Morbidity and Mortality Report Week 02, 2009 NWFP/FATA

Transcription

1 Morbidity and Mortality Report Week 2, 29 NWFP/FATA 3 9 Jan, 29

2 DEWS Reporting Units and Consultations: During week 1, 29 total 126 weekly reports were received from the flood affected district (Peshawar) and the 4 districts hosting the IDP from conflict areas of FATA & NWFP, reporting total 15,389 patient consultations. The DEWS has been initiated in the hosting districts with a more focus on the health facilities providing care for the IDPs either in the IDP camps or living with the host community and mobile clinics. However the weekly DEWS reporting is collected / received from the other health facilities in the districts also. Table 1: Weekly DEWS reports and total consultations, last 4 weeks, NWFP/FATA, Pakistan Week - 51/8 (13-19 Dec, 28) Week - 52/8 (2-26 Dec 8) Week - 1/9 (27 Dec 8-2 Jan, 9) Week - 2/9 (3-9 Jan, 9) District Reporting unit / Consultations Charrsada 17 / / / / 1563 Mardan 51 / / / / 3378 Nowshehra 11 / / / / 1545 Peshawar 6 / / / / 893 Total 139 / / / / From 35, 28 to week 2, 29 total 721,748 consultation were reported and the number of weekly reporting units consultations remains fluctuating (especially in Peshawar) because of the ongoing military activities against the insurgents in the area and the IDP hosting districts where DEWS was initiated recently (Figure 1). Figure 1: Weekly Pattern of DEWS reporting, in NWFP. # of RUs RU's Weekly pattern of reporting units and consultations Cns. # of Cns W35/ Epi-w eek W1/9 2 Distribution of consultations by Diseases: In week 2, 29 total 15,389 patient consultations were reported from 126 reporting sites. Compared to the previous week the number of consultation has decreased in week 2, 29. Acute respiratory tract infections are reported as the leading cause of consultations in all the reporting facilities and all districts accounting for (37%) 5782 of all consultations reported. Upper Respiratory Tract Infection was reported in (3%) 4683 and Lower Respiratory Tract Infection in (7%) 199 of the total consultations. Acute Diarrhoea reported in (1) 1642, 1

3 unexplained fever () 663, scabies () 575, suspected Malaria () 29 and Bloody Diarrhoea () 182 of the total consultations. Other health events were reported for 4 of the consultations during the week. Table 2 and figure 2, depict the distribution of all consultations by disease. Diseases Consultations Percentage AJS 8 - BD MAL Total % 4 Distribution of consultation by diseases, NWFP/FATA 1 BD 7% MAL Distribution of Consultations by Age Groups and by Disease: In children less than five years of age total 3947 (26%) consultations were reported. Upper Respiratory Tract Infection is the highest reported cause accounted for 35% of the total consultations, Lower Respiratory Tract Infection, Acute Diarrhoea 17% and Bloody Diarrhoea 2%. In children below 5 years age 3% consultations reported for other health events. In children 5 to 15 years of age total 3584 (23%) consultations were reported. Upper Respiratory Tract Infection reported in 32% as the leading cause of consultations followed by lower respiratory tract infection 7%, Acute Diarrhoea, Bloody Diarrhoea 2%, suspected Malaria 2% and Scabies of consultations. Other health problems reported in 37% consultations in the age group. In years age group, total 4917 (32%) consultations were reported with Upper Respiratory Tract Infection as the leading cause of consultations sharing for 27% of consultations. Lower Respiratory Tract Infection reported in 6%, Acute Diarrhoea 9%, Bloody Diarrhoea, suspected Malaria 2% and Scabies and other health problems in 48% of total consultations in the age group. In adults 45 years and above age group total 2941 (19%) consultations reported. Upper Respiratory Tract Infection accounted for 28% of consultations followed by Lower Respiratory Tract Infections 6%, Acute Diarrhoea 7%, and Scabies, suspected Malaria and other health problems reported in 5% of the consultations. 2

4 Figure2.Proportion of primary causes for all reported cases by age groups, week 3, 29, NWFP/FATA, Pakistan 3% 3% 3% 17% 35% < 5yrs (n=3,947) BD 2% MAL 37% 6% BD 2% MAL 2% 7% 32% 5 - <15yrs (n=3,584) 48% 9% BD MAL 2% 6% 27% 15-44yrs (n=4,917) 5% 7% 6% 3% 45yrs (n=2,941) 28% Acute Respiratory Infections and Diarrhoeas as leading seasonal Diseases in the IDP hosting districts: In week 2, 29 total 5782 consultation of Acute Respiratory Infections were reported which is accounting for 37% of the total reported consultations and is leading cause of consultation in all age groups. Acute Upper Respiratory Tract Infection was reported in 4683 (3%) and Lower Respiratory Tract Infection reported in 199 (7%) of the patient consultations reported during week 2, 29. Compared to the previous week, Acute Upper Respiratory Tract Infection, increased by 7%, while Acute Lower Respiratory Tract Infection, remained almost the same. Acute Diarrhoea was reported in 1642 (1) and Bloody Diarrhoea in 182 () of the patients attended during the week. As the total number of Patient consultation, has decreased in week 2 29, similarly the number of consultations for & BD. But when the proportion of consultations for Diarrhoeal Diseases compared for the three weeks it shows a slightly increasing trend for Acute Diarrhoea. The proportion of Acute Diarrhoea in the IDP Camps remains a little high than the rest of the community. No clustering of Acute Diarrhoea cases or suspected cases of Cholera reported from any area in the IDP hosting districts. With a little weekly fluctuation the trends of the common seasonal diseases remains steady. Fig 3: Weekly trend of, BD, &, in NWFP/FATA, Pakistan. Percentage Weekly trend of,, and BD, NWFP/FATA /8 1/9 2 Epi-w eek BD 3

5 Scabies: In week 2, 29, there were 575 cases of Scabies reported from the IDP hosting districts implementing DEWS in NWFP; accounting for of the total consultations during the week. The weekly proportion of consultations for Scabies, showing a fluctuating pattern ranging from 3% to 5% of the reported consultations (fig 4). On further analysis it was noted that Scabies reported from the health facilities in the IDP hosting districts is relatively little higher than reported from the IDP camps. Figure 4: Weekly comparison of Scabies in flood affected and IDP hosting districts of NWFP/FATA, Pakistan 6 Weekly trend of scabies, NWFP/FATA Percentage /8 1/9 2 Epi-w eek Daily Situation of Common Diseases in the IDP camps The Disease situation, Health care delivery, medicine supply, Water quality, Sanitation and environmental hygiene in the IDP camps are monitored on daily basis. Appropriate measures are jointly taken in collaboration with partners when needed. The following paragraphs present a brief overview of the common diseases in the IDP camps. Kacha Garhi IDP camp, Peshawar: In week 2, 29, remained the leading cause of consultations with an average of 33% daily consultations for, followed by acute diarrhoea with some daily fluctuation. In week 2, the daily consultations for Lower respiratory infection reported in 6%. Compared to previous weeks Lower Respiratory Tract infection was reported high in week 2, 29. The daily average of Acute Diarrhoea consultations remained around 15% while the daily average for Bloody Diarrhoea remained less than 2% in Kacha Gari IDP camp. IDP camp Palosa, Charrsada: The general disease situation in the IDP camps remained stable. The daily average for the consultations for Acute Respiratory Tract Infection remained above 25% in the Palosa IDP camp while the daily average for Lower Respiratory Tract Infection remained below 5%. The daily average consultations for Acute Diarrhoea, remained above 15% during week 2 higher than the daily average reported for the previous week which was less than 15 on average. Benazir complex IDP camp, Nowshehra: In IDP camp Benazir complex, Nowshehra, Upper respiratory infection is the highest cause of morbidity with an average of 3 of the total daily consultations reported from the camp. 4

6 Compared to the previous week the daily average of ARI consultations has dropped in week 2. The daily average consultations for Acute Diarrhoea remained around 1 of all consultations. The overall disease situation in the IDP camp remained stable. IDP Jalozai camp Pabbi, Nowshera: The influx of new IDPs families in the Jalozai camp remained continues during the week 2 as well. There was an outbreak of Chicken pox in the camp in the previous two weeks which is stable now. There is suspected outbreak Mumps reported in the camp, which is being responded well. The disease situation in the camp remained as usual with daily Acute Respiratory Tract Infection consultations reported in more than 25% of the total daily patient consultations. Lower Respiratory Tract Infection was reported in a very small proportion (< ) of daily consultations. Acute Diarrhoea reported in around of the patient consultations daily. Alerts and outbreak: In week 2, 29 two alerts was reported and are responded accordingly. One alert of acute watery diarrhoea was reported from DHQ hospital, Mardan. Sample collected and sent to NIH for further laboratory investigation and the result was negative. Lady health workers of the area are activated to health education and hygiene promotion. A suspected outbreak of Mumps is reported at the Jalozai IDP camp which is being responded in collaboration with the health partners 5