South Sudan. Integrated Disease Surveillance and Response (IDSR) Epidemiological Update W (Dec 11-Dec 17)

Transcription

1 South Sudan Integrated Disease Surveillance and Response (IDSR) Epidemiological Update W5 27 (Dec -Dec 7) Ministry of Health Republic of South Sudan Printed: 7:35 Tuesday, 9 December 27 UTC

2 Contents Surveillance Response Slide Table IDSR surveillance performance indicators by county (W5) Cholera Table 2 Summary of key IDSR surveillance indicators Table 3 IDSR report submissions (W5) Slide 8 Slide 9 Table Summary of key cholera response indicators Figure 2 Cholera epidemic curve (National) Slide 2 Slide 3 Slide 4 Figure Trend in IDSR completeness over time Map a Map of IDSR completeness by county (W5) Map b Map of IDSR timeliness by county (27) Table 4 EWARS surveillance performance indicators by partner (W5) Table 5 Summary of key EWARS surveillance indicators Table 6 EWARS report submissions (W5) Slide Map 3a - 3d Maps of distribution of cholera cases (Jul 26 - present) Slide Slide 2 Figure 3a - 3k Cholera epidemic curves by county Table 2 Summary of response indicators by Hub Slide 3 Figure 4a Cholera cases by sex (27) Figure 4b Cholera cases by age (27) Figure 4c Cholera cases by patient outcome (27) Alert Slide 5 Slide 6 Slide 7 Table 7 Alert performance indicators by Hub (W5) Table 8 Summary of key alert indicators Table 9 Alert performance indicators by event (W5) Table Event risk assessment Map 2a - 2f Maps of key disease alerts by county (W5) Sources of data. Weekly IDSR Reporting Form 2. Weekly EWARS Reporting Form 3. Daily cholera line list 4. Event based surveillance form W5 27 (Dec -Dec 7)

3 Highlights W5 27 Completeness for IDSR reporting is 44% at county level and 67% for the IDP sites A total of 4 alerts were reported, of which % have been verified. alerts were risk assessed and required a response Measles declined in Panyijiar [2 cases in wk5; 4 cases in wk5]. Measles vaccination & sample collection - new arrivals and vaccinated sites Second round of OCV completed in Kapoeta South; Kapoeta East; Tonj East; and one payam in Tonj North (Marial Lou) A total of new cholera cases and deaths (CFR.% ) were reported. The cumulative total since the start of the current outbreak on 8 June 26 is 2,438 cases and 436 deaths (CFR 2.3% )*. * Note: The cholera data may be subject to adjustments as line list data continues to received and entered from the field.

4 Surveillance IDSR surveillance indicators Table IDSR surveillance performance indicators by county (W5 27) Hub Reporting Performance (W5 27) Performance (Cumulative 27) # counties # reports received Completeness Timeliness Completeness Timeliness Aweil 5 2% 2% 88% 83% Bentiu % 56% 75% 65% Bor 2 8% 8% 38% 34% Juba 6 3 5% 5% 65% 58% Kwajok % 43% 92% 79% Malakal 3 % % 29% 25% Rumbek % 88% 97% 87% Torit % 25% 93% 77% Wau % 67% 92% 84% Yambio % % % 95% South Sudan % 44% 72% 44% Completeness for IDSR reporting at county level was 44% in week 5 and cumulatively at 72% for 27 Timeliness for IDSR reporting at county level was 48% in week 5 and cumulatively at 44% for 27

5 Surveillance Trend in IDSR completeness Figure Trend in IDSR completeness over time % 8% 6% Percent 4% 2% % W52 26 W5 27 W9 27 W3 27 W8 27 W22 27 W26 27 W3 27 W35 27 W39 27 W44 27 W48 27 Completeness Completeness footnote (to be drafted) 2 W5 27 (Dec -Dec 7)

6 Surveillance Maps of IDSR completeness by county Map a Map of IDSR completeness by county (W5 27) Map b Map of IDSR completeness by county (27) Renk Manyo Renk Manyo Raja Melut Fashoda Maban Abyei Pariang Abiemnhom Malakal Panyikang Baliet Aweil North Aweil East Rubkona Longechuk Twic Mayom Guit Fangak Canal Pigi Aweil West Luakpiny Nasir Aweil Gogrial South Maiwut Gogrial WestEast Koch Nyirol Ulang Aweil Centre Tonj North Ayod Mayendit Leer Tonj East Akobo Jur River Rumbek North Panyijiar Duk Uror Wau Tonj South Cueibet Rumbek Centre Twic East Pochalla Rumbek East Yirol East Nagero Yirol West Bor Pibor Wulu Tambura Awerial Mvolo Terekeka Ezo Nzara Mundri East Lopa Lafon Kapoeta North Yambio Mundri West Ibba Maridi Kapoeta East Raja Melut Fashoda Maban Abyei Pariang Abiemnhom Malakal Panyikang Baliet Aweil North Aweil East Rubkona Longechuk Twic Mayom Guit Fangak Canal Pigi Aweil West Luakpiny Nasir Aweil Gogrial South Maiwut Gogrial WestEast Koch Nyirol Ulang Aweil Centre Tonj North Ayod Mayendit Leer Tonj East Akobo Jur River Rumbek North Panyijiar Duk Uror Wau Tonj South Cueibet Rumbek Centre Twic East Pochalla Rumbek East Yirol East Nagero Yirol West Bor Pibor Wulu Tambura Awerial Mvolo Terekeka Ezo Nzara Mundri East Lopa Lafon Kapoeta North Yambio Mundri West Ibba Maridi Kapoeta East Juba YeiLainya Kajo KejiMagwi Morobo Kapoeta South Torit Budi Ikotos Juba YeiLainya Kajo KejiMagwi Morobo Kapoeta South Torit Budi Ikotos Counties that submitted IDSR reports in W48 are shown in green in map a Counties that did not submit IDSR reports in W48 are shown in grey in map a Completeness Completeness % 2% 4% 6% 8% % % 2% 4% 6% 8% % 3 W5 27 (Dec -Dec 7)

7 Surveillance EWARS surveillance indicators Table 4 EWARS surveillance performance indicators by partner (W5 27) Partner Performance Reporting (W5 27) Reporting (Cumulative 27) # sites # reports received Completeness Timeliness Completeness Timeliness CMD 2 % % 42% 42% GOAL 2 % % 95% 88% HLSS % % 2% 78% IMA 4 % % 29% 2% IMC 8 8 % % 94% 94% IOM 7 7 % % 98% 98% IRC % % 86% 67% Medair 2 2 % % 99% 93% MSF-E 2 2 % % 77% 75% MSF-H % % 98% 94% SMC 3 3 % % 75% 73% UNIDO % % 2% 2% UNKEA 2 5% 5% 65% 57% World Relief % % 69% 63% Total % 67% 79% 74% Timeliness and completeness for EWARN/IDP reporting stands at 67% for week 5 while cumulatively, completeness and timeliness are 67% and 74% respectively for 27

8 Alert Alert performance indicators Table 7 Alert performance indicators by Hub Hub W5 Cumulative (27) Table 8 Summary of key alert indicators W5 Cumulative (27) # alerts % verif. # alerts % verif. Aweil % 2 42% Bentiu % 89 43% Bor % 36 4% Juba 2 % 82 6% Kwajok % 43 37% Malakal % 63 9% Rumbek % 8 42% Torit % 72 58% 4 75 Total alerts raised % 4% % verified % 23% % auto-discarded % 5% % risk assessed % 2% % requiring a response Wau % 7 3% Yambio % 65 34% South Sudan 4 % 75 4% A total of 4 alerts triggered in week 5; with % verified & % risk assessed with % requiring a response

9 Alert Event risk assessment Table 9 Alert performance indicators by event Event W5 Cumulative (27) Table Event risk assessment W5 Cumulative (27) # alerts % verif. # alerts % verif. Indicator-based surveillance Malaria % 75 43% AWD % 75 4% Bloody Diarr. % 39 42% Measles % 65 32% Low risk Medium risk 8 High risk 5 Very high risk Meningitis % % Cholera % 44 3% Yellow Fever % 8% Guinea Worm % 9 43% AFP % 32 66% VHF % 6 94% Neo. tetanus % 6 % Event-based surveillance EBS total % 3 93% During week 5; the infectious hazards with the highest number of alerts triggered are shown in table 9.

10 Alert by disease county in week 5, 27 Acute Watery Diarrhoea Bloody Diarrho ea Guinea Total County Worm Measles Cholera Malaria Alerts Ayod 2 Duk Juba 2 Yirol West Total Alerts 6 Number of Alerts Acute Watery Diarrhoea AFP Alerts by disease in week 5 and 5 of 27 Bloody Diarrhoea Guinea Worm wk5 Viral Haemorrh agic Fever 5 Measles wk5 Cholera Malaria During week 5, a total of 6 alerts were triggered The alert distribution by hazard and location is shown in the table and figure

11 Cumulative alerts by disease and county for Number of Alerts by disease, South Sudan, week -5, 27 n=86 alerts Acute Watery Diarrhoea AFP Bloody Diarrhoea Cholera EBS Guinea Worm Malaria Measles Neonatal Tetanus Viral Haemorrhagic Fever Yellow Fever The Figures show the cumulative alerts triggered in 27 by hazard and location Cholera registered the highest number (8) alerts in 27.

12 Cumulative alerts for the top 2 counties for 27 Number of alerts by county, week -5, 27 Mayom Budi Tonj South Uror Kapoeta North Tonj East Rumbek North Malakal Ulang Bor Kapoeta East Duk Torit Nyirol Panyijiar Awerial Yirol West Yirol East Rubkona Jur River Ayod Juba Wau Number of alerts 8 The Figures show the cumulative alerts triggered in 27 by location Most alerts have been reported from Wau, Juba, Ayod, Jur River, and Yirol East

13 Cumulative Count of uuid alerts by risk assessment stage in 27 Total Alerts County OUTCOME RISK_ASSESS RISK_CHAR VERIFICATION Acute Watery Diarrhoea AFP Bloody Diarrhoea Cholera EBS Guinea Worm Malaria Measles Neonatal Tetanus 6 6 Viral Haemorrhagic Fever 5 6 Yellow Fever Measles 6 6 Cholera Malaria 2 2 meningitis 2 2 Total Alerts The Figures show the cumulative alerts by risk assessment state in 27 A total of 697 alerts at verification stage; 5 risk assessed and characterized with an outcome.

14 Alert Maps of key disease alerts by county Map 2a Malaria (W5 27) Map 2b Bloody diarrhoea (W5 27) Map 2c Measles (W5 27) Duk Juba Number of alerts Number of alerts Map 2d Cholera (W5 27) Number of alerts Map 2e Guinea Worm (W5 27) Map 2f Event-based surveillance (W5 27) Yirol West Juba Number of alerts 7 W5 27 (Dec -Dec 7) Number of alerts Number of alerts

15 Summary of new and ongoing confirmed epidemics Aetiologic agent Location (county) New epidemics: no new epidemic Date first reported New cases since last bulletin Cumulative cases to date (attack rate %) Case management Interventions Vaccination Health promotion WASH Ongoing epidemics: Measles Panyijiar 2/7/ (.42) Yes Yes Yes N/A Cholera 27counties 8/6/26 2,438 (.49) Yes Yes Yes Yes Ongoing epidemics epidemics There are two ongoing epidemics No active transmission in any of the affected counties. Only sporadic transmission reported in Juba. Measles transmission has declined in Panyijiar. Mobile EPI team deployed to Nyal and Ganyiel where most of the new measles cases have originated in the recent weeks.

16 Response Confirmed epidemics Ongoing epidemics - Epidemic description - Measles in Panyijiar county Number of cases/deaths Measles Epidemic curve, Panyijiar county, weeks 26 to 5 27 Alive Died Epidemiological week seen at HF Age (years) Female (n) Male (n) Total cases Percentag e Cum. % <yr % 24.% -4yrs % 77.8% 5-4yrs % 9.6% 5+yrs %.% Total cases % Case proportion 35% 3% 25% 2% 5% % Measles case distribution by Payam, Panyijiar county, wk 26 - wk 5, % 6.2% 4.8% 2.4% Transmission has declined in Panyijiar New cases reported among IDPs arriving from Leer and Mayendit Cases also reported in areas that were not reached during the campaign in Panyijiar Mop up vaccination ongoing in these areas Sample testing underway to determine if new suspect cases are due to measles or rubella. 5% 3.8% 5.2% 3.8% 2.8% 2.%.%.3%.3%.3%.3%.7% %

17 For more help and support, please contact: Dr. Pinyi Nyimol Mawien Director General Preventive Health Services Ministry of Health Republic of South Sudan Telephone: Dr. Mathew Tut Moses Director Emergency Preparedness and Response (EPR) Ministry of Health Republic of South Sudan Telephone: Notes WHO and the Ministry of Health gratefully acknowledge health cluster and health pooled fund (HPF) partners who have reported the data used in this bulletin. We would also like to thank ECHO and USAID for providing financial support. The data has been collected with support from the EWARS project. This is an initiative to strengthen early warning, alert and response in emergencies. It includes an online, desktop and mobile application that can be rapidly configured and deployed in the field. It is designed with frontline users in mind, and built to work in difficult and remote operating environments. This bulletin has been automatically published from the EWARS application. More information can be found at Ministry of Health Republic of South Sudan