Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Mar;32(1):45-51.
doi: 10.21101/cejph.a7605.

Thirteen-year surveillance results of acute flaccid paralysis cases in Southeast Turkey and the effect of refugee movements on surveillance results

Nezir Özgün  1 , Gülnaz Kubat  2 , Birgül Turan  2 , Mert Özgün  3 , İzzettin Toktaş  4 , Gülay Korukluoğlu  5
Affiliations
Free article

Thirteen-year surveillance results of acute flaccid paralysis cases in Southeast Turkey and the effect of refugee movements on surveillance results

Nezir Özgün et al. Cent Eur J Public Health. 2024 Mar.
Free article

Abstract

Objective: Acute flaccid paralysis (AFP) is a major neurological problem. Turkey has accepted over 4 million refugees since 2011 due to the wars in neighbouring countries. In the long term, refugees can have adverse effects on the limited resources of health, sanitation, water supply, foodstuff, and shelter services of host countries, precipitating the transmission and spread of enteroviruses causing AFP. This study examines the 13-year surveillance and incidence of AFP cases in southeast Turkey, and questions possible impact of refugee movements on these parameters, comparing the periods before (2007-2010) and after (2011-2019) 2011, when the refugee movements emerged.

Methods: The records of cases reported from southeast part of Turkey with suspected AFP between January 2007 and December 2019 were reviewed retrospectively.

Results: Of the patients, 121 (58.5%) were male. Mean age was 80.36 ± 46.67 months. Eighty-five (41.1%) were aged 60 months or younger. The number of patients under 60 months increased significantly after 2011. Mean incidence was calculated as 0.88 cases/100,000 person years versus 1.58 cases/100,000 person years in the period before and after 2011, respectively. Guillain-Barré syndrome (GBS) was the most common cause of AFP in both periods. As of 2011, however, the incidence of acute transverse myelitis increased approximately 4 times and GBS decreased proportionally. Non-polio enteroviruses were the most frequent isolates, detected from 9.1% of stool samples.

Conclusion: Although refugee movements appear to may have adverse effects on AFP incidence and surveillance outcomes, larger studies involving the whole country, particularly at places where no refugees settled, are needed to achieve more conclusive evidence.

Keywords: acute flaccid paralysis; enterovirus; non-polio enterovirus; refugees; surveillance.

PubMed Disclaimer

Similar articles

See all similar articles

References

    1. Shibuya K, Murray JLC. Poliomyelitis. In: Murray JLC, Lopez AD, Mathers CD, editors. The global epidemiology of infectious diseases [Internet]. Geneva: WHO; 2004 [cited 2022 Aug 21]. p. 111-49. Available from: https://citeseerx.ist.psu.edu/document?repid=rep1&type=pdf&doi=b10232006....
    1. Wright PF. Eradication of poliomyelitis by the year 2000. Biomed Pharmacother. 1992;46(10):501. - DOI
    1. Global Polio Eradication Initiative. Polio-free countries [Internet]. Geneva: GPEI; 2016 [cited 2022 Aug 21]. Available from: https://polioeradication.org/where-we-work/polio-free-countries/.
    1. Solomon T, Willison H. Infectious causes of acute flaccid paralysis. Curr Opin Infect Dis. 2003;16(5):375-81. - DOI
    1. Global Polio Eradication Initiative. Polio today [Internet]. Geneva: GPEI [cited 2022 Aug 21]. Available from: https://polioeradication.org/polio-today/.