Nadowli-Kaleo District hits epidemic threshold for meningitis. Streptococcus pneumoniae remains the predominant causative organism for meningitis.

Transcription

1 MINISTRY OF HEALTH Nadowli-Kaleo District hits epidemic threshold for meningitis. Streptococcus pneumoniae remains the predominant causative organism for meningitis. VOLUME 4 WEEK 4 27 th January, 219

2 The Ghana Weekly Epidemiological Report is a publication of the Ghana Health Service and the Ministry of Health, Ghana Ghana Health Service 219 ISSN i

3 Acknowledgement This publication has been made possible with technical and financial support from the Bloomberg Data for Health Initiative, the CDC Foundation and the World Health Organisation ii

4 Disease/Health event Summary of Weekly Epidemiological Data for Week 4, 219 Weekly Spotlight: Nadowli-Kaleo district in hits epidemic threshold for meningitis. Streptococcus pneumoniae remains the predominant causative organism for meningitis SUMMARY OF PRIORITY DISEASES AND EVENTS - WEEK 4, 219 The total all-cause notifiable disease morbidity for the week (as per IDSR Weekly Summary Reporting Form) was 1,21 cases with one death each from meningitis and maternal death. Acute watery diarrhoea in persons aged 5 years and above was the highest proportion of cases reported and contributed 54% of the notifiable diseases case load during Week 4 [See Figure 1 and Annex 1, summary of reported cases/deaths] Acute watery diarrhoea in persons 649 Influenza-like illness 417 Meningitis 53 Measles 41 Yellow fever (suspected) 18 Diarrhoea with blood 12 AFP (suspected polio) 7 Adverse events following Number of Figure 1: Reported notifiable diseases/conditions, Ghana, Week 4, 219 INFLUENZA-LIKE ILLNESS (IDSR Weekly Report) A total of 417 cases with no deaths were reported through IDSR weekly reporting [Table 1]. Laboratory samples were sent from sentinel sites to Noguchi Memorial Institute for Medical Research (NMIMR) with results pending. Table 1: Reported Influenza-Like Illness cases by Region and District, Ghana, Week 4, 219 Region Districts Deaths Brong-Ahafo Sunyani 1 Eastern New Juaben 117 Accra 29 Adentan 8 Ga Central 2 Ga East 32 Ga West 33 La-Nkwantanang-Madina 1 Ledzokuku-Krowor 14 Shai Osudoku 94 Tema 67 Greater Accra Volta Ketu South 5 Western Sekondi-Takoradi 5 Total 417 HUMAN RABIES No case of Human Rabies was recorded in Week 4. NEONATAL TETANUS No case of Neonatal Tetanus was recorded during the Week under review. ACUTE FLACCID PARALYSIS (SUSPECTED POLIOMYELITIS) Seven cases of Acute Flaccid Paralysis (AFP) were reported during the Week [Table 2]. All the stool specimens tested at the Polio Laboratory at NMIMR were negative for wild polio virus. Table 2: Suspected Poliomyelitis cases and deaths by Region and District, Ghana, Week 4, 219 Region Districts Deaths Dormaa West 1 Brong-Ahafo Nkoranza North 1 Greater-Accra Accra 2 Upper West Jirapa 1 Western Bia West 2 Total 7 CHOLERA No cholera case was reported during the Week. MATERNAL DEATHS During the Week, one maternal death was recorded in the New Juaben Municipality, in the Eastern region.. 1

5 YELLOW FEVER Eighteen (18) suspected cases of Yellow Fever were reported across the country [Table 4]. Samples were sent to the National Public Health and Reference Laboratory with results pending. Table 4: Suspected Yellow Fever cases by Region, Ghana, Week 4, 219 Region District Deaths Ashanti Kwabre 3 Tain 1 Brong-Ahafo Tano North 1 Birim Central 1 Eastern Lower Manya Krobo 1 Ada West 2 Ga West 1 Greater-Accra La-Dade-Kotopon 1 Kassena Nankana West 1 Upper East Talensi 1 Lawra 1 Nadowli-Kaleo 1 Sissala West 1 Upper West Western Prestea-Huni Valley 2 Total 18 MENINGITIS In Week four, 53 cases of meningitis were recorded with one death [Table 6]. Six districts hit the alert threshold with one district in epidemic threshold for meningitis [Figure 8]. Nadowli- Kaleo district crossed the epidemic threshold recording an attack rate of 16.4 per 1, population. Asutifi North, Banda, Jaman North, Zabzugu, Lawra and Nandom districts all crossed the alert threshold recording attack rates of 3.1, 4., 3.9, 5., 9.1 and 7.1 per 1, population respectively. MEASLES A total of 41 suspected cases of Measles were reported across the country [Table 5]. Samples were taken and sent to the National Public Health and Reference Laboratory [NPHRL] for investigations with results pending. As at the end of Week 4, there were three confirmed measles cases, one each from the Ejisu Juaben, New Juaben and Ningo Prampram districts Table 5: Reported Suspected Measles cases by Region and District, Ghana, Week 4, 219 Region Districts Deaths Asunafo North 2 Asunafo South 2 Asutifi North 2 Asutifi South 1 Berekum 2 Jaman South 1 Kintampo North 1 Pru 1 Sene East 1 Sunyani 1 Tain 1 Tano North 1 Brong-Ahafo Techiman South 1 Afram Plains South 1 Asuogyaman 1 Ayensuano 1 Kwahu North 3 Nsawam Adoagyiri 2 Eastern Upper Manya Krobo 1 Adentan 1 Ga Central 3 Ga West 1 Kpone Katamanso 1 La-Dade-Kotopon 1 Ningo Prampram 1 Greater Accra Upper East Pusiga 1 Upper West Sissala West 2 Volta Ho 1 Bibiani-Anhwiaso-Bekwai 1 Ellembelle 1 Western Prestea-Huni Valley 1 Total 41 Table 6: Meningitis cases and deaths by Region, Ghana, Week 4, 219 Cerebrospinal Cerebrospinal Region Fluid (CSF) Lab Fluid (CSF) Test Positive Deaths CFR (%) District in Alert Ashanti 1 1 Brong-Ahafo Central Eastern 2 2 Greater Accra Northern Upper East Upper West Volta 1 1 Western District in Epidemic Total (Ghana) Attack Rate per 1, population [Asutifi North; 2 cases (AR= 3.1), Banda; 1 case (AR= 4.), Jaman North; 4 cases (AR= 3.9), Zabzugu; 5 cases (AR=5.), Lawra; 6 cases (AR=9.1) Nadowli-Kaleo; 12 cases (AR=16.4) Nandom; 4 cases (AR=7.1) Ghana Weekly Epidemiological Report Vol.4 Week 4 27 January 219 2

6 Confirmed Pathogens from Meningitis Laboratory Results, Week 4, 219 Lumbar Puncture was done for 51 out of the 53 cases with 8 testing positive [Table 6]. There were 1 cases of Streptococcus pneumonia confirmed by Polymerase Chain Reaction Test (PCR) [Bawku 1, Pusiga 1 and Nadowli-Kaleo-6] [Figure 9]. The remaining two were Gram stain positive. Table 7: Meningitis cases confirmed, Ghana, Week 4, 219 Districts CSF CSF positive Deaths Causative Organism Bawku Streptococcus pneumoniae Pusiga Streptococcus pneumoniae Lawra Gram positive diplococci Nadowli-Kaleo Streptococcus pneumoniae Jaman North Gram positive diplococci Figure 2: Chart showing Meningitis threshold profile of selected districts in Ghana, Week 1-4, 219 District Week 1 Week 2 Week 3 Week 4 Banda 1 Nadowli-Kaleo 6 Tatale-Sanguli 4 1 Nandom 1 Zabzugu 1 1 * Epidemic Alert None, Data presented represents number of confirmed cases. Districts in Meningitis Alert or Epidemic In week 4, only Nadowli-Kaleo crossed the epidemic threshold [Figure 2 & 7]. Lawra district on the other hand was in alert phase for the week under review [Figure 5]. Zabzugu was in epidemic phase in weeks 2 and 3 [Figure 2 & 4], however recorded only 1 confirmed case in each of the respective weeks. Banda district crossed the alert threshold in weeks 3 and 4 recording no confirmed case in both weeks [Figure 3]. Tatale-Sanguli was in epidemic phase in week 2 having recorded 4 confirmed cases of meningitis [Figure 2]. Nandom district crossed the epidemic and alert thresholds in weeks 3 and 4 respectively however did not record any confirmed case for both weeks [Figure 6] Figure 3: Meningitis threshold monitoring chart for Banda, Week 4, 218-4, Banda Alert Epidemic Zabzugu Alert Epidemic Figure 4: Meningitis threshold monitoring chart for Zabzugu, Week 4, 218-4, Lawra Alert Epidemic Figure 5: Meningitis threshold monitoring chart for Lawra, Week 4, 218-4, Nandom Alert Epidemic Figure 6: Meningitis threshold monitoring chart for Nandom, Week 4, 218-4, Nadowli-Kaleo Alert Epidemic Figure 7: Meningitis threshold monitoring chart for Nadowli-Kaleo, Week 4, 218-4, 219 Ghana Weekly Epidemiological Report Vol.4 Week 4 27 January 219 3

7 Figure 8: Districts in Alert or Epidemic phase for Meningitis, Week 4, 219 Figure 9: Distribution of PCR confirmed Meningitis pathogens Week 4, 219 RECOMMENDATIONS HEALTH WORKERS National Level, Regions, Districts and Health Facilities are required to: Update their preparedness and response plans and stockpile the necessary logistics, reagents and medication for managing meningitis Intensify surveillance on meningitis Enhance staff awareness on detection, notification, investigation, case management guidelines and public education Promote general public awareness on prevention, signs and symptoms, and reporting to the nearest health facility upon suspicion of meningitis. GENERAL POPULATION Avoid overcrowding (particularly avoid infected persons sneezing, coughing) Drink lots of water Improved ventilation (opening of windows in your rooms) Report to the nearest health facility if you have fever or headache with neck pain 4

8 ANNEX 1: SUMMARY OF REPORTED CASES/ EVENTS: WEEK 4 (WEEK ENDING 27 JANUARY 219) Disease/Health Event (suspected/confirmed) Week 3 Week 4 Cumulative to Week 4 Deaths CFR Deaths CFR Deaths (susp) (%) (susp) (%) (susp) AFP (suspected polio) Acute haemorrhagic fever syndrome Adverse events following immunization Anthrax Acute watery diarrhoea in persons aged >5 years ,872 Cholera Dengue fever Diarrhoea with blood Dracunculiasis (Guinea worm) Influenza-like illness ,554 Maternal deaths Measles Meningitis Neonatal tetanus Plague Public health event of international concern (PHEIC) Human rabies SARS Smallpox Yellow fever (suspected) NATIONAL TOTAL , , *CFR does not include maternal deaths CFR (%) This report and subsequent ones should be shared with regional and district heads as well as heads of other agencies. A feedback addressed to the Editor-In-Chief is welcome 5

9 Editorial Board Dr. Anthony Nsiah-Asare Dr. Badu Sarkodie Dr. Michael Adjabeng Dr. Emmanuel Kofi Dzotsi Dr. Kwame Amponsa-Achiano Dr. David Opare Dr. Franklin Asiedu-Bekoe Mr. Kwame Kodom Achempem Mr. Isaac Baffoe-Nyarko Prof. Kwadwo Koram Dr. Ivy Frances Osei Dr. Ernest Kenu Dr. Phyllis Antwi Ms. Selina Ababio Dr. Dennis Laryea Dr. Sally-Ann Ohene Dr. Chastity Walker Editorial Team Editor Mr. Gideon Kwarteng Acheampong Managing Editor Mr. Kwame Acheampong Owusu Editor-In-Chief Dr. Kenneth Ofosu-Barko 6