MONTSERRADO COUNTY:PARTNERING FOR ZERO

CASES OF EVD

Dr. Mosoka P. Fallah

NATIONAL INCIDENT MANAGEMENT SYSTEM

ENHANCING THE ROAD TO ZERO CASES: INTEGRATED SURVEILLANCE SYSTEM

Case Detection

Case Investigation

Contact Tracing Active Case Finding

Epi-data management

CASE DETECTION: CATALYST FOR ZERO CASES OF EVD IN MONTSERRADO

ETU

Case Detection

Zero Cases

July Aug. Sept. Oct. Nov. Feb.

Case Detection

# of Cases

MONTSERRADO DETERMINIES THE PATH TO ZERO EBOLA CASES IN LIBERIA

MAPPING OF PARTNERS SUPPORTING CASE DETECTION

Zone Districts EpiZone Name PresenceContact Tracing Active Case Finding Active Case Finding Active Case Finding Case Investigation

100 16 New Kru Town UNDP ACF UNDP MSF-Swiss(8) OXFAM IRC

200 15 Logan Town WHO ACF WHO MSF-Swiss (8) MSF-Swiss (800) IRC

300 14 Clara Town AVAILABLE ACF AVAILABLE MSF-Swiss(8) CONCERNED (100) IRC

400 7 West Point UNDP ACF UNDP MSF-Swiss(7) OXFAM (110) IRC

500 7 & 8 Soniwein WHO ACF UNDP MSF-Swiss (6) IRC

600 8 Slipway WHO ACF WHO MSF-Swiss (6) IRC

700 8 & 9 Sinkor WHO ACF WHO IRC

800 9 Larkpazee WHO ACF WHO IRC

900 10 Old Road AVAILABLE ACF AVAILABLE IRC

1000 5 & 6 Congo Town UNDP/WHO ACF WHO/UNDP IRC

1100B1 4 & 5 Paynesville Peace UNDP ACF UNDP IRC

1100B2 11, 3 & 12 Paynes Pipeline AVAILABLE\WHO & AVAILABLE ACF WHO IRC

1100A1 5 Paynesville Duport Road UNDP ACF UNDP IRC

1100A2 6 Paynesville ELWA WHO ACF WHO IRC

1200 12 Gardnersville AVAILABLE ACF WHO IRC

1300 13 New Greogia AVAILABLE ACF AVAILABLE IRC

1400 2 & 11 Barnersville WHO/AVAILABLE ACF WHO IRC

1500 1 Common Wealth (Louisiana) WHO ACF WHO IRC

1600 1, 15 & 11 Caldwell UNDP/AVAILABLE ACF UNDP MSF-Swiss (8) IRC

1700 1A Cayresburg WHO ACF WHO IRC

1700 1B AVAILABLE ACF AVAILABLE IRC

1800 1 Todee AVAILABLE ACF AVAILABLE IRC

1900 17 St. Paul AVAILABLE ACF AVAILABLE MSF-Swiss (8) IRC

ETUs walk-ins

Case Investigato

rs

Contact Tracing

Active Case Finde

r Community dead: pick up withoutinvestigation

Secret burials (2)Hidden sick (3) Hidden contacts

Investigate 100% Case

100% contacts follow-up

IMPORTANCE OF INTEGRATED CASE DETECTION

MECHANISM OF INTEGRATED CASE DETECTION: CASE INVESTIGATION

AND CONTACT TRACING

JFK Redemption

Hospital

JDJDuport Road

Zone:100,200,300,1500,

1600,300,1900

Zone:500,600,700,800,

900,1000

Zone:1200,1300,1400,

Zone:1100A1,1100A2,

1100B1,1100B2,1500,

1700,1800

Case Investigation: Contact Follow-up

Simultaneous

Active Case Finding

Door to door

awareness

Daily search for the all sick

Daily search for the dead

Daily search for potential

contacts coming as

visitors

INTEGRATING ACTIVE CASE FINDING

Foundation

Peace Building

Community-led

quarantine contacts

Community-led Re-

integration

Case Investigation and Zonal Contact Tracing Supervisor

ACTIVE CASE FINDING INTERVENTION STRATEGY

Door to door awareness

Daily search for the dead

Daily search for contacts /visitors

Daily search for the all sick

Reduce denial, empower community provide Intelligence information to Active Case findersIdentify the hidden sick and connect them with Case Investigation/Contact tracers . Assist in Community-based Quarantine of contacts.

Uncovered hidden Bodies in homes/religious center/clinics etcPrevent secret burials.Identify hidden contacts or contacts that are not seen or loss to Follow-up. Alert the contact tracer. Send them back or quarantine them and reduce EVD Transmission

Objective

DATA FLOW DIAGRAM IN ACTIVE CASE FINDING

ACF Submits data toCommunity leader

Community leader validates& summarizes data.

Submits to supervisor

Supervisor uploads data onlinewith mobile phone.

Sends data form to monitorSends attendance to

Administrator

From ACF to Comm Leader

(Internet)Data from mobile

app upload to Online database.

ACF collects data from HHs daily

From ACF to Comm Leader

From ACF to Comm Leader

IT Coordinator retrieves online data, generates charts for CBI staff reports.

Develops desktop databaseFor paper forms data entry

PROJECT COORDINATORManages, supervises directs

all aspects of project; prepares relevant reports and briefs

for partners and donors.

CBI Staff

ACF Submits data toCommunity leader

Community leadervalidates

& summarizes data.Submits to supervisor

Receives paper data forms and submits to

CBI Field Coordinator.Makes random HH check

to validate dataAnd confirm cases

(Internet)Data from mobile

app upload to Online database.

ACF visits HHs dailyand collects data on paper forms

CBI Field CoordinatorGenerates reports fro

submitted data,Makes field visits to EVD

hotspots, coordinates contact tracing & coordinates withOther CBI staff

AdministratorCoordinates daily

administrative, logistical &

financial functions of project

Psychosocial Coordinator

Collects data on quarantined

homes, submits to relevant agencies to supply food. Daily information

sharing among CBI staff and Project Coordinator based on field data and

reports

1

2

3

4

5

5c

5b

5a

3b

3a

0

IT Coordinator retrieves online data, generates charts for CBI staff reports.

Develops desktop databaseFor paper forms data entry

Supervisor uploads data online

with mobile phone.Sends data form to

Monitor Sends attendance

to Administrator

PROJECT COORDINATORManages, supervises & directs

all aspects of project; prepares relevant

presentations, reports & briefs for

partners and donors.

WHO DISTRICTS CASES SUMMARY REPORT FOR NOVEMBER 1 TO DECEMBER 5, 2014

District Houses SickSick

ToETU DeadSafe

Burial Visitors QuarantinedCompleted

Quarantined OrphansNeeding

CounselingNeeding

Food#Survivors

Reintegrated#1-C (Caresburg) 965 45 0 1 0 0 0 0 0 0 0 0#2 44,626 12 0 0 0 87 1 0 0 1 1 1#3 23,892 39 0 11 3 233 20 1 0 0 0 1#6 61,137 101 1 2 0 732 0 0 27 0 0 0#8 9,435 65 12 5 3 120 0 12 0 0 0 0#9 2,125 21 2 2 1 130 0 0 0 0 0 0Total 142,180 283 15 21 7 1302 21 13 27 1 1 2

UNDP DISTRICTS CASES SUMMARY REPORT FOR THE MONTH OF NOVEMBER 2014

District #Houses #Sick#Sick ToET #Dead #Buried Visitors #Quarantined

Need Food

Need Counseling

#Completed Quarantined #Orphans #Reintegarted

#15 2666 157 5 7 4 224 19 128 272 6 177 0#16 1980 49 17 74 40 168 59 121 60 105 58 17#4 2321 46 12 66 35 163 58 109 48 105 52 11#11-Dixville Township 418 8 0 0 0 2 0 0 0 0 0 0#15-B (Caodwell) 2613 10 0 1 0 42 90 4 16 94 16 3#15-C (New Georgia Town Center) 432 10 0 0 0 27 58 43 3 101 58 0

Total 10,430 280 34 148 79 626 284 405 399 411 361 31

NEED ASSESSMENTS OF CASE INVESTIGATION

IRC: Supporting Case Investigation in Montserrado County Vehicles Available: 16 Vehicles Available: 11

Gap in Vehicles: 5

NEED ASSESSMENT OF ACTIVE CASE FINDING

ZONE # OF ACTIVE CASE FINDERS GAP Key PARTNERPARTNER PARTNER100 220 94 UNDP MSF-Swiss(8) OXFAM 200 180 47 WHO MSF-Swiss (8) MSF-Swiss (800)300 240 279 WHO MSF-Swiss(8) CONCERNED (100)400 140 75 UNDP MSF-Swiss(7) OXFAM (110)500 10 8 WHO MSF-Swiss (6)600 12 10 WHO MSF-Swiss (6)700 299 130 WHO800 10 34 WHO900 20 997 WHO

1000 22 30 WHO/UNDP1100B1 34 40 UNDP1100B2 200 267 WHO1100A1 43 20 UNDP1100A2 700 79 WHO

1200 0 597 Free1300 0 565 Free1400 200 Free1500 25 0 Free1600 245 403 UNDP MSF-Swiss (8)1700 Free1700 200 178 WHO1800 0 287 Free1900 0 Free MSF-Swiss (8)

2800 4140

NEED ASSESSMENT OF CONTACT TRACING: SCALE-UP PLAN TO INTENSIFY CLOSE

SUPERVISION

Monitors: 8

Available Resources/LogisticsProvided by ACF

Supervisors: 22

Contact Tracers: 250

Vehicles: 6

13 Monitors2 Operational

Managers

Motorbikes: (5) ACF

MCHT(10)46 Motorbikes

15 Vehicles

250

46

Funding SourceScale-up

ACF from OFDA Grant

UNMEER

FUTURE DIRECTIONS

Identifying and removing glitches in the integration process.

Continuous work to operationalize the integration Frequent meetings with the leads of each of the

components on Case Detection RESOURCES!! LOGISTICS!!!! STRONG MONITORING AND CLOSE PRECISE-

SURGICAL-LIKE SUPERVISION Active Case Finders will use their numerical

advantage to work with the Community engagement pillar for: (1) The Senatorial Election and (2) Christmas EVD reduction campaign

QUESTIONS