situation report for acute watery …...demonstrations on domestic water treatment and domestic...
TRANSCRIPT
SITUATION REPORT FOR ACUTE WATERY DIARRHEA/CHOLERAEpidemiological Week 5 (30th January – 5th Feb 2017)
HighlightsAs of week five, the number of new acute watery diarrhea/ cholera cases reported has increased compared to the previous week due to the spread of the outbreak to new districts.
A total of 913 acute watery diarrhea/cholera cases and 10 deaths (CFR 1.1%) were reported during epidemiological week 5 (30th January to 5th February) from 38 districts in 8 regions.
The weekly CFR has decreased from 1.7% in week 4 to 1.1% in week 5. This indicates an improvement of patient care and overall response activities.
Over 30% of the new cases were reported from Baidoa. New cases were also reported from Burhakaba district in Bay region and Ufeyn, Bari region.
Situation updateA total of 913 acute watery diarrhea/cholera cases and 10 deaths were reported from 38 districts in 8 regions of south central and Puntland (refer table 1). However, the CFR rate declined from 1.7% to 1.1% in week five, even though the number of cases has increased from 877 cases to 913 cases during the reporting period.
The total number of cases reported was 4026 cases and 57 deaths (CFR 1.4%) since January 2017. The current outbreak a�ects 38 districts; it is a spillover from the cholera outbreak of the previous year attributed to severe drought that has a�ected most parts of the country. Currently, the a�ected regions are located in the south-central and Puntland regions, and they reported the following cases:
Bay Region: A total of 460 cases and 3 deaths were reported in week 5 from the districts of Baidoa, Bayhow, Aliyow Munim and Burhakaba, and the trend has gradually increased over the past 5 weeks.
Banadir Region: A total of 109 cases and 3 deaths were reported from 17 districts and the trend shows a reduction in number of cases and case fatality rate. The most a�ected districts were Hodan and Dharkenley.
Hiiran Region: A total of 35 cases and 1 death were reported in Beletweyne and Jalalaqsi. However, the trend of cases has increased this week as compared to the previous week
Lower Shebelle Region: A total of 99 cases and 1 death were reported from 9 districts. Cases were reported in Afogoye, Janale, Qoryoley, Marka Hospital, Shanalbond and Hantiwadag. One death was reported in Janale. The number of cases have continued to decline over the past two weeks.
Middle Shebelle: A total of 106 cases and 2 deaths were reported in Jowhar, Mahadaay and Hawaadley. The two deaths occurred in Jowhar and Mahadaay. The number of cases have gradually increased in the past 2 weeks.
Lower Jubba: A total of 33 cases and 0 deaths were reported from Kismayo since the beginning of the year. Cases were reported in Farjano and Fanole sections within Kismayo town.
Highlight of Cumulative Cholera Data from 1st January - 5th February 2017
Page-1
Map of Somalia showing location of AWD cases and alerts, epiweek-5, 2017
N
913 new cases reported this week
10 deaths reported this week
4 026 cumulative cases reported between Week 1-5
57 Cumulative deaths
1.5% overall case fatality rate
33 districts reported AWD cases in the south central regions
5 districts reported cases in Puntland regions
100 0 100 km
LegendSOM_adm2
Non Cholera alerts received
Cholera hot spot, no active cases
Active AWD/ cholera cases
Page-2
Considering the available surveillance data, there is strong evidence that the cholera outbreak is spreading to new villages and districts. The ongoing drought, subsequent water shortage and malnutrition are exacerbating the spread of the outbreak.
Most of the districts reporting the cholera cases are along the Shebelle River and there is a severe water shortage due to dryness of the river.
Active transmission of cholera is still going in all districts in Banadir region, but Hodan, Daynile, Dharkeynlay and Wadajir recorded the highest number of cholera cases.
The a�ected districts of Bay region are characterized by insecurity making implementation of response activities very di�cult
Bari: A total of 28 cases and 0 deaths were reported from Bossaso and Ufayn during the week.
Mudug: A total of 43 cases where reported from the districts of Galkayo, Galdogob and Jariiban
Table 1. Distribution of acute watery diarrhea/Cholera cases reportedin Somalia week 1-5
MiddleShabelle
(%)Live Dead Live Dead Live Dead CFR
Bay 234 5 2.1 265 0 0.0
47 2 4.3 17 0 0.0
111 4 3.6 116 0 0.0
50 0 0.0 65 1 1.5
11 0 0.0 36 1 2.8
20 0 0.0 0 0 0.0
14 0 0.0 5 0 0.0
Hiraan 24 0 0.0 23 0 0.0
4 0 0.0 0 0 0.0
0 0 0.0 12 1 8.3
45 0 0.0 27 0 0.0
26 0 0.0 21 1 4.8
0 0 0.0 0 0 0.0
3 0 0.0 0 0 0.0
Qoryoley 9 0 0.0 11 0 0.0
0 0 0.0 0 0 0.0
10 0 0.0 11 0 0.0
31 0 0.0 27 0 0.0
877 1 1.71 913 10 1.10 4026 57 1.42
Lower Shebelle
Baioda
130 4 3.1 109 3 2.8
1225 16 1.3
185 3 1.6
431 4 0.9
231 2 0.9
85 2 2.4
54 1 1.9
53 0 0.0
233 2 0.9
7 0 0.0
15 1 6.7
130 0 0.0
120 1 4.8
24 0 0.0
11 1 9.1
20 0 0.0
10 0 0.0
43 0 0.0
58 1 0.0
683 21 3.117 districts
Aliyow Munim
Bayhow
0 0 0.0 62 3 4.8 62 3 4.8Burhakaba
Jowhar
Mahadaay
Balad
Hawaadley
Beletweyne
Buluborte
Jalaqsi
Afogye
Janale
Busley
Waagaade
Marka hospital
Bosasso
0 0 0.0 1 0 0.0 1 0 0.0Ufayn
15 0 0.0 6 0 0.0 21 1 0.0Galdogob
Madulow
8 0 0.0 6 0 0.0
24 0 0.0 23 0 0.0
34 0 0.0
159 0 0.0Hantiwadag
0 0 0.0 33 0 0.0 33 0 0.0Kismayo
Shalanbond
Total
Week 530th Jan to 5th Feb 2017
Cumulative CasesWeek 1-5
Region District Week 423rd to 29th January 2017
Bari
48 0 0.0 30 0 0.0 78 0 0.0Galkayo
13 0 0.0 7 0 0.0 20 0 0.0Jariiban
Mudug
Lower Jubba
**CFR stands for case fatality rate, × The most a�ected districts in Banadir include Afgoye (28), Baydhabo (23), Boondheere(21), C/Casis (19) and Celesha (10)
(%)CFR
(%)CFR
Banadir
913 new cases reported this week
10 deaths reported this week
4 026 cumulative cases reported between Week 1-5
57 Cumulative deaths
1.5% overall case fatality rate
33 districts reported AWD cases in the south central regions
5 districts reported cases in Puntland regions
Page-3
Response activities
Coordination:
Coordination meeting was conducted between the Federal ministry of Health, WASH and Health clusters.
Surveillance and laboratory services:
Surveillance o�cers have scaled up the enhanced surveillance activities including rumor verification in a�ected areas
Active case search was implemented in all the a�ected districts
WASH:
Chlorination of water sources was implemented in Baidoa, Burhakaba and surrounding areas
Construction of four Solar powered shallow well (One for the school and the MCH) and 1 for the community in Mukidhere, Burfule and Hawadley villages of Mahadaay and Balad Districts, Middle Shebelle region.
Construction of five water kiosks in Mahadaay district
Rehabilitation of two twin latrines at the school and 1 twin latrine at the MCH in Balcad district
Setting up of two plastics tanks-One for the MCH and 1 for the community to store water in Hawadley village
Case management and infection control:
A new CTC was established in Buurhakaba to manage acute watery diarrhea cases
Training of health workers in case management was also done during the week
Social mobilization:
Awareness on open defecation is being conducted in Jowhar
Hand washing campaigns are also implemented in Jowhar
Demonstrations on domestic water treatment and domestic preparation of ORS have also conducted
Fig 1. AWD/Cholera cases and Case Fetality Rate in Somalia April 2016- Feb 2017
0.0
2.0
4.0
6.0
8.0
10.0
12.0
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Wee
k 9
Wee
k 11
Wee
k 13
Wee
k 15
Wee
k 17
Wee
k 19
Wee
k 21
Wee
k 23
Wee
k 25
Wee
k 27
Wee
k 29
Wee
k 31
Wee
k 33
Wee
k 35
Wee
k 37
Wee
k 39
Wee
k 4
1
Wee
k 4
3
Wee
k 4
5
Wee
k 4
7
Wee
k 4
9
Wee
k 51
Wee
k 1
Wee
k 3
Wee
k 5
Cas
e F
atal
ity
Rat
e (%
)
Num
ber
of
AW
D/C
hole
ra c
ases
Cases CFR (%)
Drought begins
Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16 Jan-17 Fe-17
Floods begin
weeks/months
Page-4
The weekly situation report is prepared by WHO and the health cluster team. For any queries kindly contact
Mutaawe Lubogo [email protected]; Iliana Mouradi [email protected]; Abdihamid Ibrahim
Logistics and supplies:
1 IDDK kit was delivered to Baidoa hospital
OCV
The planning for the Oral Cholera Vaccination campaigns targeting seven hotspot locations in three regions continued this week;
Urgent Needs
Contact details
Shortage of funds is hampering the implementation of response activities to contain the ongoing cholera outbreak in Somalia, and it’s important to raise funds to sustain the cholera response
Additional medical and non-medical supplies to be prepositioned in high risk districts
Building local capacities among health workers and partners on managing cholera cases and related areas
Engagement of the local health authorities in monitoring the response activities in all a�ected districts