جمهىری اسالمی افغانستان وزارت صحت عامه ریاست عمىمی ارزیابی و معلىمات صحی

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1 Islamic Republic f Afghanistan Ministry f Public Health Evaluatin & Health Infrmatin Summary: DISEASE EARLY WARNING SYSTEM -Plus (DEWS-Plus) Weekly Epidemilgical Reprt 48 Out f 493 functinal DEWS plus sentinel sites, 487 (98.7%) have submitted reprts this week. Out f a ttal f 434,331 new cnsultatins (182,005 male, 252,326 female) this week, 36.4% r 158,204 (75,580 male, 82,624 female) cnsultatins were reprted due t DEWS targeted diseases. Main causes f cnsultatins in this week were Diarrheal Diseases, 31,675 cases (7.3% ut f ttal new cnsultatins) and Pneumnia, 18,896 cases (4.4% ut f ttal new cnsultatins). A ttal f 181 deaths were reprted this week, f which 35 were due t DEWS targeted diseases, which includes 25 Pneumnia deaths, 6 Meningitis/SIC deaths and 3 Diarrheal Diseases deaths and 1 viral hepatitis death. There was nly ne suspected Measles utbreak reprted frm Paktya prvince. Figure1: Surveillance/DEWS-Plus Sentinel Sites with GPS lcatin by type f Health Facility د افغانستان اسالمی جمهىریت د عامه روغتیا وزارت د ارزونی او روغتیائی معلىماتى لىی ریاست جمهىری اسالمی افغانستان وزارت صحت عامه ریاست عمىمی ارزیابی و معلىمات صحی 29 Nv- 5 Dec 2015 Table 1: Cverage f DEWS-Plus Surveillance System Type f Health Facility Ttal Health Facilities (HF) HF cvered by DEWS-Plus RH/PH DH CHC/BHC Plyclinic Private Hspital Special Hspital Ttal , ,

2 Disease Number f cases Disease % ut f ttal cnsultatins Indicatr based Surveillance: The Indicatr-based surveillance cmpnent f DEWS-plus reprts n weekly bases n 15 pririty infectius diseases frm sentinel sites. The data is cmpared with previus weeks and crrespnding week f previus years and the alert and epidemic threshld is checked t see if disease incidence has crssed these levels and necessary actin is initiated. Figure 2: DEWS targeted diseases Pneum nia Percentage f Diseases ut f ttal cnsultatin during week 48 with Dehydra tin Bldy Diarrhea Meningit is Viral Hepatitis Measles < 5 years 5 years Nenatal Tetanus Malaria Typhid Fever < 5 years years Number f cases f diseases during week < 5 years 5 years Pneum nia with Dehydra tin Bldy Diarrhea Meningit is Viral Hepatitis Measles Nenata l Tetanus Malaria Typhid Fever < 5 years years

3 Percentage Precentage Percentage Percentage Vaccine Preventable Diseases (VPDs): Table 2: Cases and deaths due t VPDs by age grup during week 48, 2015 Diseases Cases Deaths <5 years 5 years Ttal <5 years 5 years Ttal CFR/100 Measles Pertussis Diphtheria Tetanus Seasnal Diseases: Trend f Pneumnia percentage ut f ttal cnsultatin in recent weeks-2015 Current situatin Trend f with severe dehydratin percentage ut f ttal cnsultatin in recent weeks Current situatin Average f 3 years data ( ) Average f 3 years data ( ) Trend f Measles percentage ut f ttal cnsultatin in recent weeks Current situatin Average f 3 years data ( ) Trend f Malaria percentage ut f ttal cnsultatin in recent weeks Current situatin Average f 3 years data ( ) 3

4 Event-Based Surveillance: During week 48 a ttal f 1 utbreak detected, investigated and respnded t by DEWS-plus. The details are as belw: 1. Measles Outbreaks 1. Suspected Measles utbreak was reprted n 5 th December 2015 frm Pir Bagh village f Gardiz district, Paktya prvince with 12 suspected cases (6 cases in age grup under five and 6 cases in age grup ver five). The investigatin team visited the area (n specimens cllected yet). The vaccinatin cverage f the area was 80% and 70 under-five children were vaccinated in the affected area. Vitamin A supplements were distributed and health educatin sessins cnducted in the affected area. The active surveillance has been established fr detectin and investigatin f further cases. Figure 3: Outbreaks investigated during the week 46,

5 Table 2: Updates n the utbreaks reprted during 2015 (01 Jan t 5 December) Disease/event N. f utbreaks N. f lab cnfd. Outbreaks N. f cases N. f deaths Measles CCHF Pertussis Suspected Rabies/dg bites Mass psychgenic illness Mumps Scabies Viral Hepatitis Fd pisning Chickenpx Pneumnia Cnjunctivitis Watery Diarrhea Malaria Chlera Anthrax Leishmaniasis Ttal Labratry surveillance: In this week a ttal f 39 different specimens/samples were received by CPHL, ut f which 5 specimens were psitive fr Measles, 4 were negative fr Measles and 1 specimen was psitive fr Rubella while the rest are under the prcess. (Fllw-up by CPHL). Recmmendatins: High number f cases (abve alert threshld) and deaths due t Pneumnia in the age grup less than 5 years (8.9 % Pneumnia cases amng ttal cnsultatins and 25 deaths) is a cause f cncern. This shuld be analyzed and discussed at prvincial level amng stakehlders t find ut the reasns fr high mrbidity and mrtality and take apprpriate actins. The increase in the malaria cases (as cmpared t the average f last three years) and its utbreaks shuld be given cnsideratin at the central and field levels. 5

6 The increase in the cases and deaths due t CCHF shuld be taken by the cncerned departments at varius levels. Early reprting and hspitalizatin f CCHF cases, IEC and strng crdinatin with animal health department and actins t be taken by them t cntrl the ticks n the animals.( CDC department f MPH shuld implement the cntrl measures in human) 6