A cumulative of 7,727 cases has been notified to date, since the onset of the epidemic on 25 October 2007.

Transcription

1 KITGUM DISTRICT SURVEILLANCE REPORT ON HEPATITIS E UPDATE OF HEPATITIS E EPIDEMIC IN KITGUM DISTRICT, 1 st SEPTEMBER 28. Table 1: Disaggregating of cases by Sub county Sub county New cases Cumulative cases New death Cumulative deaths CFR (%) Madi Opei 7 1, Agoro 33 1, Paloga 15 1, Padibe E/W 42 1, Mucwini 31 1, Kitgum Matidi 5 6 Orom 92 4 Layamo Akwang 2 7 Kitgum T/C Lokung Palabek Gem 7 1 Sudan 17 2 Namukora Lagoro 3 Omiya Anyima 6 Amida 3 Acholi bur 2 Total 175 7, % Highlights A total of 175 new cases of Hep. E was registered in Epi week 35, which is a 21 % reduction in the number of cases during the week as compared to the previous week. A cumulative of 7,727 cases has been notified to date, since the onset of the epidemic on 25 October 27. 1

2 There were 4 new deaths reported in week 35; 2 of which were pregnant women. This gives a cumulative of 121 deaths, with a CFR of 1.6%. Three (3) of the deaths occurred at hospital levels (2 in Kitgum Hospital & 1 in St. Joseph Hospital). Seventeen 17/19 (9%) of the sub counties have been affected in the district. Overall, the trend of Hepatitis E epidemic continues to decline in the last 8 weeks. However, the intensity of the disease in Kitgum Town Council continues to rise gradually. It should be remembered that interventions in the rural urban setting of Kitgum Town Council is the most complicated, as was evidenced in the past cholera outbreak in 27. A meeting is planned for Thursday 4 September 8 to map out strategies of rolling out interventions to Kitgum Town. It should also be noted that many Agencies have most often shunted interventions in Kitgum Town, for reasons that their programmes/ projects are targeting IDPs. Emerging issues The District Task Force has requested all Agencies to provide information on all funds secured for Hepatitis E response (either donations or internal funding); with attached planned activities against the funds. The Task Force will subsequently re align the Agencies planned activities against the District Response Plan. Eventually, supervision and monitoring will be conducted by the District Technical Team to ensure that implementation of intervention activities are in line with agreed strategies and standards. This is intended to improve on the efficiency, effectiveness and comprehensive coverage of intervention measures. DESCRIPTIVE HEPATITIS E EPIDEMIOLOGY IN KITGUM DISTRICT 28 In fig 1 below which is the district hepatitis E Epi curve based on first day of attending to health facility from October 27 to 31 th Aug 28, in the last 8 Epi weeks we continue to register a decline. 2

3 Epi curve of Hepatitis E Cases in Kitgum District 25 Oct 27-31th Aug Number of Cases Figure 1 26-Oct 25-Oct 29-Oct 28-Oct 27-Oct 1-Nov 3-Oct 31-Oct 6-Nov 8-Nov 7-Nov 4-Nov 2-Nov 3-Nov 5-Nov 9-Nov 1-Nov 12-Nov 13-Nov 11-Nov 14-Nov 15-Nov 16-Nov 19-Nov 18-Nov 17-Nov 2-Nov 21-Nov 24-Nov 22-Nov 23-Nov 25-Nov 26-Nov 29-Nov 28-Nov 27-Nov 3-Nov 2-Dec 3-Dec 1-Dec 4-Dec 5-Dec 16-Dec 18-Dec 17-Dec 6-Dec 9-Dec 8-Dec 7-Dec 1-Dec 12-Dec 13-Dec 11-Dec 14-Dec 15-Dec 2-Dec 19-Dec 21-Dec 26-Dec 28-Dec 27-Dec 24-Dec 22-Dec 23-Dec 25-Dec 6-Jan 8-Jan 7-Jan 3-Dec 29-Dec 2-Jan 31-Dec 3-Jan 1-Jan 4-Jan 5-Jan 9-Jan 1-Jan 12-Jan 13-Jan 11-Jan 14-Jan 15-Jan 16-Jan 19-Jan 18-Jan 17-Jan 2-Jan 21-Jan 26-Jan 28-Jan 27-Jan 24-Jan 22-Jan 23-Jan 25-Jan 3-Jan 29-Jan 2-Feb 1-Feb 31-Jan 6-Feb 9-Feb 8-Feb 7-Feb 1-Feb 12-Feb 13-Feb 11-Feb 14-Feb 15-Feb 4-Feb 3-Feb 5-Feb 16-Feb 18-Feb 17-Feb 2-Feb 19-Feb 21-Feb 24-Feb 22-Feb 23-Feb 26-Feb 25-Feb 29-Feb 28-Feb 27-Feb 2-Mar 3-Mar 1-Mar 4-Mar 5-Mar 6-Mar 9-Mar 8-Mar 7-Mar 1-Mar 11-Mar 16-Mar 19-Mar 18-Mar 17-Mar 2-Mar 21-Mar 14-Mar 12-Mar 13-Mar 15-Mar 24-Mar 22-Mar 23-Mar 25-Mar 6-Apr 8-Apr 7-Apr 26-Mar 29-Mar 28-Mar 27-Mar 3-Mar 31-Mar 2-Apr 3-Apr 1-Apr 4-Apr 5-Apr 1-Apr 11-Apr 9-Apr 16-Apr 19-Apr 18-Apr 17-Apr 2-Apr 21-Apr 14-Apr 12-Apr 13-Apr 15-Apr 26-Apr 28-Apr 27-Apr 24-Apr 22-Apr 23-Apr 25-Apr wk 16 Weeks 6-May 8-May 7-May 3-Apr 29-Apr 2-May 3-May 1-May 4-May 5-May Graph of number of cases of HEV versus age group in kitgum wk May 15-May 1-May 11-May 9-May 12-May 13-May wk May 18-May 17-May 2-May 19-May 21-May 26-May 28-May 27-May 24-May 22-May 23-May 25-May 3-May 29-May 31-May 2-Jun 3-Jun 1-Jun 4-Jun 5-Jun 6-Jun 9-Jun 8-Jun 7-Jun 1-Jun 11-Jun 16-Jun 19-Jun 18-Jun 17-Jun 2-Jun 21-Jun 14-Jun 12-Jun 13-Jun 15-Jun 26-Jun 28-Jun 27-Jun 24-Jun 22-Jun 23-Jun 25-Jun 6-Jul 8-Jul 7-Jul 3-Jun 29-Jun 2-Jul 3-Jul 1-Jul 4-Jul 5-Jul WK WK WK WK WK WKwk W Jul 11-Jul 9-Jul 16-Jul 19-Jul 18-Jul 17-Jul 2-Jul 21-Jul 14-Jul 12-Jul 13-Jul 15-Jul W Jul 28-Jul 27-Jul 24-Jul 22-Jul 23-Jul 25-Jul 3-Jul 29-Jul 1-Aug 31-Jul 6-Aug 9-Aug 8-Aug 7-Aug 1-Aug 11-Aug 4-Aug 2-Aug 3-Aug 5-Aug W W W Aug 18-Aug 17-Aug 14-Aug 12-Aug 13-Aug 15-Aug 2-Aug 19-Aug 22-Aug 21-Aug 24-Aug 23-Aug 26-Aug 25-Aug 29-Aug 28-Aug 27-Aug W W33W34W yrs 5-9 yrs 1-14 yrs yrs 2-24 yrs yrs 3-34 yrs yrs 4-44 yrs yrs 5-54 yrs 55-59yrs 6-64 yrs yrs 7-74 yrs yrs 8-84 yrs 85 above age not classified age groups 381 S1 number of cases Fig 2 The most affected age group according to fig 2 is between 1 45 years with peak at 2 24 years. 3

4 Weekly Incidence of HEV Outbreak in Kitgum District, October 27-31th August , , Number of Cases Figure Weeks 5, 4, 3, 2, 1, - Weekly Attack Rate/ 1, Pop Fig 3 shows district hepatitis E weekly incidence, the graph shows that in the last 8 Epi weeks there is continued decline in cases of HEV. A new peak is starting to be formed and this has been attributed to cases coming up in Paloga and Potika sub counties. 4

5 Hepatitis E distribution by sub county in kitgum district 28 Akwang, 7, % lokung, 226, 3% Orom, 92, 1% Sudan, 17, % Namukora, 11, % Layamo, 181, 2% tgum Matidi, 6, 1% kitgum T/c, 47, 1% Palabek Gem, 7, % Madi Opei, 11, 14% wini, 197, 14% Padibe, 1599, 21% Paloga, 1323, 17% Agoro, 1944, 26% Figure 4 Figure 4 shows the hepatitis E burden per Sub County, the most affected sub counties are now Agoro (26%) followed by Padibe (21%) and Madi Opei(14%), Paloga (17%) and Mucwini (14%) respectively. SUB COUNTY TRENDS OF HEPATITIS E IN KITGUM DISTRICT 1. Madi Opei: The weekly incidence curve of Madi opei as seen in Fig 5 shows a decreasing trend of hepatitis E cases in the sub county. Weekly HEV incidence curve of Madi Opei Sub county cases W47 W48 W49 W5 W51 W52 W1 W2 W3 W4 W5 W6 W7 W8 W9 W1 W11 W12 W13 W14 W15 W16 W17 Epi week W18 W19 W2 W21 W22 W23 W24 W25 W26 W27 W28 W29 W3 W31 W32 W33 W34 W35 Figure 5 2. Agoro Sub County 5

6 Number of Cases Weekly incidence curve for Hepatitis E in Agoro Subcounty W1 W2W3 W4 W5W6 W7 W8W9 W1 W11 W12 W13 W14 W15 W16 W17 W18 Epi week W19 W2 W21 W22 W23 W24 W25 W26 W27 w28 W 29 W 3 W31 W32 W33 W34 W35 Figure 6 This Sub County is slowly having a decline in the cases of hepatitis E for the past 8 weeks as shown in fig 6, most cases are from Potika parish which has paused a big challenge to the task force as some areas like pawach have no clean water sources because of the rock underneath. 3. Paloga sub county As reflected in fig 7 the cases per week have continued to decrease following the intensive interventions put in place. However there has been erratic supply of chlorine tablets for now a month which complicates the likely future of hepatitis E trend in the sub county. Paloga weekly Hepatitis E incidence curve cases W1 W11 W12 W13 W14 W15 W16 W17 W18 W19 W2 W21 W22 W23 W24 W25 W26 W27 W28 W 29 W 3 W 31 W32 W33 W34 W35 Epi weeks Figure 7 4. Padibe Sub Counties(Padibe East and West) 6

7 3 Padibe weekly hepatitis E incidence curve 25 2 number of cases W13 W14 W15 W16 W17 W18 W19 W2 W21 W22 W23 W24 W25 W26 W27 W28 W29 W3 W31 W32 W33 W34 W35 Epi week Fig 8 There is general decline in the trend of HEV in Padibe Sub County as reflected in figure 8 Padibe East Registered 21 and Padibe West Registered 21 Cases of HEV making a total of 42 in Epi week Mucwini: Mucwini graph continues to show the decline in the trend of HEV Mucwini weekly hepatitis E incidence curve W8 W9 W1W11W12W13W14W15W16W17W18W19W2W21W22W23W24W25W26W27W28 W 29 epi week W 3 W W32W33W34W35 31 Fig 8 DSF/HMIS KDLG & WHO KITGUM FIELD OFFICE