Abstract
Background: Monthly surveys provide an opportunity for paediatricians in Aotearoa to contribute to international and national surveillance of rare childhood conditions. This is linked to active surveillance of acute flaccid paralysis (AFP) undertaken for Manatū Hauora and reported to the Western Pacific Region (WPR) Office of the World Health Organization (WHO).
Methods:
• Review and analysis of the NZPSU database to describe the contribution of paediatricians to this project in 2022/23, identify conditions under surveillance and review recent research findings
• Audit of AFP surveillance against hospital discharge diagnoses and World Health Organization standards
Results: Each month from July 2022 to June 2023 around 200 paediatricians responded to an online survey reporting children in their care with acute flaccid paralysis or other rare childhood diseases.The overall response rate was 74%.
In 2022 responding paediatricians reported 20 cases of acute flaccid paralysis, 4 infants with HIV positive birthing parent, 22 infants with birthing parent with positive syphilis serology, 8 adverse drug reactions in childhood, 46 children aged under 15 years who presented with self-harm and were seen by a paediatrician, and 22 cases of severe acute hepatitis. From March 2022 there were reports of 52 children with COVID-19 who required ICU level care or who had a multi-inflammatory condition. There were no reports of congenital rubella. Principal investigators for each condition obtained further clinical information and used this to inform policy and practice. Achievements include third trimester testing for syphilis and ongoing research to address self-harm in the paediatric population.
Audit against hospital discharge data identified a further 5 cases with AFP. The AFP rate of 2.6 cases per 100,000 0–14-year olds was considerably higher than the expected rate of 1 case per 100,000. Two timely stool samples were provided for only 44% of AFP cases in 2022.
Conclusion: Paediatricians are key players in routine active surveillance that contributes to understanding of poliomyelitis in the WPR and enhances understanding of rare childhood diseases in Aotearoa.