The Surveillance System of Poliomyelitis/Acute Flaccid Paralysis in the Islamic Republic of Iran: History, Structures and Achievements

Background and Objectives: : According to the global strategy for polio eradication, targeted surveillance of the disease is one of the main tasks of the health system. The purpose of this study was to review the status and surveillance of poliomyelitis/acute flaccid paralysis (AFP) in Iran.   Methods: The present study was a review on the processes, structures and achievements of the poliomyelitis/AFP surveillance system in Iran during 2017-2019. The data of this study were obtained from the surveillance system of the Center for Communicable Disease Control; a review of the records, documents, books and published articles; and interviews with process owners and experts of poliomyelitis/AFP surveillance.   Results: The polio eradication program in Iran is based on the action plan of the World Health Organization that was introduced initially in 1988. Currently, the surveillance system of AFP is active at three levels: country, university, and city. The number of poliomyelitis cases in the country decreased from 50 cases per year in 1985 to zero in 2001, and Iran has been a polio-free country since 2001. The final report on polio eradication in Iran was approved by the regional commission on polio detection in April 2006.   Conclusion: The surveillance system of AFP has had a proper effectiveness throughout the country. Maintaining this situation in the country requires an increase in the sensitivity of the surveillance system of the disease, regular monitoring of vaccine coverage, strict implementation of international health regulations, especially on the eastern borders of the country, and providing technical assistance to neighboring countries.