilling its objectives. We recommend coverage of the system to be extended to private sector and report sharing at directorate level. Regular capacity building of the staff is recommended for maintaining the quality and timeliness.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".