South Sudan Emergency type: Complex Emergency Reporting period: 1 30 September 2018

Transcription

1 HEALTH CLUSTER BULLETIN # 9 3 September 218 A vaccinatr administering TT vaccine t a wman f child bearing age in Old Fangak. Pht: CMA. Suth Sudan Emergency type: Cmplex Emergency Reprting perid: 1 3 September MILLION PEOPLE IN HEALTH NEED HIGHLIGHTS 2.4 MILLION TARGETED Fllwing the Ebla virus Disease utbreak in the Demcratic Republic f Cng, the Health Cluster highly invlved in crdinating partners wrking in high-risk areas. Six partners (IOM, CORDAID, CUAMM, SCI, WHO and Wrld Visin Suth Sudan, AAHI ) are wrking in 14 screening sites in the Yei River, Trit, Maridi, Jubek, Wau, Tambura and Gbude States. CUAMM, Crdaid, Wrld Visin, IMC and AAH are earmarked t respnd in seven islatin facilities lcated in Yei River, Trit, Maridi, Jubek, Wau, Tambura and Gbude States. Health Link Suth Sudan is crdinating the Ebla presparedness activities in Jubek State. The Health and Lgistics clusters secured funds frm the Suth Sudan Humanitarian Fund Reserve allcatin t supprt case management, infectin preventin and cntrl, surveillance and labratry capacity. Samaritan Purse and Alima are wrking ut mdalities t supprt training f partners n islatin centres and case management MILLION DISPLACED HEALTH SECTOR MILLION REFUGEES HEALTH CLUSTER PARTNERS EARMARKED IN HRP TO IMPLEMENT HEALTH RESPONSE MEDICINES DELIVERED TO HEALTH FACILITIES/PARTNERS 349 ASSORTED EMERGENCY MEDICAL KITS (CORE PIPELINE) HEALTH CLUSTER ACTIVITIES OPD CONSULTATIONS VACCINATION CHILDREN (6-59 MONTHS) VACCINATED AGAINST MEASLES EARLY WARNING ALERT AND RESPONSE NETWORK 41 EWARN SENTINEL SITES FUNDING $US 13 M REQUESTED 34.9* 95.1 M FUNDED GAP

2 Number f cases Key Cntext Update Fllwing the inter clan cnflicts in Juba PC, a sectin f the IDPs (abut 7 ) has been relcated t Mangateen, cnsequently Internatinal Medical Crps (IMC) has been engaged in setting up basic health care services and started prvisin f primary health care services since early September. Tw health facilities (PHCU and PHCC) are perating 24/7 in Mangateen site. Public Health Risks and Key Gaps By the end f September 218 cmpleteness fr IDSR reprting at cunty level was 78% while cmpleteness fr EWARS reprting frm the health facilities serving IDPs was 72%. Malaria remains the tp cause f mrbidity and mrtality that accunts fr 62% and 81% f cases and deaths by the end f September 218. Cnsequently, trend analyses shwed that 15 cunties in 5 hubs currently had malaria trends that were significantly higher than expected. Cunties with malaria trends that exceed the threshld (third quartile f trends fr the perid ) included: Rubella in Yirl East Aweil hub (Aweil Center); Rumbek hub (Rumbek Center, Rumbek East, Rumbek Nrth, Wulu, Yirl East, Yirl West); Kuajk hub (Abyei, Ggrial East, Tnj East, Tnj Suth, and Twic Mayardit); Bentiu hub (Maym); and Juba hub (Terekeka). Yirl East Cunty after a ttal f 6 ut f the 7 samples tested retrspectively were IgM psitive fr rubella. A ttal f 18 cases with n deaths were reprted frm Yirl East. Half (5%) f the cases were less than five years f age. Mst f the suspect measles cases are frm Adir payam with mst cases reprted frm Madhiemgk and Adir villages. All the cases reprted had nt received any measles vaccine dse. Respnse entailed enhanced rutine vaccinatin, case surveillance and line listing, and behaviur change cmmunicatin t prmte Suspect rutine measles immunisatin. cases by Payam in Yirl East, week 25-37, Yali Adir Epidemilgical week 218 Age Female Male Ttal cases Percentage % Cum% <1yr 1 1 6% 6% 1-4yrs % 5% 5-9yrs % 89% 1-14yrs % 1% Ttal cases % PAGE 2

3 Cases Cases Animal bites (suspect rabies) In September 218, a ttal f 3 animal bite (suspect rabies) cases with n deaths were reprted in Trit twn. The cases are distributed evenly by gender. Nearly 7% f the cases were reprted in children aged -19 years. Nyng and Him dnge are the mst affected payams. As part f the ne-health respnse, a taskfrce meeting was cnvened t secure human antirabies vaccines; cnduct a risk cmmunicatin campaign t mitigate the risk f animal bites especially in children; and t engage the Ministry f Livestck and Fisheries and FAO t cnduct vaccinatin f dmestic animals Suspect rabies cases in Trit week 32-38, Epidemilgical week 218 Age (yrs) FemalMale Ttal cases Percentage Cum % -9yrs % 52% 1-19yrs % 67% 2-29yrs 1 1 4% 7% 3-39yrs % 85% 4-49yrs 1 1 4% 89% 5-59yrs % 1% Ttal cases % Hepatitis E virus in Fangak cunty During September 218, Hepatitis E cases were reprted in Fangak Cunty. At least 13 suspect HEV cases including ne cnfirmed HEV case were reprted and investigated in Old Fangak. All the 13 cases were HEV RDT psitive. Over half (54%) f the cases are 2-29 years f age. The cases appear t be ccurring spradically and are using River water (largely frm Phw River). Supprtive clinical management and cmmunity awareness and hygiene prmtin are n-ging. 4 HEV suspect cases Fangak week 23-36, Epidemilgical week 218 PAGE 3

4 # cases Age Female Male Ttal cases Percentage Cum.% 1-19yrs % 31% 2-29yrs % 85% 3-39yrs % 1% Ttal cases % Health Cluster Sub-Natinal Respnse Analysis Bentiu PC and Beynd Bentiu Respnse Under 5 mrtality rate =.25/day/1, (Emergency threshld: 2/day/1,) Crude mrtality rate =.19/day/1, (Emergency threshld: 1/day/1,) Bentiu PC weeks AWD Malaria ARI Cnsultatins Tw Malaria pints were set up by MSF. Mentr Initiative cmpleted indr residual spraying in all sectrs. A reactive Measles campaign was cnducted in which 38,628 children (75%) were vaccinated. Water quality mnitring wrkshp were facilitated by WHO fr Health, WASH and cmmunity leadership. Beynd Bentiu Respnse Three Malaria pints were set up by MSF in Bentiu twn. Increases in Malaria cases were reprted in all cunties. PAGE 4

5 # cases Beynd Bentiu Respnse weeks AWD Malaria Cnsultatins Malakal PC and Beynd Malakal Respnse Epidemilgical analysis Malakal PC and Malakal twn * Week 1 t Malakal PC. All clinics (IMC, IOM, MSF) Malakal Twn. All clinics (IMC, MSF) Ttal number f cnsultatins versus number f AWD, ARI and Malaria cases % f pririty diseases amngst all cnsultatins IMC data fr Malakal PC nt available fr week 6-8 and fr Malakal twn nt available fr week 6. * PAGE 5

6 Malaria ARI AWD Number f AWD, ARI and Malaria cases with % f under 5 and ver 5 by epidemilgical week Partner Implementatin Key Highlights IOM established three pint f entry (PE) screening sites at Yei Airprt and Kaya brder pints and Yei RRC pint f cntrl in Yei River State; cntinuusly participating in nging assessment t identify up t eight (8) PC screening lcatins including the already established nes; IOM prvided cnsultatins in seven IOM static clinics in Wau, Bentiu and Malakal PCs and cllectins sites as well as in fur IOM-supprted mbile clinics; kicked ff the implementatin f the Accelerated and Integrated HIV Respnse fr Unifrmed Frces and Surrunding Cmmunities in the (frmer) Jnglei State. CARE Internatinal prviding an integrated f HIV and TB prgramming in Ruweng State Hspital; carried ut sexual educatin, adlescent health, hygiene prmtin and demnstratin f hand washing, distributed handwashing facilities t the schls and distributin f sanitary pads t schl ging girls in Ruweng State reaching 2 84 students (1 271 bys and 813 girls); cnducted training n infectin preventin and cntrl, expanded prgramme n immunizatin (EPI) and mnitring and evaluatin fr health wrkers as well as cmmunity leader s sensitizatin f Family planning in Greater Pariang. Christian Missin Aid (CMA) with supprt frm UNICEF trained 165 vlunteers n EPI vaccinatin and vaccine management in Fangak Cunty t implement Maternal Nenatal Tetanus Eliminatin (MNTE) campaign and vaccinated a ttal f (Bys- 8854, Girls-1,841) children between the 6-59 mnths with Measles vaccine and 12,45 (Pregnant-2,6, WCBA-1,444) wmen with Tetanus txid vaccine. LiveWell cnducted 1 35 cnsultatins; reached peple with hygiene prmtin messages in Yirl East; children received malaria treatment; cnducted cnsultatins in Pibr and distributed 1 5 msquit nets t IDPs in Juba. IMC cntinued the prvisin f a cmprehensive and integrated health and nutritin services including utpatient cnsultatins, expanded prgram n immunizatin, nutritin, reprductive health, and gender based vilence, mental health and psychscial supprt at its health facilities in PCs f Malakal, Wau and Juba, Nyal and Maban. The MENTOR Initiative cnducted larval surce management entmlgical surveillance in Malakal PC; Larval surce management Entmlgical surveillance Fly cntrl in Bentiu PC and distributed malaria cmmdities in Maban Refugee sites. PAGE 6

7 WHO In additin t the n-ging supprt t the EVD preparedness activities, WHO prepsitined an assrted cnsignment f materials including 3 tents, a set f 5 PPE, furniture and 5 infrared thermmeters t each lcatin in Wau, Yambi, Nimule and Yei t set up Ebla screening sites; deplyed five state supprt teams t pririty pints f entry t set up new screening psts and islatin sites at additinal pints f entry and t enhance the perfrmance f existing nes. The priritized pints f entry include airprts with internatinal flights and grund crssings with significant traffic and thse brdering the DRC, including Juba Internatinal Airprt, Nimule, Bazi, Kaya, Wau Airprt, Gangura and Sakure; cnducted a five-day training f 23 state malaria crdinatrs, state malaria mnitring and evaluatin fficers and natinal malaria cntrl prgramme staff t imprve their skills in malaria surveillance, Mnitring and Evaluatin including malaria epidemic preparedness and respnse; prvided 4 Rta Virus kits, 9 Rubella IgM kits, 4 Measles IgM kits and 2 Supplementary; cnducted a training f partners frm the frmer Jnglei and Unity States n Nutritin Sentinel Site Surveillance System; prvided 1 treatments fr rehydrating children with severe acute malnutritin in Renk ; cnducted a risk assessment fcusing n the ppulatin immunity and AFP surveillance in respnse t the circulating vaccine-derived plivirus (VDPV2) in the Hrn f Africa; in partnership with UNKEA cmmenced multi-vaccine campaigns (OPV, Measles, MenAfriVac) in Nasir Cunty; upgraded the existing Juba Internatinal Airprt screening site; prcured assrted re-usable materials including cleaning materials, tents, batteries wrth 22, $US required fr setting up and running the temprary screening areas at the brder pints; dispatched 1 sachets f ORS (that can manage 5 cases f mderate dehydratin), 29 Kits f Basic Malaria mdule that can prvide treatment fr 13,775 cases f uncmplicated malaria, 4 Supplementary Malaria Mdules that can prvide treatment fr 14 severe malaria cases and 6 Basic units f the IEHK that can prvide treatment f cmmn diseases fr 6 peple fr a perid f three mnths and 6 vials f Ambisme Injectin t HSE, ALIMA, MSF France and HAA in Mundri East; distributed 4 Kits f IHEK Basic Malaria Mdule t treat 4 peple at PHCU and cmmunity levels fr three mnths, 4 kits f IHEK Supplementary Malaria Mdule fr 4, peple with severe malaria in Hspitals and PHCCs t GOAL; prepsitined 5 kits f Nifurtimx Eflrnithine Cmbinatin Therapy (NECT) t treat 2 patients in stage 2 f HAT; 125 vials f Pentamidine t treat 5 patients fr stage 1 f HAT; 5 kits f CATT reagents and ikit f CATT accessries fr diagnsing 5 suspected cases f HAT; 73 vails f Sdium Stibglucnate t treat 146 patients; 5 bxes f 24 Kala azar test strips t test 12 KA suspected cases; 5 vails f Ambisme t treat KA special cases (pregnant wmen, Elderly, severely ill with anaemia r malnutritin in Tambura, Yei, Yambi, Maridi and Nimule; mbile medical team was deplyed t Yirl East cunty t supprt the implementing partners and cunty health department in cnducting a catch-up measles vaccinatin campaign targeting ver 32 children 6-59 mnths ld; prvided technical supprt t the MH in initiating the rtavirus diarrhea sentinel surveillance in Al Sabah Children hspital and Katr PHCC. UNICEF vaccinated (male and female 6 343) with ral pli vaccine, 11,475 (male and female 5 563) with measles vaccine, pregnant wmen with tetanus txid vaccines; cnducted 5422 (2376 children under 5) curative cnsultatins and distributed 3 22 lng-lasting insecticidal nets (LLINs) in Ud -Baggari in Wau Cunty and Br- Meridia in Raja Cunty in the frmer Western bahr el Ghazal State and Kck and Bieh in Kch cunty and Padeah and Thrnyr in Leer cunty in the frmer Unity State. Implementatin Challenges The threats frm PC Yuth in Malakal directed t staff frm Equatrials has disrupted health activities as sme f NGO staff were nt allw t enter in the POC. This made difficult t run 24/7 ur facilities within the POC. This affected reprductive health and mental health mainly. Lack f ambulance t facilitate night referrals frm IMC Wau health facility t the nearest hspitals. Cntacts: Ms Magda Armah Health Cluster Crdinatr Mbile: armahm@wh.int Dr Fikru Zeleke Abebe Public Health Officer Mbile: fikru.zeleke@gmail.cm Ms Jemila M. Ebrahim Cmmunicatin Officer Mbile : ebrahimj@wh.int PAGE 7