Weekly Morbidity and Mortality Report. Week 04 (17-23 Jan), NWFP/FATA, Pakistan

Transcription

1 Weekly Morbidity and Mortality Report Week 4 (17-23 Jan), 9 NWFP/FATA, Pakistan

2 DEWS Reporting Units and Consultations: During week 4, 9 total 13 weekly reports were received from the five districts in NWFP. The five districts are hosting the internally displaced people from the conflict affected districts in FATA & NWFP and the flood affected population in district Peshawar as well. Total 27,963 consultations were reported in week 4, 9. Table 1 showing the weekly pattern of DEWS reporting and number of consultations reported in the last four weeks by districts. Table 1: Weekly DEWS reports and total consultations, last 4 weeks, NWFP/FATA, Pakistan Week - 1/9 (27 Dec 8 2 Jan, 9) Week - 2/9 (3-9 Jan, 9) Week - 3/9 (1 16 Jan, 9) Week - 4/9 (17 23 Jan, 9) District Reporting unit / Consultations Charrsada / / / / 2812 Mardan / / / 61 4 / 1141 Nowshehra 11 / / / 31 7 / 224 Peshawar 8 / / / / Total 139 / / / / DEWS reporting in the districts are initiated with primary focus on the IDPs living in the camps as well as with the hot families and the flood affected population of Peshawar. Weekly DEWS data is collected through the Health facilities in the IDP camps, mobile clinics in the areas where IDPs are living in clusters and the health facilities providing care for the IDPs living with the host community. However the weekly DEWS reports are collected / received from the other health facilities in the districts also. From 3, 8 to week 4, 9 total 768,638 consultation were reported and the number of weekly DEWS reporting and number of consultations remains fluctuating because of the security situation in the area (Fig1). Figure 1: Pattern of weekly DEWS reporting, and number of consultations NWFP. # of RUs RU's Cns. Weeky pattern of reporting units and consultations # of Cns W3/ W1/ Distribution of consultations by Diseases: In week 4, 9 total 27,963 patient consultations were reported from 13 reporting sites. Compared to the previous week the number of consultation has increased in week 4, 9. Acute Respiratory Tract Infections (ARI) are reported as the leading cause of consultations in all the reporting facilities and all districts accounting for (32%) 894 of all consultations 1

3 reported. Upper Respiratory Tract Infection was reported in (23%) 6363 and Lower Respiratory Tract Infection in (9%) 291 of the total consultations. Acute Diarrhoea reported in (%) 141, unexplained fever (8%) 2113, scabies (4%) 1241, suspected malaria () 39 and Bloody Diarrhoea () 31 of the total consultations. Other health events were reported for (48%) 132 of the consultations during the week. Two cases of suspected Dengue Haemorrhagic Fever were reported and laboratory investigation reports, of the blood samples of both the cases revealed negative results. During the week total 42 cases of Acute Jaundice Syndrome were reported from all the districts. In general the disease situation in week 4, 9 presents a usual picture reported from the area. No suspected cases of Measles and Meningitis were reported from any reporting site in all the districts during the week. Table 2 and Figure 2 present the distribution of consultations by common priority diseases. Table 2 and figure 2, depict the distribution of all consultations by disease. Diseases Consultations AD 141 AJS 42 - BD MAL SCB Total % SCB 4% Distribution of consultations by diseases AD % 23% BD 48% 9% MAL Distribution of Consultations by Age Groups and by Disease (fig 3): In children less than five years of age total 79 (%) consultations were reported. Upper Respiratory Tract Infection is the highest reported cause accounted for 32% of the total consultations, Lower Respiratory Tract Infection 16%, Acute Diarrhoea 1 and Bloody Diarrhoea 2%. In children below years age 3% consultations reported for other health events. In children to 1 years of age total 6189 (22%) consultations were reported. Upper Respiratory Tract Infection reported in 24% as the leading cause of consultations followed by lower respiratory tract infection 1, Acute Diarrhoea 6%, Bloody Diarrhoea, suspected malaria 2% and scabies 7% of consultations. Other health problems reported in % consultations in the age group. In 1-4 years age group, total 964 (34%) consultations were reported with Upper Respiratory Tract Infection as the leading cause of consultations sharing for 18% of consultations. Lower Respiratory Tract Infection reported in 7%, acute diarrhoea 3%, bloody diarrhoea, suspected malaria and scabies 4% and other health problems in 8% of total consultations in the age group. In adults 4 years and above age group total 691 (24%) consultations reported. Upper Respiratory Tract Infection accounted for 2 of consultations followed by Lower Respiratory 2

4 Tract Infections 6%, acute diarrhoea 3%, and scabies 4%, suspected malaria and other health problems reported in 8% of the consultations. Figure3.Proportion of primary causes for all reported cases by age groups, week 4, 9, NWFP/FATA, Pakistan 3% % SCB 3% AD 1 < yrs (n=,79) BD 2% MAL 32% 16% % SCB 7% AD BD MAL 6% 2% 1 24% - <1yrs (n=6,189) 8% BD SCBAD 4% 3% MAL 7% 18% 7% 1-44yrs (n=9,64) 8% SCB AD 4% 3% 6% 4yrs (n=6,91) 2 8% Acute Respiratory Infections and Diarrhoeas as leading seasonal Diseases: In week 4, 9 total 894 consultation of Acute Respiratory infections were reported which is accounting for 32% of the total reported consultations and is leading cause of consultation in all age groups. Acute Upper Respiratory Tract Infection was reported in 6363 (23%) while Lower Respiratory Tract Infection reported in 291 (9%) of the patient consultations reported during week 4, 9. As compared to the previous week the proportion of consultations for ARI dropped in week 4, 9 (Fig. 4). Acute Diarrhoea was reported in 141 (%) and Bloody Diarrhoea in 31 () of the patients attended during the week. As the total number of Patient consultation, has increased in week 4 9, similarly the number of consultations for AD & BD. But when compared with the proportion of consultations for Diarrhoeal Diseases in the previous week it remains almost the same. 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 4). Fig 4: Weekly trend of AD, BD, &, in NWFP/FATA, Pakistan Weekly trend of,, AD and BD, NWFP/FATA /8 1/ AD BD 3

5 Scabies: In week 4, 9, total 121 cases of scabies were reported from the DEWS implementing districts of NWFP; accounting for 4% of the total consultations during the week. The weekly proportion of consultations for Scabies remains fluctuating between 3% and % from week 41, 8 to week 4, 9 (fig ). Scabies outside the IDP camps is reported higher as compared to within the 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 /9 3 Epi-week Weekly situation of the common reportable diseases in the individual IDP camps NWFP: 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 and relevant sector when needed. The following paragraphs present a brief overview of the common diseases in the IDP camps. Kacha Garhi IDP camp, Peshawar: In week 4, 9, total 19 patient consultations were reported from the Kacha Gari IDP camp Peshawar. Upper Respiratory Tract Infection () was reported in 432 (22%) patients and is the leading cause of consultations in the camp. Acute Diarrhoea was reported as the second common cause of consultations and reported in 168 (9%) patients, lower respiratory tract infection reported in 6%, Scabies 3% and Bloody Diarrhoea, Unexplained Fever and suspected Malaria each reported for of the consultations. Other health problems were reported in 8% of the consultations in the camp. The patient consultations for ARI and Diarrhoeal Disease remained steady during the last two weeks (fig. No unusual health event was reported from Kacha Garhi IDP camp during week 3, 9. 4

6 Fig 6: The weekly trend of AD, BD, &, in the Kacha Gari IDP camp Peshawar, NWFP, Weekly trend of AD, BD, and, IDP Kacha Garhi camp, Peshaw ar / AD BD Palosa IDP camp, district Charrsada: During week 4, 9 total 784 patient consultations were reported from Palosa IDP camp Charsada. Acute Respiratory Tract Infections were reported in 337 (43%) consultations. Upper Respiratory Tract Infection in 37% and Lowe Respiratory Tract Infection in 6% patients reported in week 4, 9. Acute Diarrhoea reported in while Bloody Diarrhoea, Scabies and Unexplained Fever each reported in of consultations during the week. The weekly pattern of the most common diseases under surveillance, showing a consistent increase in Acute Upper Respiratory Tract Infection, while Lower Respiratory Tract Infection remained steady during the last 4 weeks. Acute Diarrhoea presents a gradually declining trend and Bloody Diarrhoea remained steady during the last 4 weeks. In general disease situation in the IDP camps remained stable Fig 7: The weekly trend of AD, BD, &, in the Palosa IDP camp district Charsada, NWFP Weekly trend of AD, BD, and, IDP camp Palosa, District Charrsda / AD BD Benazir complex IDP camp, Nowshehra: In week 4, 9 total 297 patient consultations were reported from Benazir complex IDP camp Resalpur district Nowshera. Acute Upper respiratory infection reported as the most common

7 reason of consultation and reported in 113 (38%) of the patients. Acute Diarrhoea Reported as the second common cause of consultation in 44 (1%) patients. Acute Lower Respiratory Tract Infection 2 %, suspected Malaria, Scabies and Unexplained Fever 3% each, reported in the week. Acute Diarrhoea in the IDP camp has increased during week 4, 9, and preventive measures are further enforced at the camp. Fig 8: The weekly trend of AD, BD, &, in the Benazir complex IDP camp district Nowshera, NWFP 6 Weekly trend of AD, BD, and, IDP camp Benazir complex, Nowshehra / AD BD IDP Jalozai camp Pabbi, Nowshera: The Jalozai IDP camp is still expanding continuously and new families in the Jalozai camp are being registered and the camp population is rapidly increasing day by day. The population at the Jalozai IDP camp has reached to 288 and people and is expected to exceed, by the next week. Further expansion in the Health care services in the camp are is in planning with the increasing population.during week 4 total 2194 patient consultations were reported at the camp. Acute Respiratory Tract Infection was reported in 63 (27%) of the consultations as the leading disease. Acute Diarrhoea reported in 271 (12%) and Scabies in 1 (2%) patients attended in the camp. The general disease situation in the camp remained stable. An outbreak of Mumps was encountered in the camp previous week is stable now and no new cases reported. Fig 9: The weekly trend of AD, BD, &, in the Jalozai IDP camp district Nowshera, NWFP 3 Weekly trend of AD, BD, and, IDP camp Jalozai, district Now shehra / AD BD 6

8 Alerts and outbreak: In week 4, 9, four alerts were received from the IDP hosting districts and responded accordingly as following: 1. A case of Acute Flaccid Paralysis (AFP) was reported from Nowshehra. The Polio team the field investigation of the case and stool sample taken and sent to NIH for further laboratory investigation/confirmation. 2. DHQ hospital, Charrsada reported one suspected case of Acute Flaccid Paralysis, Polio team investigate the case, collected stool sample and sent to NIH for further laboratory testing/confirmation. 3. Two suspected cases of dengue haemorrhagic fever reported from district Mardan. The cases were close relatives with a travel history to Karachi. Blood sample for one patient was reported for Dengue Fever antibody by a local Laboratory but NIH reported negative results for both the cases. 4. Mardan Medical Complex, Mardan reported an increasing number of Acute Jaundice cases. The Mardan Medical Complex is a referral facility and patients are being received from all over the district and from the adjacent districts therefore the clustering of patients could not be detected as yet. The hospital authorities have been requested to keep a line listing of all the AJS cases to identify any potential clustering of the reported cases. There was an outbreak of Mumps encountered at Jalozai IDP camp, Nowshehra last week. In collaboration with the health partners the outbreak was addressed and the situation is under control now and no new cases of Mumps reported. 7