Liberia IDSR Epidemiology Bulletin

Transcription

1 Country Population: 4,373,279 l Volume 10, Issue 13 Mar. 26- Apr.1, 2018 Data Source: CSOs from 15 Counties and Lab Highlights Figure1. Public Health Events Reported in Epi-week 13 Keynotes and Events of Public Health Significance A total of 182 suspected cases of immediately reportable diseases and events including 15 deaths was reported Two confirmed cases of Lassa Fever were reported from Grand Bassa and Montserrado Four confirmed cases of measles were reported from Margibi and Bomi One confirmed case of Shigellosis was reported from River Gee Completeness and timeliness of health facility reports were 96% and 87% Reporting Coverage Table 1. Weekly IDSR Reporting Coverage, Liberia, Epi week 13, 2018 County Number of Expected Report from Health Facility Number of Reports Received Number Received on Time Completeness (%) Timeliness (%) Bomi Bong Gbarpolu Grand Bassa Grand Cape Mount Grand Gedeh Grand Kru Lofa Margibi Maryland Montserrado Nimba Rivercess River Gee Sinoe Liberia Legend 80 <80 Fourteen of the fifteen counties submitted weekly IDSR report on time The national target for weekly IDSR reporting is 80% 736(96%) Health facilities reported IDSR data 92 (100%) Health districts reported IDSR data 662(87%) Health facilities out of 764 reported timely IDSR data IDSR Weekly Epidemiology and Surveillance Bulletin Page 1

2 Vaccine Preventable Diseases Measles One Hundred-one suspected cases of measles were reported from the following Counties; Montserrado (44), Margibi (18), Nimba (14), River Gee (7), Bong (4), Grand Bassa (3), Maryland (2), Bomi (2), Rivercess (2), Sinoe (2), Grand Gedeh (2), Lofa (1) Samples were collected for 40 of the suspected cases of which (6) were tested, classification of cases includes; o Positive (4), Negative (2) and pending (4) o Confirmed cases were reported from two counties: Margibi (2) and Bomi (2) Vaccination status among the suspected cases are as follow: vaccinated 35 (35.3%), Not vaccinated 21 (21%), and Unknown 43 (43%) Age distribution among suspected cases are as follow: <1-year-old: 5 (5%), 1 4 years: 36 (36%), 5 years: 58 (58%) Cumulatively, since Epi-week one, 1,839 suspected cases have been reported. Epi-classification among these cases are as follow: lab confirmed 177 (10%), Epi-linked: 1,215 (66%), clinically compatible: 19 (1%), Discarded: 128 (7%), and pending: 300 (16.3%) Of the 128 samples tested negative for Measles, 113 have been tested for Rubella; positive 58 (51%), and negative 44 (39%) while 11 (10%) are pending testing Public Health Actions Case management initiated for all the suspected cases and community engagement ongoing Active case search is ongoing Phases 1 & 2 of the measles campaign targeted: 2,080,474 (95%) age 6-59 months vaccinated: 2,982,326 (97%) Acute Flaccid Paralysis (Suspected Polio) Five cases of Acute Flaccid Paralysis were reported from the following Counties; Bong (2), Montserrado (1), Lofa (1) and Bomi (1) Cumulatively, since Epi week one, 9 cases has been reported and are pending laboratory confirmation. IDSR Weekly Epidemiology and Surveillance Bulletin Page 2

3 Neonatal Tetanus Zero cases of Neonatal tetanus were reported Cumulatively, since Epi-week one, 4 clinically diagnosed cases has been reported Viral Hemorrhagic Diseases Ebola Virus Disease (EVD) Zero cases of EVD alerts were reported Cumulatively, since Epi-week one, 20 EVD alerts have been reported and all tested negative by RT-PCR Lassa fever Five suspected cases of Lassa fever were reported from the following Counties; Montserrado (3), Nimba (1 dead) and Bong (1) Samples were collected from all the suspected cases and tested: positive (2) and negative (4) Cumulatively, since Epi week one, 52 suspected cases have been reported Samples were tested for 50 suspected cases out of which, 8 tested positive and 42 negative by RT-PCR. The CFR in confirmed cases is 88% Yellow fever One suspected case of Yellow fever was reported from Grand Cape Mount County Sample was collected for the case, and has been tested negative Cumulatively, since Epi-week one, 27 suspected cases have been reported Meningitis Zero suspected cases of meningitis were reported Cumulatively, since Epi-week one, 22 suspected cases have been reported. Eight have been tested of which two were positive by RT-PCR for Neisseria meningitides serotype w and six negatives The two positive cases are part of an outbreak of meningococcal disease in Lofa County Events of Public Health Importance Maternal Mortality Three maternal deaths were reported from two counties; Bong (2) and Montserrado (1) Reported causes of death were post-partum hemorrhage (2) and unknown cause All the deaths were reported to have occurred in the health facility Cumulatively, since Epi-week one, 74 maternal deaths have been reported (see Table 3 for causes of death) IDSR Weekly Epidemiology and Surveillance Bulletin Page 3

4 Table 2. Cumulative Maternal Deaths Reported by Counties, Liberia, Epi-week 1-13, 2018 County Current week Cumulative % of Cumulative Maternal deaths Grand Bassa Maryland Bomi Grand Kru Sinoe River Gee Montserrado Bong Margibi Nimba Lofa Rivercess Gbarpolu Grand Cape Mount Grand Gedeh Liberia Table 3. Causes of reported maternal deaths, Liberia, Epi-week 1 13, 2018 Causes Number Percent (%) Congestive heart failure Septicemia Raptured ectopic Post-partum hemorrhage Renal failure Anemia Obstructed labor Septic abortion Transfusion reaction Retained placenta Abrutio placenta Epileptic Eclampsia Induced Abortion Pre-Eclampsia Criminal Abortion Cardio-pulmonary arrest Pulmonary embolism Total IDSR Weekly Epidemiology and Surveillance Bulletin Page 4

5 Neonatal Mortality Eight neonatal deaths were reported from five counties; Bong (2), Montserrado (1), Grand Bassa (1), Grand Kru (1), Gbarpolu (1), Sinoe (1) and Margibi (1) Causes of deaths were sepsis (4), birth asphyxia (2), prematurity (1), and jaundice (1) All of the deaths were reported to have occurred at the health facility Cumulatively, since Epi-week one, 163 neonatal deaths have been reported Table 4. Cumulative Neonatal Deaths Reported by Counties, Liberia, Epi-week 1-13, 2018 County Current Week Cumulative Neonatal deaths % of Cumulative Neonatal deaths River Gee Maryland Sinoe Grand Kru Montserrado Bong Rivercess Grand Gedeh Gbarpolu Grand Bassa Lofa Nimba Margibi Grand Cape Mount Bomi Total Human Exposure to Animal Bite (Suspected Human Rabies) Fourty-seven cases of animal bite were reported from the following Counties; Montserrado (19), Grand Gedeh (5), Nimba (5) Lofa (4), Sinoe (4), Bong (3), Rivercess (2), Gbarpolu (1), Bomi (1), River Gee (1), Margibi (1), Grand Bassa (1) Cumulatively, since Epi-week one, 307 cases of animal bite have been reported of which zero cases were suspected for human rabies. Acute Bloody Diarrhea (Shigellosis) Twelve suspected cases of acute bloody diarrhea were reported from the following Counties; Rivercess (3), RiverGee (3), Margibi (2), Montserrado (2), Nimba (1) and Sinoe (1) Samples were collected for eight of the suspected cases reported of which, (1) tested positive from Gedepo District, River Gee County Cumulatively, since Epi-week one, 149 suspected cases of acute bloody diarrhea have been reported with stool samples collected from 130 suspected cases IDSR Weekly Epidemiology and Surveillance Bulletin Page 5

6 Of the 130 suspected cases, samples were tested for 55 suspected cases of which thirteen cases were positive (shigella dysenteriae isolated), 41 negative (no growth of shigella dysenteriae) while one pending laboratory confirmation Sixty-six cases were reported as part of an outbreak in Firestone District, Margibi County Severe Acute Watery Diarrhea (Cholera) Zero suspected cases of cholera were reported Cumulatively, since Epi-week one, 35 suspected cases of cholera have been reported of which twenty tested negative (no growth of vibrio cholera) Public Health Measures National level: Joint supportive supervision (EPI, DIDE and lab) in five Lassa fever and measles endemic counties is ongoing County level: Case management initiated for all suspected cases and community engagement ongoing on IDSR Weekly Epidemiology and Surveillance Bulletin Page 6

7 Points of Entry-updates Type of Ports POE Cumulative Arrival Departure Nationality Travelers Vaccinated Liberian Alien Arrival Departure Arrival Departure Liberian Alien IDSR Alerts Alerts Verified Airport James Spriggs Paynes Seaport Ground Crossing Roberts Internation Airport Freeport of Monrovia Buchanan Port Bo Water Side Ganta Yekepa Loguatuo Total Traveler for the Week IDSR Weekly Epidemiology and Surveillance Bulletin Page 7

8 AFRO Public Health Events The National Public Health Institute of Liberia continues to monitor acute public health emergencies and outbreaks occurring in the African Region in order ensure to preparedness and preventive measures are implemented. During this week, 57 events are being monitored through WHO Health Emergencies Program in the African Region. Key events highlighted during the week include the following: Cholera in Angola Cholera in Mozambique Cholera in Tanzania Monkeypox in Central African Republic Humanitarian crisis in Nigeria Source: WHO Notes Completeness refers to the proportion of expected weekly IDSR reports received (target: 80%) Timeliness refers to the proportion of expected weekly IDSR reports received by the next level on time (target: 80%). Time requirement for weekly IDSR reports: o o o Health facility - required on or before 5:00pm every Saturday to the district level Health district - required on or before 5:00pm every Sunday to the county level County - required on or before 5:00pm every Monday to the national level Non-polio AFP rate is the proportion of non-polio AFP cases per 100,000 among the estimated population under 15 years of age in 2017 (annual target: 2/100,000) Non-measles febrile rash illness rate refers to the proportion of discarded measles cases per 100,000 population Annualized maternal mortality rate refers to the maternal mortality rate of a given period less than one year and it is the number of maternal deaths per 100,000 live births Annualized neonatal mortality rate refers to the neonatal mortality ratio of a given period less than one year and it is the number of maternal deaths per 1,000 live births IDSR Weekly Epidemiology and Surveillance Bulletin Page 8

9 Epi-linked refers to any suspected case that has not had a specimen taken for serologic confirmation but is linked to a laboratory confirmed case Confirmed case refers to a case whose specimen has tested positive or reactive upon laboratory testing, or has been classified as confirmed by either epidemiologic linkage with a confirmed case, or clinical compatibility with the disease or condition Case Fatality Rate (CFR) is the proportion of deaths among confirmed cases IDSR Weekly Epidemiology and Surveillance Bulletin Page 9

10 Immediately reportable diseases, conditions, and events by County during Epi week 12 and cumulative reports, Liberia, 2018 No. of Health Districts No. of Health District reported Acute Flaccid Paralysis (Polio) Diarrhoea (Shigellosis) Severe Acute Watery Diarrhoea (Cholera) Human Exposure to Animal bites (Suspected Rabies) Lassa Fever Counties A D A D A D A D A D A D A D D D A D A D A D A D Bomi Bong Gbarpolu Grand Bassa Grand Cape Mount Grand Gedeh Grand Kru Lofa Margibi Maryland Montserrado Nimba Rivercess River Gee Sinoe Total Weekly Measles Meningitis Maternal Mortality Neonatal Mortality Neonatal Tetanus VHF (including EVD) Yellow Fever Other Diseases/Events Cumulative Reported Cumulative Laboratory Confirmed D = Dead Note: A = Alive Editorial Team - NPHIL: Roseline N. George ; Advertus N. Mianah Surveillance Coordinator/DIDE; Himiede W. Wilson & Irene Pewu Epidemiologist/DIDE; Sumo Nuwolo, Musand Kromah, Lasee W. Colee, T. Lafayette Hall, Alberta B. Corvah, Sumor Lomax Flomo & Samuel Zayzay Disease Investigators/DIDE; Trokon O. Yeabah Data Manager/DIDE; Partners: CDC & WHO Kwuakuan D.M. Yealue, Jeremy Sesay IDSR Weekly Epidemiology and Surveillance Bulletin 10 Page

11 National Public Health Institute of Liberia (NPHIL) PURPOSE In collaboration with the Ministry of Health, NPHIL strengthens existing infection prevention and control efforts, laboratories, surveillance, infectious disease control, public health capacity building, response to outbreaks, and monitoring of diseases with epidemic potential. OUR MISSION To prevent and control public health threats by promoting healthy outcomes and serving as a source of knowledge and expertise. GOALS Contribute to the development and sustainability of the public health workforce Develop, enhance, and expand the surveillance and response platform Develop and strengthen the laboratory system and public health diagnostics Develop, enhance, and expand process and structures to protect environmental and occupation health Expand, conduct, and coordinate public health and medical research to inform Liberian public health policies Ensure sustainable financing and operations of the NPHIL Epidemiological bulletin published with support of WHO and CDC For comments or questions, please contact Thomas K. Nagbe, PA Dip., BSc, MPH Director, Infectious Disease and Epidemiology Division National IHR Focal Person National Public Health Institute of Liberia Republic of Liberia tnknue31112@gmail.com Phone: / Website: Ralph W. Jetoh, MD Deputy director Infectious Disease and Epidemiology Division National Public Health Insttute of Liberia Republic of Liberia ralphica2000@gmail.com Phone: / Website: IDSR Weekly Epidemiology and Surveillance Bulletin Page 11