Week-46 Ending 18 Nov

Transcription

1 Somalia Weekly Update Week-46 Ending 8 Nov. 208 info@somaliapolio.org

2 Trend of VDPVs isolated from AFP and ES by Month and cvdpv3 isolated from AFP cases cvdpv3 and cvdpv Oct-7 Nov-7 Dec-7 Jan-8 Feb-8 Mar-8 Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 and cvdpv3 isolated from ES samples ( ) avdpv2 VDPV2 & cvdpv3 compatible cvdpv Oct-7 Nov-7 Dec-7 Jan-8 Feb-8 Mar-8 Apr-8 May-8 Jun-8 Jul-8 Aug-8 Sep-8 Oct-8 Nov-8 Dec-8

3 and cvdpv3 headlines from AFP - No new reported from AFP since the last positive case was reported from L. Jubba region of J. west district with on onset of paralysis on 2 September A total of six cvdpv3 cases were reported in One case has co-infection of both and cvdpv3 from ES samples - two new s reported this week from 2 ES samples collected from Kawma and Egyptian Hospital ES sites. The samples were collected on 20 September 208 and 04 October 208 respectively - In total has been isolated from 7 sewage samples in Mogadishu in 208. One ES sample has co-infection of and cvdpv3. cvdpv3 from AFP - No new cvdpv3 reported from AFP since the last positive case was reported from M. Shabelle region of Runingod district on 7 September A total of six cvdpv3 cases were reported in One case has co-infection of both and cvdpv3 cvdpv3 from ES samples - No cvdpv3 reported from ES samples since the last Positive cvdpv3 was reported on 23 August cvdpv3 isolated from 0 sewage samples in Mogadishu. ES sample has coinfection of both and cvdpv3 J. West Daynile /3 (n=) List of the positive cases and ES samples are presented on next slides

4 List of and cvdpv3 from AFP cases # EPID # Region Province District City/Village Gender Notified by Accessibility Lifestyle Age (months) Date of Onset of Paralysis OPV Doses SOM/HRN/BBT/8/002 Central HIRAN BULO BURTI JAMECO MUBARAK Female MCH inaccessible Nomadic 72 /05/ SOM/MSH/WRS/8/00 Central 3 SOM/MSH/WRS/8/003 Central MIDDLE SHABELLE MIDDLE SHABELLE IPV OPV Date of last OPV Results & cvdpv3 Co infection WARSHEIKH MUNGAB Male VPV accessible Nomadic 30 6/05/ /05/208 cvdpv3 WARSHEIKH BOHI Male Hospital accessible Nomadic 39 23/05/ cvdpv3 4 SOM/GDO/DLO/8/002 South Gedo DOLO KABASA IDP Male Vaccinator accessible Urban 24 26/05/ /05/208 5 SOM/LJB/KSM/8/005 South LOWER JUBA KISMAYO GULWADE Male DFA/VPV accessible Nomadic 24 24/06/ /05/208 cvdpv3 6 SOM/MSH/MDY/8/002 Central MIDDLE SHABELLE 7 SOM/BAN/DYN/8/003 Cntral BANADIR DANYILE MAHADAY SHAAN Male VPV accessible Rural 42 29/06/ /05/208 cvdpv3 TABELHA- SH IBRAHIM 8 SOM/LJB/KSM/8/006 South LOWER JUBA KISMAYO ALANLEY Male Male Hospital accessible urban 36 0/07/ /05/208 Traditional Healer accessible Rural 56 27/07/ cvdpv3 9 SOM/LJB/KSM/8/008 South LOWER JUBA KISMAYO FANOLE DP Female Vaccinator accessible Urban 24 29/07/ /07/208 0 SOM/LJB/KSM/8/007 South LOWER JUBA KISMAYO FANOLE IDP Male Vaccinator accessible Urban 96 30/07/ SOM/LJB/JMW/8/002 South LOWER JUBA JAMAME WEST MAZAGIRO Female VPV Inaccessible rural 32 02/09/ SOM/MSH/RNG/8/002 South MIDDLE SHABELLE RUNINGOD MASAJID Male VPV Inaccessible Nomadic 05 07/09/ cvdpv3

5 cvdpv3 cvdpv3 cvdpv3 cvdpv3 cvdpv avdpv2 cvdpv3 cvdpv3 cvdpv3 avdpv2 Summary Environmental Samples and Lab Classification Epidemiological Week-207 Epidemiological Week-208 District Name of Site Date of Establishment Waberi 2-Oct 9 Sept. 207 Shangani Urobo 20 Sept. 207 Shangani Urobo2 7 Aug. 208 HamerewoiniKawma 2 Sept. 207? Hodan Egyt. Hosp 23 Nov ? Legend 9 cvdpv3 avdpv2 Not scheduled 5 NPENT 0 Sent for sequencing NEV+NPEV 2 Pending 6 Sabin Scheduled but not collected 3 Negative 7 NPENT + Sabin 2 Sabin 2 4 NEV 8 3 Sabin + NPEV + NEV

6 List of cvpv2 & cvdpv3 isolated from ES samples S/N PROVINCE DISTRICT SITENAME IDCODE Date Sample Collection STATUS VDPVs nt dc from sabin Date Lab Result S/N PROVINCE DISTRICT SITENAME IDCODE Month STATUS VDPVs nt dc from sabin Date Lab Result BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/7/002 22/0/207 02//207 2 BANADIR WABERI WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/7/002 ES/SOM/BAN/WBR/TOO/7/003 Oct-702// //207 2// BANADIR BANADIR WABERI HODAN TWENTY-ONE EGYP OCTOBER ES/SOM/BAN/WBR/TOO/7/003 ES/SOM/BAN/HDN/EGH/8/008 Nov-722/02/ & 372/03/208 6// BANADIR BANADIR HAMAR HAMAR WEYN WEYN KAWMA KAWMA ES/SOM/BAN/HMW/KAW/8/00 Jan-8 04/0/ & 440/02/208 0/2/ BANADIR BANADIR HAMAR HAMAR WEYN WEYN KAWMA KAWMA ES/SOM/BAN/HMW/KAW/8/002 Jan-8 /0/ /02/208 0/2/ BANADIR BANADIR HODAN HAMAR WEYN EGYPKAWMA ES/SOM/BAN/HDN/EGH/8/008 ES/SOM/BAN/HMW/KAW/8/05 Feb-82/04/ /05/208 2/3/ BANADIR BANADIR HAMAR HAMAR WEYN WEYN KAWMA KAWMA ES/SOM/BAN/HMW/KAW/8/03 ES/SOM/BAN/HMW/KAW/8/06 Mar-89/04/208 cvdpv3 42 6/05/208 2/5/ BANADIR BANADIR WABERI HAMAR WEYN TWENTY-ONE KAWMA OCTOBER ES/SOM/BAN/WBR/TOO/8/009 ES/SOM/BAN/HMW/KAW/8/07 Mar-803/05/208 avdpv2 6 08/06/208 27/03/ BANADIR BANADIR HAMAR HAMAR WEYN WEYN KAWMA KAWMA ES/SOM/BAN/HMW/KAW/8/00 ES/SOM/BAN/HMW/KAW/8/09 Mar-87/05/208 cvdpv3 5 08/06/208 2/4/ BANADIR BANADIR HAMAR HAMAR WEYN WEYN KAWMA KAWMA ES/SOM/BAN/HMW/KAW/8/0 ES/SOM/BAN/HMW/KAW/8/033 Mar-823/08/208 cvdpv3 5 28/09/208 2/4/208 0 BANADIR BANADIR HAMAR HAMAR WEYN WEYN KAWMA KAWMA ES/SOM/BAN/HMW/KAW/8/02 ES/SOM/BAN/HMW/KAW/8/034 Mar-830/08/208 cvdpv3 7 24/0/208 2/4/208 2 BANADIR BANADIR WABERI HAMAR WEYN TWENTY-ONE KAWMA OCTOBER ES/SOM/BAN/WBR/TOO/8/00 ES/SOM/BAN/HMW/KAW/8/035 Mar-806/09/208 cvdpv3 7 04/0/208 2/4/ BANADIR BANADIR HAMAR HAMAR WEYN WEYN KAWMA KAWMA ES/SOM/BAN/HMW/KAW/8/05 ES/SOM/BAN/HMW/KAW/8/036 Apr-83/09/ /0/208 2/5/ BANADIR BANADIR HAMAR WABERI WEYN KAWMA TWENTY-ONE OCTOBER ES/SOM/BAN/HMW/KAW/8/04 ES/SOM/BAN/WBR/TOO/8/009 Apr-80/03/208 cvdpv3avdpv2 8 27/03/208 2/5/ BANADIR BANADIR HAMAR WABERI WEYN KAWMA TWENTY-ONE OCTOBER ES/SOM/BAN/HMW/KAW/8/06 ES/SOM/BAN/WBR/TOO/8/06 Apr-89/04/208 +cvdpv3 39 6/05/208 6/05/ BANADIR BANADIR WABERI WABERI TWENTY-ONE TWENTY-ONE OCTOBER OCTOBER ES/SOM/BAN/WBR/TOO/8/06 ES/SOM/BAN/WBR/TOO/8/08 Apr-8 0/05/208 +cvdpv3 43 type 2 08/06/208 & 6/05/ BANADIR BANADIR WABERI WABERI TWENTY-ONE TWENTY-ONE OCTOBER OCTOBER ES/SOM/BAN/WBR/TOO/8/09 ES/SOM/BAN/WBR/TOO/8/09 May-8 7/05/ /06/208 5/06/ BANADIR BANADIR HAMAR WABERI WEYN KAWMA TWENTY-ONE OCTOBER ES/SOM/BAN/HMW/KAW/8/07 ES/SOM/BAN/WBR/TOO/8/030 May-8 02/08/ /09/208 8/6/ BANADIR BANADIR HAMAR WABERI WEYN KAWMA TWENTY-ONE OCTOBER ES/SOM/BAN/HMW/KAW/8/09 ES/SOM/BAN/WBR/TOO/8/036 May-8 3/09/208 avdpv /0/208 8/6/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/037 20/09/208 24/0/208 9 BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/08 May-8 7 8/6/208 2 BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/00 08/03/208 cvdpv3 2/04/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/027 Jul-8 cvdpv /07/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/0 5/03/208 cvdpv3 2/04/208 2 BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/032 Aug-8 cvdpv3 8 9/09/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/02 22/03/208 cvdpv3 2/04/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/033 Aug-8 cvdpv3 8 25/09/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/03 29/03/208 cvdpv3 02/05/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/033 Aug /09/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/04 05/04/208 cvdpv3 02/05/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/034 Aug /0/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/00 08/03/208 cvdpv3 2/04/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/030 Aug-8 44 /9/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/027 2/07/208 cvdpv3 23/07/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/035 Sep-8 4 &43 4/0/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/032 6/08/208 cvdpv3 9/09/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/036 Sep /0/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/033 23/08/208 cvdpv3 25/09/ BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/036 Sep-8 avdpv2 8 24/0/ BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/037 20/09/208 4& 43 5// BANADIR WABERI TWENTY-ONE OCTOBER ES/SOM/BAN/WBR/TOO/8/037 Sep-8 42 &49 24/0/208 3 BANADIR HODAN EGYP ES/SOM/BAN/HDN/EGH/8/039 04/0/ & 50 5// BANADIR HODAN EGYP ES/SOM/BAN/HDN/EGH/8/039 Oct-8 49 & 50 5//208 3 BANADIR HAMAR WEYN KAWMA ES/SOM/BAN/HMW/KAW/8/037 Oct-8 4&43 5//208

7 SIA Activity Calendar Apr Dec. 208 Activity Target area Date Status NID bopv Somaliland and Puntland 30 Apr- 03 May 208 Campaign completed NID bopv South and Central Except Banadir, Lower and Middle Shabelle 5-8 May 208 Campaign completed Third response round mopv2 Campaign Banadir, Lowe Shabelle and Middle Shabelle 5-8 May 208 Campaign completed Synchronized mopv2 Campaign (with Kenya and Ethiopia), Round South and Central regions without Banadir, Lower and Middle Shablle regions synchronized with Kenya response campaign 9-2 Jul 208 Campaign completed Small scale bopv Response Banadir, Lower and Middle Shablle regions 23-Jul 208 Campaign completed Synchronized mopv2 Campaign (with Kenya and Ethiopia), Round 2 South and Central regions with out Banadir, Lower and Middle Shabelle regions synchronized with Kenya response campaign 4-8 Aug. 208 Campaign completed mopv2 Daynile district 9-22 Sept. 208 Campaign completed NID 2 using bopv All 9 regions in Somalia (Targeted over : 3 million U-5 Children) -7 October 208 Campaign completed NID 3 using bopv All 9 regions in Somalia (Targeted over 3 million U-5 Children 29 Oct - 5 Nov 208 Campaign completed Upcoming Campaigns snid mopv2 In 9 regions of South and Central zones November 208 Preparation on going

8 Preparation for third round mopv2 in South & Central zone Campaign Summary Campaign name: SNID synchronized round 3 Campaign date: November 208 Vaccine type: mopv2 Target area: 9 out of 0 regions in South and Central. 67 districts in total. region is completely inaccessible (Middle Jubba) Target population: over.5 million under 5 children

9 NID round 3 implementation progress Campaign Summary Campaign type: NID round-3 for 208 Campaign date: SL, South & Central: 29 Oct. -st Nov Puntland: Nov. 208 Vaccine type: bopv Targeted accessible areas (light green area of the map) The red area inaccessible. Very small areas from the light red area, most of the accessible areas inside the light red areas district capitals Target of U5 Children: 3,85,870 Number of Regions: 8 Regions region is completely inaccessible Number of team Supervisors (DFAs):,883 Number of Vaccination Teams: 4,98 Number of ICMs Involved:,835 Number of ICMs Supervisors involved: 47 Coverage Intra Campaign IM coverage: 98% Administrative data: 2,699,476 vaccinated (94%) Post campaign IM Coverage: 99% Post campaign LQAS: of the 00 lots, 94 pass and 3 fail

10 NID-3 Administrative Summary Row Labels Sum of Target <5 Pop Sum of 0- months Vaccinated Sum of 2-59 months Vaccinated Sum of Zero doses Sum of Total Vaccinated Sum of Target <5 Pop Central,097,973 74, ,567,532,048,357 95% Puntland 520,90 80,82 437,096 4,4 522,56 00% Somaliland 659,752 0, ,962 5,29 644,54 98% South 600,332 88, ,997 2,60 484,422 8% Grand Total 2,878, ,632 2,23,622 23,097 2,699,476 94% Graph no.

11 Comparison of proportion of reached children NID-, NID-2 and NID-3 00% 90% 80% 70% 60% 50% 40% 30% 20% 0% 0% L. Jubba Bay Bakool Gedo M. Jubba Hiran M. Shabelle L. shabelle Galgaduud Banadir Nugal Mudug Bari Karkar Sanag Sool Ayn Awdal Sahil Sanaq Sool Galbeed Togdher South Central Puntland Somaliland Total NID- % of reache children NID-2 % of reache children NID-3 % of reache children Admin coverage improved from 8% to 85% in round 3 Accessibility continues to be the main issue for missed children in Central and South zones of Somalia An estimated number of 479,060 children were missed in the round While 450,00 were missed due to access issue, approximately 6,000 were missed due to different reasons, including non-availability and team performance

12 Post IM data/result summary Sampling Sampling frame is created with a list of all settlements (n=,047) in the SIA area. Of these 5% are rural, 33% are nomadic, 5% are urban and % are IDPs 2.5% of Households (HHs) in each DFA areas had proportional distribution of samples across different type of settlement The sampling frame also used for the LQAS Clusters (0 HHs each) were selected randomly from all DFAs giving equal proportion of sample size for all settlement types Data collection Data was collected from 79 DFAs using ODK by trained data collectors staring from the end of the campaign 40 HHS visited from each DFA. 4 children on average from each DFA. (An average of child within age group 0- months age and months age)

13 Post IM data/result summary The cumulative data shows, Despite type of settlement, most have achieved more than 95% IM coverage verified by figure marking. Majority of the missed children in number are reported from urban areas (64%); mainly from Banadir (n=597) followed by Lower Shabelle (n=366) and Galbeed in Somaliland (n=77). 97% of districts have achieved IM coverage of > 95% for both age groups. The 3 districts with less than 95% cumulative coverage are Galisore, Kurtunware and Wanlewain. Galinsor district from Galgadood region has 88% coverage for the 0- age group. Pot IM data collected from 78 DFAs. While 702 have achieved > 95% IM coverage, 75 DFAs have coverage between 90%-95%. Six DFAs ( from Bossaso, from Kismayo, from Marka, from Kurtunware, from Dharkenle district have IM coverage less than 90%.

14 Proportion of DFA areas where ODK data is being received through ODK Row Labels Number of DFA areas # DFAs send data through ODK # DFAs send data through ODK (Proportion of ODK implementation area) AWL % BAN % BAY % BKL % BRI % GDD % GDO % HRN % LJB % LSH % MSH % MUD % NUG % SAH % SNG % SOL % TOG % WGB % Total % Of the total 726 DFAs (Accessible areas), 68% of DFAs (n=68) were submitting their data through ODK.

15 Actual sites where SIA is collected using ODK and shared

16 # missed children parent not Avalavel child at school child at market/street child traveling HHs not visited child asleep child new born child is visitor child is sick Religious No faith Fatigue Rumour Demand for other services No response unknown post % HH aaware about camapaign NID-3 Post-campaign IM coverage by region Missed not availavel Missed Team Performance Missed Refusal Province # HHs Visited % HHs correctly Marked # children 0- age Visited # children 0- age Vaccinated % children 0- age Vaccinated # children 2-59 age Visited # children 2-59 age Vaccinated % children 2-59 age Vaccinated % totla U5 children Vaccinated Awdal % % % 99% % Banadir % % % 98% % Bay % % % 99% % Bakool % % % 00% % Bari % % % 99% % Galgadud 38 99% % % 99% % Gedo % % % 00% % Hiran % % % 00% 0 98% L Jubba % % % 99% % L Shebella % % % 95% % M Shabelle 24 99% % % 99% % Mudug 37 00% % % 00% 0 00% Nugal % % % 00% % Sahil 60 99% % % 00% 0 00% Sanag % % % 97% % Sool % % % 99% % Togdher % % % 99% % Galbeed % % % 99% % M. Jubba No Campaign Total % % % 99% %

17 # missed children parent not Avalavel child at school child at market/street child traveling HHs not visited child asleep child new born child is visitor child is sick Religious No faith Fatigue Rumour Demand for other services No response unknown post % HH aaware about camapaign NID-3 Post-campaign IM coverage by type of settlement Province Count of hh_added % HHs correctly Marked # children 0- age Visited # children 0- age Vaccinated % children 0- age Vaccinated # children 2-59 age Visited # children 2-59 age Vaccinated % children 2-59 age Vaccinated % totla U5 children Vaccinated Missed not availavel Missed Team Performance Missed Refusal IDP/Refugees % % % 99% % Nomadic % % % 00% % Rural % % % 99% % Urban % % % 99% % (blank) 0 00% % % 00% 0 00% Grand Total % % % 99% % Proportion of missed children by tpe of settlemnt 9% % 26% 64% IDP_refugees Nomadic Rrural Urban

18 Post IM- Reasons for missed children by type of settlement parent not Avalavel 64 child at school child at market/street child traveling HHs not visited child asleep child new born child is visitor child is sick Religious No faith Fatigue Rumour Demand for other services No response Missed not availavel Missed Team Performance Missed Refusal unknown post IDP_refugees Nomadic Rrural Urban

19 AFP Surveillance

20 204W0 204W03 204W05 204W07 204W09 204W 204W3 204W5 204W7 204W9 204W2 204W23 204W25 204W27 204W29 204W3 204W33 204W35 204W37 204W39 204W4 204W43 204W45 204W47 204W49 204W5 205W0 205W03 205W05 205W07 205W09 205W 205W3 205W5 205W7 205W9 205W2 205W23 205W25 205W27 205W29 205W3 205W33 205W35 205W37 205W39 205W4 205W44 205W46 205W48 205W50 205W52 206W02 206W04 206W06 206W08 206W0 206W2 206W4 206W6 206W8 206W20 206W22 206W24 206W26 206W28 206W30 206W32 206W34 206W36 206W38 206W40 206W42 206W44 206W46 206W48 206W50 206W52 207W02 207W04 207W06 207W08 207W0 207W2 207W4 207W6 207W8 207W20 207W22 207W24 207W26 207W28 207W3 207W33 207W35 207W37 207W39 207W40 207W42 207W44 207W46 207W48 207W50 207W52 208W02 208W04 208W06 208W08 208W0 208W2 208W4 208W6 208W8 208W20 208W22 208W24 208W26 208W28 208W30 208W32 208W34 208W36 208W38 208W40 208W42 208W44 Week-46 Somalia Weekly EPI/POL Update Epidemiological Curve 0 January Nov Pending Lab Pending ERG Discarded Compatable WPV avdpv cvdpv3 and cvdpv3 Lost Sample

21 Table no.- Total W3 207W32 207W33 207W34 207W35 207W36 207W37 207W38 207W39 207W40 207W4 207W42 207W43 207W44 207W45 207W46 207W47 207W48 207W49 207W50 207W5 207W52 Total W0 208W02 208W03 208W04 208W05 208W06 208W07 208W08 208W09 208W0 208W 208W2 208W3 208W4 208W5 208W6 208W7 208W8 208W9 208W20 208W2 208W22 208W23 208W24 208W25 208W26 208W27 208W28 208W29 208W30 208W3 208W32 208W33 208W34 208W35 208W36 208W37 208W38 208W39 208W40 208W4 208W42 208W43 208W44 208W45 208W46 Total 208 Week-46 Somalia Weekly EPI/POL Update Weekly AFP cases reported by Provinces, Somalia. (cases are distributed across weeks based on date of onset of paralysis). PROVINCE BANADIR GALGADUD M. SHABELLE L. SHABELLE HIRAN BARI NUGAL 0 9 MUDUG TOGDHER 9 0 GALBEED SANAQ AWDAL SAHIL SOOL LOWER JUBA BAY GEDO MIDDLE JUBA BAKOOL Total Somalia Twelve (2) new AFP cases were reported last week bringing the total AFP cases reported in 208 to 32 from 9 regions, compared to 322 AFP cases from 9 regions at the same time point in 207. Silent (not reporting) for > 8 weeks Reported AFP cases Community Samples collected in silent regions Community Samples collected but regions not silent

22 Table no.-2 Week-46 Somalia Weekly EPI/POL Update 277 Discarded 0 WPV 2 In process (lab) 23 Pending 32 AFP cases reported in Compat ible Pending ERG/ Lost Sample Classification of AFP cases by status (207 & 208) 5 6 cvdpv3 Chart no. Note: The total number of cvdpv cases are 2. (6 cvdpv3, 5, one () had both and cvdpv3). & cvdpv3 Pending ITD (inadequate samples) ZONE CENTRAL Puntland Somaliland SOUTH PROVINCE Discard ed Pendin g Total Discard ed VDPV Pendin g Total BANADIR GALGADUD HIRAN L. SHABELLE M. SHABELLE BARI MUDUG NUGAL AWDAL GALBEED SAHIL SANAQ SOOL TOGDHER BAKOOL BAY GEDO LOWER JUBA MIDDLE JUBA Grand Total

23 Week-46 Somalia Weekly EPI/POL Update Annualized NP-AFP Rate by Zone, 208 Surveillance Indicators by Zone and Region Central Puntland Somaliland South Total Somalia Annualized NP-AFP rate by accessibility status, 208 Graph no Banadr region-magnified Banadr region-magnified In-accessible Partially Acceessible Accessible Somalia Graph no. 3 Map no. Map no. 2

24 Map no. 3 Map no. 4 Week-46 Somalia Weekly EPI/POL Update Surveillance Indicators (NP-AFP rate and Stool adequacy) by district, 208 Banadr region-magnified 2/5 districts reported at least AFP case since the first week of 208. The 3 districts not reported any AFP in 208 are Abdul Aziz, Hamar Jabjab and Hamarweyne all from Banadir region of Central zone. Of the 3 districts Abdulaziz and Hamerwyne are silent for more than a year (52 consecutive weeks). The last AFP was on week 9 and week 06 respectively Of the 2 districts reporting AFP cases in 208, 03 have annualized NP-AFP rate above 2 per 00,000. In addition, 08 districts have stool adequacy rate of above 80% The remaining 3 districts have not reported any AFP case in 208; However, no district in Somalia has been silent for more than 52 consecutive weeks as of this week Banadr region-magnified

25 Week-46 Somalia Weekly EPI/POL Update 600 Number of NP-AFP cases reported across years during the same period ( ) by zone CENTRAL PUNTLAND SOMALILAND SOUTH SOMALIA Central zone have reported lower number of AFP cases compared to the number reported in 207 during the same period. A total of 43 additional community samples were collected from healthy children. Majority of these samples were collected from access compromised and silent districts of Central and South zones.

26 # AFP cases NP-AFP Rate # Cases with Adequate Specimen Cases pending lab results Cases with lab. result. Cases with stool in good cond. % Cases with stool in good cond. # of samples with NP-EV Isolated % Samples with NP EV Isolated # cases with Sabin like virus Isolation % of cases with S L Virus Isolation Week-46 Somalia Weekly EPI/POL Update Summary of AFP surveillance key indicators by Zone, 208 ZONE % Stool Adequacy % Inv. within 48 hours % Notification within 7 days Central % 99% 98% % 20 0% 8 8% Puntland % 00% 00% % 3 4% 6 4% Somaliland % 00% 97% % 6 5% 6 0% South % 00% 88% % 2 7% 2 2% Total % 00% 95% % 4 7% 22 8% Table no.-4

27 Week-46 Somalia Weekly EPI/POL Update CENTRAL ZONE PROVINCE Regional U5 Pop. Summary of AFP surveillance key indicators by Province, 208 Expected # of AFP cases as of this Week Number of AFP cases reported NP-AFP Rate (Target 2/00000) % Stool Adq. (Target >80%) % Notif. within 7 days (Target >80%) % Stool condition (Target >80%) % Samples with EV isolated (Target >7) % cases with SL isolated (Target >0) # Cases with late 60 days follow-up BANADIR % 00% 00% % 3% 0 GALGADUD % 95% 00% 0% 5% 2 HIRAN % 00% 00% 5% 0% 2 LOWER SHABELLE % 00% 00% 3% 8% MIDDLE SHABELLE % 95% 00% 8% 0% BARI % 00% 00% 6% % 0 MUDUG % 00% 00% 0% 20% 2 NUGAL % 00% 00% 6% % 2 AWDAL % 95% 00% 3% 0% 0 GALBEED % 00% 00% 6% 2% 0 SAHIL % 00% 00% 0% 25% 0 SANAQ % 86% 00% 20% 20% 0 SOOL % 00% 00% 0% 0% 0 TOGDHER % 00% 00% 6% 0% 0 BAKOOL % 00% 00% 0% 0% BAY % 83% 00% 3% 0% 6 GEDO % 96% 00% % 4% 3 LOWER JUBA % 8% 00% 2% 4% 0 MIDDLE JUBA % 92% 00% 0% 0% 0 SOMALIA 636, % 95% 00% 7% 8% 30 PUNTLAND SOMALILAND SOUTH

28 Zone Week-46 Somalia Weekly EPI/POL Update Summary of key AFP surveillance indicators for contacts, 208 ZONE # AFP Cases # CONTACTS # Contact samples with Lab result Average contacts per cases % contacts < 5 age % Contact collected within 7 days of AFP notified % Contact with stool in Good Condition # Contact pending lab results # Specimens with NPEV isolated Central % 00% 00% 46 6% 3 4% Puntland % 00% 00% 6 4 % 9 7% Somaliland % 00% 00% % 6 9% South % 00% 00% % 6 2% Somalia % 00% 00% % 44 5% % Specimens with NPEV Isolated # Contacts with Sabin virus isolated % contacts with Sabin like virus Isolated Summary of Community Samples collected in 208 from silent districts, Egyptian hospital and inaccessible districts Pending Negative NPENT Suspected Poliovirus PV 3 Sabin PV Sabin & PV3 Sabin PV Sabin VPV3 PV 2 Sabin Grand Total CENTRAL PUNLAND SOMALILAND SOUTH Grand Total Of the total 470 community samples collected from healthy children in 208, 57% were collected from accessible and the rest 43% were from access-compromised areas

29 Week-32 Somalia Weekly EPI/POL Update Validation and zero dose investigation of AFP cases, 208 AFP Cases Validation Zero Dose Investigation Zone # of AFP cases Reported # of AFP cases Validated % of AFP cases Validated Central % Somaliland % South Zone % Puntland % Total % Table no.-8 Zone # of Zero dose AFP cases Reported # of Zero dose AFP cases investigated % of Zero dose AFP cases investigated Central 6 55% Somaliland 0 0% South Zone % Puntland 0 0% Total % Comment 6 are from accessible, 2 from partially accessible and 20 from inaccessible districts. Only 27 of the total 38 are months age Table no.-9 Of the 32 AFP cases reported in 208, 59% (n=84) were validated by the RPOs. Of the 84 AFP cases validated, (n=33, n=26, n=25) were from accessible, partially accessible and inaccessible districts respectively There were 38 zero OPV dose AFP cases reported in 208, out of which 53% (n=20/38) were investigated

30 Week-46 Somalia Weekly EPI/POL Update Tracking lab results of AFP cases Total AFP cases 32 Tracking AFP with stool specimens cvdpv type 2 and 3 coinfection AFP cases with stool specimens 32 AFP cases without stool specimens 225 cvdpv3 Other viruses neg st in lab With lab results En route In the lab Inadequate sample (lost) cvdpv type 2 and 3 coinfection cvdpv3 SL EV -ve

31 Week-46 Somalia Weekly EPI/POL Update Sample source # Specimen collected Lab performance indicators for AFP surveillance in Somalia, 208 # Specimen with culture result # Specimens pending lab result # Specimen with culture result within 4 days % of specimen with culture result within 4 days Number of specimen with NPEV % of specimen with NPEV Number of cases with Sabin isolation % of Cases with Sabin isolation Cases % 4 7% 22 8% Contacts % 03 2% 44 5% Total % 44 0% 66 6% Table no.-0

32 Week-46 Somalia Weekly Polio Update Region Routine immunization services, status of cold chain & vaccine stocks in AFP surveillance sites, 23 Sept 208 Expected weekly AFP sites visits Health facility with routine EPI service AFP sites with EPI service and functional cold chain Health facility have EPI vaccine available Health facility with IPV vaccine available No No. % No. % No. % No. % Nugal % 9 00% 9 00% 7 89% Bari % 32 94% 34 00% 32 94% Mudug % 38 97% 38 97% 24 63% Galbeed % 23 00% 23 00% 23 00% Sahil % 0 00% 0 00% 8 80% Sanag 2 52% 00% 00% 00% Sool % 0 00% 0 00% 0 0% Awdal % 23 00% 23 00% 23 00% Togdher % 2 00% 2 00% 2 00% Middle Shabelle % 5 79% 9 00% 9 00% Hiran % 5 23% 22 00% 22 00% Galgadud % 5 58% 26 00% 25 96% Banadir % 25 36% 67 96% 64 96% Lower Shabelle % 6 53% 30 00% 24 80% Middle Juba 29 3% 0 0% 00% 0 0% Bakool % 47 07% 25% 0 9% Gedo % 20 95% 2 00% 9 90% Bay % 30 00% 30 00% 3 03% Lower Juba % 8 27% 30 00% 27 90% Somalia % % % %

33 Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses % Zero doses Number of vaccinated Zero doses Table no.-6 % Zero doses Week-46 Somalia Weekly EPI/POL Update Transit Points Vaccination activities using bopv 8 Nov 208 January February March April May June July August September October November Zones CENTRAL % % % % % % % % % % % PUNTLAND % % % % % % % % % % % SOMALILAND % % % % % % % % % % % SOUTH % % % % % % % % % % 0 0 0% SOMALIA % % % % % % % % % % % A total of,999,842< 0 years individuals were vaccinated week 44,208. Among them 9,08(%) were vaccinated for the first time.

34 00% 90% 80% 70% 60% 50% 40% 30% 20% 0% 0% Immunity Profile of NP-AFP Cases and Contacts combined Months, Week-46 Somalia Weekly EPI/POL Update Immunity Profile of NP-AFP cases and Contacts Dose -3 doses 4-6 doses 7+ doses % 90% 80% 70% 60% 50% 40% 30% 20% 0% 0% Immunity Profile of NP-AFP Cases 6-23 Months, Graph no.-9 Graph no.-22 Graph no.-20 raph no zero dose AFP cases reported in 208 from inaccessible and partially accessible areas of South (n=24), Central (n=0), from Puntland and from Somaliland. (6 are from accessible, from partially accessible and 9 from inaccessible districts) dose -3 doses 4-6 doses 7+ doses 00% 90% 80% 70% 60% 50% 40% 30% 20% 0% 0% Immunity Profile of NP-AFP cases 6-59 Months by Zone, dose -3 doses 4-6 doses 7+ doses 00% 90% 80% 70% 60% 50% 40% 30% 20% 0% 0% Immunity Profile of NP-AFP cases 6-23 Months by Zone, Dose -3 Doses 4-6 Doses 7+ Doses 9 5

35 Week-46 Somalia Weekly EPI/POL Update Immunity profile of NP-AFP cases and Contacts combined by Zone SOMALILAND CENTRAL 00% 80% 60% 40% 20% 0% % 80% 60% 40% 20% 0% dose -3 doses 4-6 doses 7+ doses 0 dose -3 doses 4-6 doses 7+ doses SOUTH Graph no.-24 PUNTLAND Graph no % 80% 60% 40% 20% 0% % 80% 60% 40% 20% 0% dose -3 doses 4-6 doses 7+ doses 0 dose -3 doses 4-6 doses 7+ doses Graph no.-26 Graph no.-27

36 BCG P- P-3 Measles OPV-3 IPV BCG P- P-3 Measles OPV-3 IPV BCG P- P-3 Measles OPV-3 IPV BCG P- P-3 Measles OPV-3 IPV Routine Immunization Coverage by zone, Somalia ( Nine months annualized) PUNTLAND SOMALILAND SOUTH CENTERAL SOMALIA (9 months)

37 Total 207 W0 W02 W03 W04 Week-45 Somalia Weekly Polio Update Fever & Rush cases reported by AFP surveillance System 0// 208 W05 W06 W07 W08 W09 W0 W W2 W3 W4 W5 W6 W7 W8 W9 W20 W2 W22 W23 W24 W25 W26 W27 W28 W29 W30 W3 W32 W33 W34 W35 W36 W37 W38 W39 W40 W4 W42 W43 W44 W45 Total 208 Fever and Rash 208 Regions CENTRAL BANADIR GALGADUD HIRAN LOWER 09 SHABELLE MIDDLE SHABELLE PUNTLAND BARI KARKAR MUDUG NUGAAL SOMALILA 05 ND GALBED AWDAL SAHIL SANAG SOOL TOGDHER SOUTH BAKOOL BAY GEDO LOWER JUBA MIDDLE JUBA Somalia

38 205W3 205W6 205W9 205W22 205W25 205W28 205W3 205W34 205W37 205W40 205W43 205W46 205W49 205W52 206W03 206W06 206W09 206W2 206W5 206W8 206W2 206W24 206W27 206W30 206W33 206W36 206W39 206W42 206W45 206W48 206W5 207W02 207W05 207W08 207W 207W4 207W7 207W20 207W23 207W26 207W29 207W32 207W35 207W38 207W4 207W44 207W47 207W50 208W 208W4 208W7 208W0 208W3 208W6 208W9 208W22 208W25 208W28 208W3 208W34 208W37 208W40 208W43 Epid curve of suspected Measles cases by week, Somalia(205 Week Week 46) N=5, N=5, N=23, N=

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