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June 18, 2026BMJ Public HealthOpen Access

Acute flaccid paralysis surveillance in Uganda from 2016-2023 identified 6,409 cases, achieving an average non-polio AFP rate of 3.4 per 100,000, though district-level performance was suboptimal.

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Population

6,409 reported acute flaccid paralysis cases among children <15 years in Uganda, 2016-2023. Median age 3…

Design

Cohort

Key result

Acute flaccid paralysis surveillance in Uganda from 2016-2023 identified 6,409 cases, achieving an average non-polio AFP rate of 3.4 per 100,000, though district-level performance was suboptimal.

Authors

EOEmmanuel Okiror OkelloRMRichard MigishaIAImmaculate Ampaire

Discussion

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Overview

Uganda's AFP surveillance meets most targets; leaves open needs for timeliness and regional equity research.

Key Points

  • This analysis aims to characterize demographic, spatiotemporal patterns, and clinical outcomes of acute flaccid paralysis in Uganda.
  • Conducted a retrospective descriptive analysis of AFP surveillance data from 2016 to 2023.
  • Assessed trends using the Mann-Kendall test and illustrated spatial patterns with choropleth maps.
  • Analyzed variables such as timeliness indicators, non-polio AFP rates, stool adequacy, and clinical characteristics.
  • Total of 6409 AFP cases reported, with 5837 (91.1%) confirmed as true AFP.
  • NPAFP rate averaged 3.4 per 100,000, meeting the target in 5 out of 8 years.
  • 30% of followed-up cases had residual paralysis, with 1% deceased and 0.6% lost to follow-up.

Study Design

Type

Observational (n=6,409)

Multicenter

Yes

Structured PICO

P
Population
6,409 children <15 years with reported acute flaccid paralysis in Uganda, evaluated retrospectively from 2016 to 2023.
O
Outcome
Case demographics, spatiotemporal patterns, clinical outcomes, and surveillance performance (timeliness indicators, non-polio AFP rates, stool adequacy)

Uganda's acute flaccid paralysis surveillance system is largely robust, meeting key targets for non-polio AFP rates and stool adequacy, though improvements in timeliness and regional equity are needed.

Cite This Study

Okello et al. (2026) conducted an observational in Acute flaccid paralysis (n=6,409). Acute flaccid paralysis surveillance was evaluated on Non-polio AFP (NPAFP) rate and surveillance performance indicators. Acute flaccid paralysis surveillance in Uganda from 2016-2023 identified 6,409 cases, achieving an average non-polio AFP rate of 3.4 per 100,000, though district-level performance was suboptimal.

synapsesocial.com/papers/6a33cfcf14a9c556e6677906https://doi.org/10.1136/bmjph-2025-003590
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Also Consider

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  2. 2Integrated Surveillance of Polio-negative AFP Cases for Tuberculosis: A Novel Approach in Rivers State, Nigeria2025
  3. 3Environmental Surveillance of Poliovirus in the Democratic Republic of the Congo: Sensitivity and Site Productivity, 2017–20252026
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  5. 5Integrated surveillance of polio-negative acute flaccid paralysis cases for childhood tuberculosis: a novel GeneXpert-based screening approach in Rivers State, Nigeria2026