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Case study

Acute flaccid paralysis (AFP) surveillance system in Lebanon: a teaching case-study

Acute flaccid paralysis (AFP) surveillance system in Lebanon: a teaching case-study

Hala Abou Naja1,&, Nada Ghosn1


1Epidemiological Surveillance Program at the Lebanese Ministry of Public Health, Lebanon



&Corresponding author
Hala Abou Naja, Epidemiological Surveillance Program at the Lebanese Ministry of Public Health, Lebanon




Lebanon has been declared polio-free since 2002. In 2003, following an imported polio case, national campaigns succeeded to contain the virus with no further cases. Since 2013, the risk of poliovirus importation became concrete. Several risk factors linked to the Syrian crisis were illustrated including wild poliovirus type 1 outbreak in Syria in 2013-2014, huge Syrian population influx into Lebanon due to insecurity, and circulating vaccine-derived poliovirus type 2 (cVDPV2) outbreak in Syria in 2017. Hence, there is continuous need to enhance Acute Flaccid Paralysis (AFP) surveillance to timely detect any imported poliovirus for the implementation of needed response. The goal of the case study is to build the capacity of Field Epidemiology Training Program (FETP) residents and other health professionals in the area of AFP reporting and prepare health care staff to any polio importation into the country. This case study is can be administered in 2-3 hours.



How to use this case study    Down

General instructions: this case study should be used as adjunct training material for novice epidemiology trainees to reinforce the concepts taught in prior lectures. The case study is ideally taught by a facilitator in groups of about 20 participants. Participants are to take turns reading the case study, usually a paragraph per student. The facilitator guides the discussion on possible responses to questions. The facilitator may make use of flip charts to illustrate certain points. Additional instructor´s notes for facilitation are coupled with each question in the instructor´s guide to aid facilitation.

Audience: this case study was developed for health care staff at hospital setting. These participants are commonly health care workers working in the county departments of health whose background may be as medical doctors, nurses, environmental health officers or laboratory scientists who work in public health-related fields and infection control personnel.

Prerequisites: before using this case study, participants should have received lectures on disease surveillance (polio/AFP surveillance).

Materials needed: Flash drive, flip charts, markers, computers with MS Excel.

Level of training and associated public health activity: Novice - Enhancing surveillance

Time required: 2-3 hours

Language: English



Case study material Up    Down

  • Download the case study student guide
  • Request the case study facilitator guide



Competing interest Up    Down

The authors declare no competing interests.



Acknowledgement Up    Down

We wish to acknowledge the Eastern Mediterranean Public Health Network (EMPHNET) for their support to develop this case study. I wish to acknowledge as well Mrs. Zeina Farah for peer-reviewing this case study.



References Up    Down

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  2. Republic of Lebanon, Ministry of Public Health. Guideline for Communicable Diseases Surveillance SystemAccessed June 7, 2020.

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