Somalia Emergency Weekly Health Update

Transcription

1 Somalia Emergency Weekly Health Update The Somalia emergency weekly health update aims to provide an overview of the health activities conducted by WHO and health partners in Somalia. It compiles health information including nine health events (epidemiological surveillance) reported in Somalia, information on ongoing conflicts in some regions of Somalia and health responses from partners. For further information please contact: Pieter Desloovere WHO Communications Officer - deslooverep@nbo.emro.who.int - T: BULLETIN HIGHLIGHTS Reporting dates 15-1 September (reflecting Epidemiological week 37) Since 5 September, over 1 suspected cholera cases and 1 deaths have been reported from Hoosingow (most affected), Dhobley, Waraq and Afmadow. Ten stool samples were collected from Hoosingow in Badade district and four from Dhobley in Afmadow district, and are being tested in the lab. Preliminary results are expected on Saturday September. IN FOCUS STORY: HIJRA Dangerous pregnancy complications in Badbaado IDP camp, Mogadishu For the past 1 months, Nadifo Mohamoud, a young mother, has been living in Badbaado IDP camp, Mogadishu. She has a small kiosk in front of her makeshift shelter and she vends clay-made ovens. Last Sunday, Nadifo s mother ran to the Badbaado health clinic, supported by health partner HIJRA. Nadifo fainted while she was trying to cook food on an open fire near her makeshift shelter. Nadifo is 9 months pregnant and is expecting her baby any time. This is not her first pregnancy; she has already given birth to three children. Unfortunately, two of her children passed away before they reached the age of five. The medical staff of HIJRA quickly dispatched an ambulance to the IDP camp, which wasn t an easy task at all. The medics were forced to leave the ambulance and take a stretcher on foot to find the unconscious mother in the camp. A few minutes later, Nadifo was brought to the clinic where she got the necessary treatment. She is suffering from hypoglycemia or low blood sugar says Abba Yusuf Awies, HIJRA qualified midwife. Without proper medical care, it may affect both the mother and the baby she added. Since Nadifo is pregnant and did not eat well due to certain circumstances, her blood sugar had dangerously dropped down. Her condition was stabilized and few hours later she came out of her coma. Nadifo will remain in the clinic a few more days till she is fully recovered. The last thing I can remember is when I was trying to put a kettle on the fire, Nadifo recalls. My mother told me later that an ambulance brought me here. I am very grateful for the help I got she says. Medical staff of HIJRA put Nadifo on a stretcher to bring her to the ambulance HIJRA Nadifo is carried to the ambulance and later brought to the Badbaado health clinic in Mogadishu

2 Proporton of R. facilitiess AVRO EPIDEMIOLOGICAL SURVEILLANCE (EPI WEEK 37, 1 1 September ) TIMELY REPORTING: Of the 19 facilities currently reporting to the Communicable diseases Surveillance and Response (CSR) sentinel surveillance network, 19 reported timely during week 37. All reporting facilities in Puntland were timely. In Southern Somalia 97 (35 of 3), Central Somalia 9.7 (59 of 1) facilities reported timely while in Somaliland, 9 (53 of 5) facilities did report timely. SITUATION OVERVIEW: Ongoing suspected outbreak of suspected cholera in Central Southern Puntland Somaliland Lower Jubba region is stabilizing but the case fatality rates remain high. Ten stool samples were collected from Hoosingow in Badade district and four from Dhobley in Afmadow district, now being processed in the lab. Preliminary results are expected on Saturday September. On 17 September, three stool samples collected from cases presenting with suspected cholera in Dhobley MCH were tested using Cholera 139 Smart II New Horizons Diagnostics Inc (Sensitive Membrane Antigen Rapid Test). All were negative for cholera. Tests are still available on ground and will continue to be used. More samples are expected. Since 5 September, over 1 cases and 1 deaths have been reported from Hoosingow (most affected), Dhobley, Waraq and Afmadow. Cross-border cases have been reported in Dadaab, Kenya. Mudug and Nugaal regions reported two cases of suspected cholera as during week 37. regions reporting cases of suspected measles and confirmed malaria have increased significantly compared to week 3. 1 Districts reporting cholera cases Districts reporting measles cases Districts reporting malaria cases Proportion of timely reporting sentinel sites by zone

3 Proportional Morbidity proportional SOUTHERN SOMALIA Table 1. Southern Somalia (3 sentinel sites) Week 3 (- August ) - reporting sites 35 Week 35 (7 Aug- Sept ) - reporting sites 3 Week 3 (3-9 Sept ) - reporting sites 35 Week 37 (1-1 Sept ) - reporting sites 35 Health Event ( < 5 yrs) ( < 5 yrs) ( < 5 yrs) ( < 5 yrs) Susp. Cholera (3.3).1 1 (1).1 (1).3 Susp. Shigellosis 9 (5.5).5 7 (1.5). 35 ().5 35 (71.).5 Susp. Measles (1). (9). 7 (1.5). 33 (.).5 Acute Flaccid Paralysis Susp. Hemorrh. Fever Susp. Diphtheria Susp. Whooping Cough 3 (7.). 7 (.9) (93.7). 1 (1).3 Confirmed Malaria 1 (5.) (57.9) (5.) (57.) 1.9 Neonatal Tetanus All other consultations 5979 (.5) 739 (7.) (.5) 7 (7.5) Total consultations 17 (.) 753 (7.3) 71 (9.) 93 (.1) * is the number of cases for individual health event as a proportion of all consultations for the reporting week Trends of cases by age group and proportional for suspected cholera in Southern Zone week 1-37, 5 yrs < 5 yrs p. morb Trends of cases by age group and proportional of suspected measles in Southern zone from week 1-37, yrs < 5 yrs p.morb Trends of cases by age group and proportional for confirmed Malaria in Southern Zone week 1-37, 5 yrs < 5 yrs P. morb While trends of suspected cholera cases reported in the sentinel sites have shown a decline since week 5, suspected cases have been reported in Afmadow and Badade districts. Between 5-1 September, a total of 93 cases and 11 deaths were reported in Hosingow village in Badade district. Suspected cases have also been reported in Dobley town in Afmadow district as well as Afmadow town. Sonce 1 September an estimated 35 cases were reported by partners in Afmadow town. More information is being gathered and samples will be collected as well. Sentinel sites in 7 out of 1 districts reported suspected measles cases with stable trends. Trends in suspected shigellosis cases have also stabilized. Immunization activities have not been conducted in Southern Somalia for the past three years. The suspected whooping cough cases have also stabilized at high levels. The proportional of confirmed malaria cases remains high at almost.

4 proportional CENTRAL SOMALIA Table. Central Somalia 1 sentinel sites Week 3 (- August ) - number of reporting sites 1 ( < 5 yrs) Week 35 (7 Aug- Sept ) - reporting sites 5 ( < 5 yrs) Week 3 (3-9 Sept ) - reporting sites 57 ( < 5 yrs) Morbidity is the number of cases for individual health event as a proportion of all consultations for the reporting week. Week 37 (1-1 Sept ) - reporting sites 59 ( < 5 yrs) Health Event Susp. Cholera 1 (5.7) (7) 1 13 (71.7.).9 11 (71.9).7 Susp. Shigellosis 53 (79.).3 31 (.). 7 (9.). 5 (7). Susp. Measles 111 (7.).7 1 (73.) 1 13 (.). 97 (91.7). Acute Flaccid Paralysis Susp. Hemorrh. Fever Susp. Diphtheria Susp. Whooping Cough 3 (.9).1 11 (1).1 3 (7.5). 51 (.3).3 Confirmed Malaria 39 (3.7) 7 (3.5) 1. 1 () (3.7) 1. Neonatal Tetanus (1).1 (1).1 5 (1).3 (1).5 All other consultations 155 (3) Total consultations 159 (3.) 159 (.) 157 (.7) 1557 (1.5) 157 (3) (.1) (3.) Trends of cases by age group and proportional for suspected cholera in Central Zone week 1-37, 5 yrs < 5 yrs p. morb Trends of cases by age group and proportional for confirmed Malaria in Central Zone week 1-37, 5 yrs < 5 yrs p. morb Trends of cases by age group and proportional of suspected measles in Central zone from week 1-37, 5 yrs < 5 yrs p.morb Suspected cholera cases have consistently declined in recent weeks with majority of cases being reported in Banadir region (95.). Similar trends have been observed with suspected shigellosis cases albeit at lower levels. Alerts of increasing suspected cholera cases were reported from Cadaado and Guriel districts in Galgadud region and upon investigation it was established that the cases were not clinically compatible with the standard case definition. As a result no samples were collected. WHO maintains a stock of transport media and rapid tests in Galcacyo ready for use whenever there are rumors in the surrounding areas. For two consecutive weeks, suspected measles cases have declined. However, in Marka, suspected measles cases are increasing. In Banadir region, Huriwa and Wadajir districts reported most of the suspected measles cases and both districts have seen declines in recent weeks. Whooping cough cases are increasing in Huriwa district, which has also experienced measles outbreak. The district has been receiving IDPs from the underserved southern regions fleeing where there is armed conflict. All regions, except Hiraan, reported confirmed malaria cases although 3.3 of cases were reported in Banadir region.

5 proportional SOMALILAND Table 3. Somaliland 5 sentinel sites Week 3 (- August ) - reporting sites 5 Week 35 (7 Aug- Sept ) - reporting sites 5 Week 3 (3-9 Sept ) - reporting sites 5 Week 37 (1-1 Sept ) - reporting sites Health Event ( < 5 yrs) ( < 5 yrs) ( < 5 yrs) ( < 5 yrs) Susp. Cholera Susp. Shigellosis 9 (5.). 1 (5). 7 (59.3). 1 (5.3). Susp. Measles 5 (1).1 (5). Acute Flaccid Paralysis Susp. Hemorrh. Fever Susp. Diphtheria Susp. Whooping Cough Confirmed Malaria Neonatal Tetanus All other consultations 3 (5.9) 5 (3.7) 5 (.1) 1 (.) Total consultations 37 (51) 55 (3.) 57 (.) (5.) Morbidity is the number of cases for individual health event as a proportion of all consultations for the reporting week Trends of cases by age group and proportional for suspected cholera in Somaliland week 1-37, 5 yrs < 5 yrs p. morb Trends of cases by age group and proportional of 1 suspected measles in Somaliland from week 1-37, 1 5 yrs < 5 yrs p.morb Sixteen suspected shigellosis cases were reported mostly in facilities in Lasanod district which reported 13 of the 1 cases reported in week PUNTLAND Table. Puntland 5 sentinel sites Week 3 (- August ) - reporting sites 5 ( < 5 yrs) Week 35 (7 Aug- Sept ) - reporting sites 5 ( < 5 yrs) Week 3 (3-9 Sept ) - reporting sites 5 ( < 5 yrs) Morbidity is the number of cases for individual health event as a proportion of all consultations for the reporting week. Week 37 (1-1 Sept ) - reporting sites 5 ( < 5 yrs) Health Event Susp. Cholera 3 (1).1 1 (1). 1 (1). 9 (.9). Susp. Shigellosis 3 (33.3).1 5 ().1 1 (). Susp. Measles 11 (1.). 5 ().1 7 (5.7).1 1 (1). Acute Flaccid Paralysis Susp. Hemorrh. Fever Susp. Diphtheria Susp. Whooping Cough 1 (1). Confirmed Malaria Neonatal Tetanus All other consultations 531 (.) 5713 (5.) 559 (3.9) 571 (3.) Total consultations 533 (.5) 57 (5.7) 5 () 571 (3.5)

6 proportional Trends of cases by age group and proportional for suspected cholera in Puntland week 1-37, yrs < 5 yrs p. morb Trends of cases by age group and proportional of suspected measles in Puntland from week 1-37, yrs < 5 yrs p.morb Six facilities in Mudug and Nugal regions reported the 9 suspected cholera cases in week 37. The facilities had not reported cases in at least weeks. Feedback is awaited on the status of investigation in the suspected cases. CONFLICT-RELATED INJURIES (Source: four major hospitals in Mogadishu) From 1 January 1 September, 5 casualties from weapon-related injuries were treated in four hospitals in Mogadishu, with 1 cases (.3) under the age of five. A total of 97 deaths above the age of five and 13 deaths below the age of five years were registered. 1 Weapon related injuries reported in four major hospitals in Mogadishu week 1-37, >5 years <5 years Breakdown of casualties treated in four major hospitals in Mogadishu, from 1-1 September Casualties discharged casualties under the age of five Number of burns fractures chest injuries operations carried out patients transferred to Nairobi or other place deaths in hospital Breakdown of casualties treated in major hospitals of Middle and Lower Jubba region, from 9-15 September Casualties discharged casualties under the age of five Number of burns fractures Number of chest injuries operations carried out patients transferred to Nairobi or other place deaths in hospital Afmadow hospital 5 Kismayo General hospital TOTAL

7 HEALTH RESPONSE Activity data from -13 September During the reporting period, AFREC with the support of World Concern trained about five traditional birth attendants (TBA) and five community health workers on Joint and Nutrition Assistance. The initiative s main objective is to educate mothers on breastfeeding practices, dietary diversity and the use of the locally available nutritional foods and good health practices. Partner Region(s) or location Health intervention(s) Target Population Total consultations Female <five years WAHA International Banadir, Hiraan Mother and child hospital Health centre MCH/OPD/ non-complicated deliveries and referral service to Hanano hospital) WARDI Banadir, Hiraan, Bay Health centers Primary health units Mobile clinics Cholera treatment centre services Center for Peace and Banadir Primary health unit Democracy/Save the Children American Refugee Committee Banadir, Lower Jubba Primary Health Unit (A fixed OPD/ORP site provides PHC, ORP services and hygiene education sessions to IDP populations; PHC - MCH/ANC/PNC) Cholera treatment centre services (classification and treatment of AWD cases) Relief International/Family Lower Shabelle Health Centre (MCH) Empowerment and Relief Organization PHF Banadir Health centre CTC International Medical Corps Banadir Primary Health Unit (static mobile clinic) Merlin Banadir Primary Health Care (MCH that provides ANC services, deliveries, immunization, some nutritional supplement to malnourished children under five years, treatment of minor illness and hygiene education sessions to IDPs and host community) Qatar Red Crescent Society Lower Shabelle Communicable disease services (Communicable and tropical disease center) Voluntary Action Committee in Banadir Health centre (PHC, MCH) Somalia Muslim Hands Banadir, Lower and Health Center Middle Jubba, Galgadud HDC Gedo Health Centers SOYDA Lower Shabelle, Banadir Health Centers Integrated Health and Nutrition InterSoS Middle Shabelle Hospital TB Center Health Centers Direct Aid Banadir, Gedo Health Centers

8 SHARDO Banadir, Bay Primary Health Unit Middle Shabelle Health Center Banadir Banadir Mobile Clinic TB Treatment HIJRA Banadir Mobile Team 3 13 Banadir, Lower Shabelle Health Centers (MCH/OPD) AFREC Lower Juba Health Centers Somali Community Concern (SCC) Banadir, Galgaduud, Middle Shabelle Primary Health unit (health post) *Whilst the information contained in this bulletin has been presented with all due care, it does not warrant or represent that the information is free from errors or omission. SOYDA A child gets medical attention at the Save the Children health facility in Baidoa district, Bay region An MCH managed by Muslim Hands medical teams provide treatment to IDPs and host communities in Mogadishu The SCC health post in Waberi district, Mogadishu provides health services to men, women and children at the Majo IDP settlement A mother and her two children at a WARDI health facility in Mogadishu