Liberia IDSR Epidemiology Bulletin

Transcription

1 Country Population: 4,373,279 Highlights Figure 1. Public Health Events Reported in Epi week 34 Volume 10, Issue 34 August 20-26, 2018 Data Source: CSOs from 15 Counties and Lab Keynotes and Events of Public Health Significance A total of 68 suspected cases of immediately reportable disease and events including 10 deaths were reported Completeness and timeliness of health facility reports were both 87% respectively Ongoing measles outbreak in Todee District, Montserrado County Reporting Coverage Table 1. Weekly IDSR Reporting Coverage, Liberia, Epi week 34, 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 Thirteen out of fifteen counties submitted weekly IDSR report on time to national level Nimba and Margibi submitted late report The national target for weekly IDSR reporting is 80% 673(87%) Health facilities reported IDSR data 88 (96%) Health districts reported IDSR data 673(87%) Health facilities out of 771 reported timely IDSR data IDSR Weekly Epidemiology and Surveillance Bulletin Page 1

2 Vaccine Preventable Diseases Measles Seven (7) suspected cases of measles were reported from Bong (2), Grand Kru (2), Grand Bassa (1), Montserrado (1) and Nimba (1) Counties Specimens were collected for six, Montserrado did not collect specimen Todee District has been in outbreak phase since epi week 32, Of the seven (7) suspected cases, 1 (14.3%) were reported to have been previously vaccinated and 6 (85.7%) had unknown status Age distribution among suspected cases are as follow: <1 year: 1 (14.3%) and 5 years: 6 (85.7%) Cumulatively, since Epi-week one, 3,645 suspected cases including 17 deaths have been reported. Of these suspected cases, 536 have been tested by the laboratory. Epiclassification are as follows: lab confirmed 260 (7.1%), epilinked 434 (11.9%), clinically confirmed 2,693 (73.8%), discarded 261 (7.2%) Of the 261 specimens tested negative for measles, 179 were tested for rubella; positive 61 (34.1%), negative 116 (64.8%), and equivocal 2 (1.1%) Public Health Action On August 2-11, 2018, Montserrado county lunched a mini measles campaign in Todee district Vaccinated 96 under 5 years in 22 surrounding communities; During the campaign these children were treated with Vitamin A along with measles vaccine Category of children vaccinated under 5years were 60 females. Age from 9 months Health education, community engagement and active case search ongoing in the community There has been no new case identify in Todee district this week (Epi week 34) IDSR Weekly Epidemiology and Surveillance Bulletin Page 2

3 Acute Flaccid Paralysis (Suspected Polio) Zero suspected case was reported Cumulatively, since Epi week one, 41 cases have been reported and 39 tested negative while 2 pending (all have been shipped) for laboratory confirmation Neonatal Tetanus Two (2) cases were reported from Grand Kru and Grand Bassa Counties including one death (Grand Bassa) Cumulatively, since Epi-week one,11 clinically diagnosed cases have been reported Viral Hemorrhagic Diseases Ebola Virus Disease (EVD) Zero alert reported Cumulatively, since Epi-week one, 15 EVD alerts have been reported and all tested negative by RT-PCR Lassa fever Two (2) suspected cases were reported from Nimba (1) and Grand Bassa (1) Counties pending testing Cumulatively, since Epi week one,159 suspected cases have been reported including 37 deaths. Of these, 131 have been tested by the laboratory. Epi-classification are as follows: lab confirmed 20, not a case 111, pending testing 17, while 11 specimens were not received at the laboratory CFR in confirmed cases is 65% (13/20) Yellow fever Three (3) suspected cases were reported from Grand Cape Mount, Nimba and Lofa Counties Specimens were collected; one tested negative and two pending testing at the lab Cumulatively, since Epi-week one, 86 suspected cases have been reported including 1 death. Of these, 76 were tested negative by the laboratory and classified as not a case while 8 specimens were not received at the laboratory Monkeypox Zero suspected case was reported Cumulatively, since Epi-week one, 4 suspected cases have been reported from Sinoe, Rivercess, Nimba and Maryland Counties Meningitis Zero suspected case was reported Cumulatively, since Epi-week one, 59 suspected cases have been reported of which twenty-six (26) have been tested; two positive by RT-PCR for Neisseria meningitides serotype w, twenty-four (24) negative Events of Public Health Importance Maternal Mortality One (1) maternal death was reported from Nimba County Reported cause of death was congestive heart failure The reported death occurred in health facility Cumulatively, since Epi-week one, 183 maternal deaths have been reported IDSR Weekly Epidemiology and Surveillance Bulletin Page 3

4 Table 2. Cumulative Maternal Deaths Reported by Counties, Liberia, Epi-week 1 34, 2018 County Annual Live birth 4.3% (EPI 2018) Current week Cumulative % of Cumulative Maternal deaths Annualized Maternal Mortality Ratio/100,000 Bong River Gee Bomi Grand Gedeh Gbarpolu Maryland Grand Kru Nimba Montserrado Grand Bassa Margibi Rivercess Sinoe Lofa Grand Cape Mount Liberia (National) Neonatal Mortality Eight (8) neonatal deaths were reported from Margibi (3), River Gee (2), Lofa (1), Grand Bassa (1) and Grand Kru (1) Counties, including two neonatal tetanus death (Grand Bassa and Grand Kru) Causes of deaths were: sepsis (4), asphyxia (2) and neonatal tetanus (2) All of the deaths were reported to have occurred in health facilities Cumulatively, since Epi-week one, 482 neonatal deaths have been reported Table 3. Cumulative Neonatal Deaths Reported by Counties, Liberia, Epi-week 1 34, 2018 County Annual Live birth 4.3% (EPI 2018) Current Week Cumulative Neonatal deaths % of Cumulative Neonatal deaths Annualized Neonatal Mortality Rate Grand Kru Montserrado River Gee Margibi Bong Rivercess Maryland Grand Gedeh Gbarpolu Lofa Sinoe Grand Bassa Nimba Bomi Grand Cape Mount Liberia (National) IDSR Weekly Epidemiology and Surveillance Bulletin Page 4

5 Exposure to Human Rabies (Animal Bites) Forty-one (41) animal bite cases were reported from Montserrado (18), Bong (6) Nimba (5), Margibi (5), Maryland (3), Lofa (2) River Gee (1) and Rivercess (10) counties Cumulatively, since Epi-week one, 950 cases of animal bites have been reported in human of which three cases have been confirmed in animal Acute Bloody Diarrhea (Suspected Shigellosis) Four (4) suspected cases were reported from Montserrado (1), Margibi (1), Grand Cape Mount (1) and Sinoe (1) Counties Two specimens were collected from Sinoe and Grand Cape Mount counties. One tested positive from Grand Cape Mount and one pending testing Cumulatively, since Epi-week one, 302 acute bloody diarrhea cases were reported with stool specimens collected from 202 cases Of the 202 specimens collected, 98 were tested; 21 positive for shigella dysenteriae and 77 negative Severe Acute Watery Diarrhea (Cholera) Zero suspected case was reported Cumulatively, since Epi-week one, 61 suspected cases of cholera have been reported of which 29 tested negative (no growth of Vibrio cholera isolated); specimens were not collected for 31 cases. Points of Entry Type of Ports Point of Entry Weekly total Arrival Departure Yellow Book Issued Travelers Vaccinated IDSR Alerts Alerts Verified Airport Seaport Ground Crossing James Spriggs Paynes Robert International Airport Freeport of Monrovia Buchanan Port Bo Water Side Ganta Yekepa Loguatuo Total Traveler for the Week Note: Yellow book issue for both arrival and departure; Vaccination coverag for both arrival and departure IDSR Weekly Epidemiology and Surveillance Bulletin Page 5

6 AFRO Public Health Event The National Public Health Institute of Liberia continues to monitor acute public health emergencies and outbreaks occurring in the African Region in order to ensure to preparedness and preventive measures are During this week, 58 events are being monitored through WHO Health Emergencies Program in the African Region. Key events highlighted during the week include the following: Ebola Virus Disease in the Democratic Republic of Congo Typhoid Fever in Zimbabwe Cholera in Nigeria Cholera in Tanzania Humanitarian crisis in Ethiopia Public Health Measures National level: Supplied 100 ampules of rabies vaccine to Lofa County as prophylaxis Preliminary investigation of maternal death was conducted All neonatal deaths have been investigated with recommendation sent to MoH for implementation County level: Case management for all reported cases ongoing Community engagement including health education ongoing IDSR Weekly Epidemiology and Surveillance Bulletin Page 6

7 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 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 7

8 No. of Health Districts No. of Health District reported Acute Flaccid Paralysis (Polio) Acute Bloody Diarrhoea (Shigellosis) Severe Acute Watery Diarrhoea (Cholera) Human Exposure to Animal bites (Suspected Rabies) Lassa fever Measles Meningitis Maternal Mortality Neonatal Mortality Neonatal Tetanus VHF (including EVD) Yellow Fever Other Diseases/ Events LIBERIA 2018 Epi Week 34 (Aug 20-26, 2018) Immediately reportable diseases, conditions, and events by County during Epi week 34 and cumulative reports, Liberia, 2018 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 Cumulative Reported Cumulative Laboratory Confirmed D = Dead A = Alive Editorial Team - NPHIL: Roseline N. George; Advertus N. Mianah Surveillance Coordinator/DIDE; Irene Pewu Epidemiologist/DIDE; Sumo Nuwolo, Godwina B. Williams, Lasee W. Colee, T. Lafayette Hall, Sumor Lomax Flomo & Samuel Zayzay Disease Investigators/DIDE; Trokon O. Yeabah Data Manager/DIDE; Partners: WHO Kwuakuan D.M. Yealue, Dr. Julius Monday & CDC Kwuakuan D.M. Yealue, Jeremy Sesay IDSR Weekly Epidemiology and Surveillance Bulletin Page 8

9 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 9