Situation report for acute watery diarrhoea/ cholera

Transcription

1 Situation report for acute watery diarrhoea/ cholera Epidemiological week 11 (13 th 19 th March 2017) Highlights There is a sharp increase in the number of AWD/ cholera cases recorded in the affected districts this week compared to the same period last year. The most affected districts and villages during this reporting period include Baidoa, Berdale and Awdinle in Bay region, Wajid and Burdhuhunle in Bakool region, Wanlaweyne in Lower Shebelle, Garbaharey and Bardhere in Gedo,and Kismayo in Lower Jubba Stool samples collected from Hudur were positive for Vibrio cholerae 01/ Ogawa. The first round of oral cholera vaccination campaign was launched in Banadir hospital on the 15 th March 2017, and a total of people aged 1 year and above received the first dose in 7 locations. Cumulative key figures as of 19th March new cases 54 deaths 2.3% case-fatality rate cumulative cases between weeks 1 and cumulative deaths 46 districts reported AWD cases in the south central region and Puntland Situation update A total of 2956 AWD/ cholera cases and 54 deaths (CFR 2.3%) were recorded in week 11 (13 19 March, 2017) from 29 districts in 13 regions. Of the 46 districts that have reported AWD/ cholera cases since January 2017, 4 of them are inaccessible including villages under Awdinle in Bay, Garbaharey villages in Gedo and Burdhunhle in Wajid district in Bakool region. The above districts were severely affected by the drought, and the water scarcity and food insecurity are contributing the high incidence rate of cholera. Currently, there are 22 cholera treatment centers (CTCs) and 17 cholera treatment units (CTUs) operational in 12 regions. However, the quality of case management services and structure of the treatment facilities may vary from one district to another. Some districts and villages affected by cholera lack adequate treatment facilities and qualified health workers especially in inaccessible areas. Page 1 of 5

2 A cumulative suspected AWD/ cholera cases and 356 deaths (CFR 2.3%) were recorded from 46 districts across 13 regions since the beginning of the year. However, the trend of cholera cases recorded in the last 11 weeks has increased significantly compared to the cases reported in the same period in 2016 (refer to below epidemic curve). Improved reporting and further spread of cases to other districts may explain the increasing number of cases. Suspected cholera cases might be underreported as well in areas controlled by Al-Shabaab. The AWD/ cholera epidemic in Hiran region has been controlled and the cholera treatment centre in Beledweyne has been closed. The current AWD/ cholera outbreak affecting 46 districts in 13 regions were a spill-over from last year s major cholera outbreak, which recorded cases and 548 deaths. Last year s outbreak was one of the worst and longest in which the country has experienced in the last five years. The distribution of new cases by region is summarized below: o Bay Region: A total of 1187 suspected cholera cases and 19 deaths were recorded in the region. Most of the cases were reported from Berdele, Awdinle, Goof-Gudud.Burey, Bayhow and Baidoa hospital. The surveillance record show that the outbreak is spreading to new districts and villages within the region especially inaccessible areas; o Banadir Region: A total of 153 suspected cholera cases and 2 deaths were recorded across 17 districts in Banadir and there is an increase in the number of cases and deaths in the past two weeks; o Hiran Region: The outbreak in Beledweyne town has been controlled and the cholera treatment center in Beledweyne has been closed. o Lower Shebelle Region: A total of 359 suspected cholera cases and 5deaths were recorded in the region. More than half of the cases were reported in Wanlaweyne district. Of the 5 deaths, 3 were from Walanweyne while 2 were recorded in Marka hospital. The number of cases have increased in the past two weeks o Middle Shebelle: A total of 74 suspected cholera cases and 0 deaths were recorded in the region. Most of the cases were reported from Jowhar town and Harwadley village. The number of suspected cholera cases have decreased in the last 2 weeks o Lower Jubba: There was an increase in the number of suspected cholera cases reported from 73 in week 10 to 115 in week 11. However, no deaths were reported this week. Oral cholera vaccination campaign was conducted in Calanley, Farjano and Fanole, the areas with the highest cholera risk in Kismayo district. o Bakol Region: There was a reduction in the number of suspected cholera cases in the past 2 weeks. A total of 439 cases and 12 deaths were reported in Hudur and Wajid compared to 568 cases and 25 deaths reported in the previous week. o Gedo region. A total of 460 suspected cholera cases and 11 deaths were reported from Garbaharey, Bardhere and Luuq districts. The trend of suspected cholera cases has increased and spreaded to Bardhere district. o Nugal. A total of 128 cases and 1 death were reported in Garowe and Burtinle districts. Only one death was recorded in Burtinle o Bari: A total of 30 cases were reported in Bosasso in the past week. o Mudug: A total of 11 cases and 3 deaths were reported in Galdogob and Galkayo districts in the past 2 weeks. Reports of AWD/ cholera cases coming from Ethiopia has been reported in the region. Page 2 of 5

3 Week 9 Week 13 Week 15 Week 17 Week 19 Week 21 Week 23 Week 25 Week 27 Week 29 Week 31 Week 33 Week 35 Week 37 Week 39 Week 41 Week 43 Week 45 Week 47 Week 49 Week 51 Week 1 Week 3 Week 5 week 7 week 9 Number of AWD/Cholera cases Case Fatality Rate (%) Available surveillance data, there is strong evidence that the AWD/ cholera outbreak is still spreading to new villages and districts, and some districts are reporting increased number of cases and deaths. Somalia continues to experience severe draught in most part of the country resulting water shortage, food insecurity, malnutrition and disease outbreaks. Even though the AWD/ cholera outbreak has been controlled in Mudug, Nugaal, Beledweyne and Buuloburte, there is active transmission in Bay, Bakool, Gedo and Lower Shebelle. The most affected districts in Bakool, Bay and Gedo are controlled by Al-Shabaab. AWD Summary by Region Week 10 SN Region 6 th March-12 th March 13 th March-19 th March Cumulative (week 1-11) Live Dead CFR(%) Live Dead CFR(%) Live Dead CFR(%) 1 Bakool , Banadir , Bari Bay , Galgaduud Gedo , Hiran Lower Jubba Lower Shabelle , Middle Shabelle Mudug Nugal Grand Total 3, , , Fig 1. AWD/Cholera cases in Somalia March 2016-March 2017 Cases CFR (%) Drought begins Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16Sep-16 Oct-16 Nov-16 weeks/months Dec-16 Jan-17 Feb-17 Mar- 17 Page 3 of 5

4 Response activities Coordination The Drought Operations Centre (DOC), a multi-partner response centre, has been established in Mogadishu to coordinate the response activities for AWD/ cholera and drought in the whole country Health and WASH cluster partners meet daily in affected regions to control further spread in the affected districts. Mapping of NGOs with capacity to manage cases in inaccessible areas have been identified and being supported by partners The Ministry of Health has been supported the deployment of mobile Rapid Response Teams and health volunteers in Bay region to manage the increasing number of cases and deaths. The Somali Medical Association together with federal Ministry of Health deployed 20 volunteer doctors with the help of the National Drought committee. These volunteer doctors were deployed Baidoa (15) and Huddur (5) for emergency response after they were given two days orientation training on emergency response. UNICEF sent 2 DDK, 6 cartons/1000 sachets of ORS, 300 of IV cannulas, and 10,000 of Zinc tablets from Baidoa to Wajid and Hudur through WHC and MARDO (local organizations). WHO has released cholera supplies to Banadir Hospital. Surveillance and laboratory Technical team led by the Director of Public of Ministry of Health has visited the affected villages in Garowe and surrounding areas to investigate rumours/alerts of AWD/ cholera Stool samples collected from Adado and Garbaharay were cultured at WHO supported National Public Health laboratory in Mogadishu; Stool samples collected from Huddur tested positive for V. cholerea Twenty health workers were trained in surveillance and rapid investigation and response by Ministry of Health and WHO in Baidoa Case management and infection control 22 AWD/ cholera treatment centres and 17 cholera treatment units have been established and operational in most affected districts; Health workers have been trained in cholera case management in most affected regions especially Bay and Bakool; UNICEF team from WASH, Health and Nutrition visited Wajid CTC during this week and provided on the job training on case management, establishment and proper organization of CTC, proper use of ORS and zinc tablet for CTC staff (WHC), ARD and Gredo. The team also assessed health and WASH needs of the CTC, identified gaps and actions for WASH and health of Wajid CTC are ongoing Health volunteers have been deployed in Bay region in G. Burey and Awdinle to manage the increasing number of cases. These have received training by the national trainers that were trained by WHO; There are plans to expand the CTUs network in Bay, Bakool, Gedo and others region in order to strengthen the timely case management. Page 4 of 5

5 WASH and social mobilization Hygienic kits have been distributed to inaccessible areas through community health volunteers and different NGOs State and Regional Government authorities were involved in the Prevention of AWD/ cholera and provide full support to Community Social mobilization, hygiene promotion. Health supplies for AWD/ cholera Emergency Response have been distributed to five districts and over 10 Villages in Bay region, Bakool, Gedo and Lower Shebelle. Urgent needs Shortage of funds is hampering the implementation of response activities to contain the cholera outbreak, and it s important to raise funds to sustain the cholera response. Additional medical and non-medical supplies to be prepositioned in high risk districts. Deploying surge teams to boost the management of AWD/ cholera cases in Bay, Gedo and Bakool regions. Engagement of the local health authorities and clan heads in the provision of basic health care to affected communities in inaccessible areas In Remote areas in Bay and Bakool regions there is an urgent need of Clean Water and food which has greatly aggravated the situation of AWD/ cholera outbreaks. Contact details The weekly situation report is prepared by federal Ministry of Health, Emergency and Surveillance unit, with technical support from WHO Somalia. Mr. Ahmed Moallim Mohamed MoH Emergency Coordinator ahmeddiscipline@gmail.com Dr. Mutaawe Lubogo WHO Epidemiologist mutaawea@who.int Page 5 of 5