South Sudan weekly report

Transcription

1 Week 31 (01-07 th August 2011) HIGHLIGHTS A WHO staff presenting a speech to the audience at the World Breastfeeding week at Central Equatorial state. To the right is the Minster of state for Central Equatorial and a representative from UNICEF South Sudan. In week 31, WHO: conducted field investigations to verify an outbreak of unknown febrile disease in Tonj North County; participated in the celebrations to mark the world breasting week at Central Equatorial State; participated in the investigations of reported cases of unknown (febrile) disease in Jonglei state; conducted a training for laboratory support services in WES for 41 participants; and conducted support supervision in Ayod treatment center for Khalazar.

2 1. Public health issues Returnees continue to come back in large numbers with population build up in Renk and other key states of their final destination Twenty two new cases of suspected Khalazar with three deaths were reported in New Fangak Payam,Jonglei state Seven new cases of Measles were reported in Agok bringing the total of measles cases reported to date to 15. Hygiene and sanitation remain the triggers of increased morbidity of diarrheal diseases, Acute Respiratory Infection and the Skin Infection amongst the IDPs and the host community especially in Agok, Awal, Juljok, Rumamer Aneet market and 2. Security situation The security situation in the country generally remained calm through the week. There has been an observation in the movement of many IDPs back to Agok. This has significantly increased the population in Agok in the last one month bringing the total population there over 29,698 IDPs in Agok. Though UNMISS have now moved in and taken over Abyei, the area still remains unsafe for the population to go back. There are reports that the area has been heavily mined. 3. Coordination and emergency preparedness and Response During the week: 1. As part of preparedness, WHO together with other health partners in Western Bhar El Ghazal mobilized for drugs and resources to respond to the potential outbreak/upsurge of malaria in the area of return. To strengthen this further, WHO replenished the drug supplies for IOM to support the management of common illnesses in the way station/idp camp in Wau. 2. Three hundred and thirty three (333) returnees arrived to Rumbek way station during the week. Among them were one hundred and eighty seven (187) children aged 0 17 years, thirty nine of them being under five, one hundred and thirty four aged at yrs while twelve were of over 60 years. WHO, SMOH and UNICEF continued ensuring that EPI services are underway at the way station. And as part of preparedness plan, WHO will

3 continue to support with strengthening of case management/ prepositioning of emergency supplies and malaria drugs in anticipation of returnees arriving at Rumbek. The programme also supported the state ministry of health in Lakes state to prepare for and conduct a health coordination meeting in Rumbek to strengthen and review the humanitarian activities in Nyang way station 3. WHO also provided support to the state ministry of health in Unity state to organize for a measles follow up campaign within the state. Other partners are expected to support with training, logistic movements, support supervision and monitoring in their respective Counties. 4. In Western Bhar El Ghazal, WHO supported the SMOH to organise for a health cluster meeting to enhance preparedness of an estimated 6000 returnees arriving in to the state. WHO presented and discussed malaria data for the last four epidemiological weeks which showed that there is an increase in the trends as shown below. Malaria cases for the last four epi weeks (WBGZ) Weeks No. of Health facilities No. of cases No. of deaths Total 12, SMOH,WHO and UNICEF are developing a response strategy to respond to the increasing numbers of malaria cases which may be a potential cause of high morbidity especially in the wake of the returnees arriving in the state 4. Communicable diseases. Disease surveillance update During the week WHO supported: 1. Twic county to enhance surveillance in the state. Nine health facilities out of nineteen functional ones reported in week 31, with only three of the seven counties of Warrap state

4 including Abyei Area Administration submitting in their weekly reports. This puts the percentage report rate of Warrap state at 42.8% for week 30. AWD, Bloody Diarrhoea and Malaria remained the leading causes of morbidity within the population in Warrap including the IDP community. Warrap is still recovering from the impact of the massive population displacement following the Abyei crisis in May. No outbreak has been reported. 2. A total of one hundred and seventeen new cases, twelve (Relapse/PKDL) and three deaths of Kalazar were reported during this week from fourteen facilities out of twenty four and currently six hundred and thirty four patients are on treatment in fourteen treatment centers this week. 3. WHO conducted IDSR training for forty one health workers in Yambio County and another for forty lab technicians. This continued support is part of WHO s strategy of improving disease surveillance in the states that have for long had silent counties. 4. In Unity state, one case of suspected meningitis was reported from MSF feeding center. WHO supported with the CSF sample collection which tested negative on rapid test. One of the Lab technicians trained in Yambio county during a practical on how to use the microscope. 5. In Tonj North County Warrap state, WHO supported the SMOH with the investigations of an outbreak : The initial report was that of unusual febrile illness marked by rapid deterioration in the health status, generalized aches, altered state of consciousness and deaths. There was associated mass hysteria as news of the unknown disease engulfed the affected population. No reports of seizures or bleeding or any particular predisposing factors or gender or age bias were reported. The cases were reported from locations around Warrap Town in Tonj North County of the State.

5 The key findings were that: the community and health facilities did not report/document any current/active cases unusual or unknown febrile disease. However, reports of increase in clinical malaria (laboratory confirmed) were documented; the review of deaths in the community did not indicate any unusual pattern. No reports of deaths, or knowledge of, or presence of unusual disease pattern associated with or without hemorrhage, high fevers, jaundice, or seizures or suspected malaria unresponsive to treatment were reported during the investigations. Detailed records of daily consultations as well as register of deaths were also reviewed and this showed that no existence of suspected conditions under investigation other than the seasonal surge in consultations for malaria. 6. WHO together with the State Ministry of Health (SMOH) in Uppernile responded to an outbreak in the state following information reports of deaths and admissions of patients in New Fangak. It was established that a total of twenty three patients were admitted in New Fangak Primary Health Care Centre (PHCC) with four fatalities. All patients were from Dor payam and happened to be soldiers. They all had a history of travel to Old Fangak area that is highly endemic to Khalazar. All patients presented with fever, haematuria, malaise and abdominal pain.the investigation team collected twenty six specimens during the screening process of which fourteen tested positive for Khalazar while two tested positive for Malaria. WHO supported the SMOH of Jonglei and Republic of South Sudan, with financial and logistical support for a mission to New Fangak to support the payam with strengthening the case management and surveillance. An assortment of drugs and medical supplies were dispatched to New Fangak health authorities for the response. As seen from the graph above, cases began being

6 recorded in week 23 however the steady rise was noticed after week 28. This is the peak season and cases are anticipated to rise. 7. WHO participated in a number of support supervision activities across selected states, In Yambio the programme supported Yambio and Zara Hospitals with the integrated supervision putting emphasis on communicable diseases and vaccine preventable disease. Under NTD, the programme conducted a support supervision visit to Ayod treatment centre to review and support the case management for the khalazar patients.the team also held a county coordination meeting with the key stake holders and further discussed the issues of lab and case management with the county health department. 8. In Western Bahergazel State, WHO/SMOH continue to respond to the anthrax cases being reported. The total cases of anthrax have reached 86. Below is the trend of the reported cases. 5. Partnerships 1. WHO participated in the world breast feeding week (1 st to 7 th August) together with SMOH-CES and UNICEF among other partners. The theme of the day was emphasizing the third dimension of Breast feeding, which happens to be communication 2. WHO supported the state ministry of health to complete the process of updating of health facility distribution and functionality in Warrap state.

7 3. To enhance preparedness and improve the lead time for reponse,the organization functionalized the WHO speed boats in Uppernile state to ease transport and access the hard to reach areas in Jonglie State and some parts of Uppernile. The organization further enabled the delivery of 5000 mosquito nets to CHD in Old Fangak to support the management of Khalazar patients. 4. WHO closely worked with the SMoH and partners in Renk to supervise and coordinate all activities towards the renk response. Health services continue to be provided in Mina site by Medair,Abayok site by IMA and river side way station by IOM.A total of 908 patients were managed in the clinic in the reporting week. EPI services continue to be strengthened A total of children received vaccination during the week, 48% of which were vaccinated against measles. 5. WHO supported the SMOHs (WES, Jonglei, Uppernile) with HIMS tools and IPD registers and distributed a total of 5,184 HMIS facility registers and 150 surveillance wall charts through the partners, WVI and IMA to be delivered to the states. 6. WHO participated in the UNCT meeting in Lakes states during which focus was put on the humanitarian assistance to the returnees and IDPs in the state. 7. As part of the capacity building of staff to strengthen and improve the delivery of Immunization services and to increase the sensitivity of AFP along with other vaccine preventable diseases surveillance in the counties, WHO conducted trainings and support supervision. This visit targeted Terekeka and Yei Counties. The main objectives were: Provide supportive supervision to field staff implementing EPI program and strengthen the VPD surveillance at county and payam levels with emphasis of integrating surveillance activities with the existing routine integrated disease surveillance 8. Acknowledgments: The progress achieved by WHO/EHA South Sudan was made possible through contributions from the following partners: For further information, please contact: Dr. Allan Mpairwe, Emergency Co-ordinator, mpairwea@nbo.emro.who.int or Ms Pauline Ajello, Communication Officer, ajellop@nbo.emro.who.int