Ministry of health through the ZNPHI launches ES on 21st
April, 2018 Approved by WHO
Although there has been no human case of polio in Zambia since 2002, the country faces a risk of polio virus importation from surrounding countries that are experiencing transmission of polio viruses and vDPV among their populations. Zambia is listed among 39 countries in Africa targeted for polio eradication. Evidence of absence of polio virus circulation is a requirement for certifying a country polio free. Active case finding and laboratory confirmation are key in this problem. As a supplement to Acute Flaccid Paralysis (AFP) surveillance, Zambia in conjunction with WHO and Global Polio Eradication Initiative (GPEI) has launched environmental surveillance (ES) for polio viruses. Environmental surveillance is an additional method to monitor the transmission of polio viruses by testing sewage samples which may contain poliovirus secreted in human faeces.
ES is an additional arm that supports evidence generation to indicate presence or absence of the polio virus circulation in the population. This strategy is not meant to replace AFP surveillance but rather supplementary to active case polio surveillance. ES has been established in 21 countries and following the launch in Zambia, another 2 African countries namely Burundi and South Africa are scheduled for ES. A mission from the WHO (AFRO region) visited Zambia with the following objectives. Prior to implementation of ES activities, the WHO regional office for Africa fulfilled the following objectives
Specific objectives were to:
- Conducted advocacy to national authorities and Global PEI partners on the role of environmental surveillance and its added value to polio eradication.
- Identified suitable sites for sewage sample collection (Lusaka and Copperbelt regions)
- Digitalized sewage drainage paths (GIS, Blue lines)
- Identified and trained sample collectors and their supervisors
- Orientated both surveillance and laboratory teams on data management issues.
- Supported country to finalize its 2018 work-plan for ES
A total of twenty-one staff form University Teaching Hospital, World Health Organization, Zambia National Public Health Institute and Ministry of Health Lusaka district health office were trained in environmental surveillance. Four sites namely, Manchinchi, Kaunda Square, Chelstone and Ngwerere treatment centreswere identified in Lusaka. Starting 21stApril, 2018 samples are collected bi-weekly and sent for laboratory confirmation.
Next Steps: To maintain ES in Lusaka and expand to the Copperbelt and North-western provinces, these sites have been selected due to the close Copperbelt and north-Western were selected due to their close proximity to neighboring countries such as Angola and Democratic Republic of Congo (DRC) while Lusaka was chosen on account of being capital.
Conclusion: The ministry of health through the ZNPHI has active disease intelligence and laboratory confirmation capacity to monitor and detect cases of polio viruses circulating among the community. The GRZ remains dedicated to ensure the disease is eradicated.