AFP Surveillance is a key strategy of Global Polio Eradication. In Iraq, it started in 1995. WHO established some performance indicators that should be used to assess the quality of AFP surveillance.

The objective of this study is to identify the trends of different performance indicators of AFP in Iraq, 2007-2016.

We reviewed AFP surveillance data in the IFA (Information for Action) software for 2007-2016. The data were compiled from almost all public health outlets in Iraq and compiled at the National AFP surveillance office. Six WHO indicators were reviewed: Non-polio AFP rate <15 years of age (Target >2/100,000), Reported AFP cases investigated <48 hours of report (Target >80%), Reported AFP cases with 2 specimens collected <14 days since onset (Stool adequacy) (Target >80%), Specimens arriving at national laboratory <3 days of being sent (Target >90%), Specimens arriving at laboratory in good condition (Target >80%) and Stool specimens from which non-polio enterovirus was isolated (NPEV%) (Target >10%).

A total of 4,915 cases were reported; 35% aged <2 years, 60% were male, 60% had fever at onset of paralysis and 38% had asymmetrical Paralysis. Only 1.3% received no OPV vaccine, 77% received >3 doses. At sixty days' examination 24% had residual paralysis. Seven cases were vaccine-derived, 156 cases were Sabin-like polioviruses and no vaccine-associated polio case. Two wild polio cases reported in 2014. Guillain-Barre syndrome accounted for 51% of cases. Specimens arriving at the national laboratory <3 days was not achieved during the whole period. NPEV% achieved the target except in 2013 (7.3%). All other indicators achieved the target throughout the whole period.

While most indicators achieved the standard, additional efforts are still needed to address the timeliness of adequate stool specimens' arrival to the laboratory. We are currently working on similar analysis at governorates and districts levels.