Weekly Morbidity and Mortality Report (WMMR) IDP Hosting Districts, NWFP, Pakistan Week # 39 (19-25 Sept.), 2009

Transcription

1 Weekly Morbidity and Mortality Report (WMMR) IDP Hosting s, NWFP, Pakistan Week # 39 (19-25 Sept.), 29 Emergency Humanitarian Action (EHA) Islamabad, Pakistan A patient receiving care at the Health Facility in IDP Palosa, district Nowshera Highlights: During the Epidemiological week 39, 29, no new alerts/outbreak reported from any area of IDPs hosting and conflict affected districts, NWFP. During this week, 18 health facilities reported 35,279 patients consultations through the DEWS network Acute Diarrhoea reported in 2,596 (7%) of the total consultations in all age groups. Diarrhoea accounts for 15% of the consultations in the children below 5 years age and 5% of the consultations in the patients above 5 years age Acute Respiratory Infections (ARI) continues to be the leading cause of morbidity, with a total of 7,642 consultations (22% of total consultations) in the IDP hosting districts of NWFP. In children less than 5 years of age, ARI accounts for 2,6 (29%) of the total consultations in the age group. Fourteen DEWS sites reported 191 Ante Natal visits, 332 consultations for chronic non-communicable diseases and 62 injuries. The WMMR is published by the World Health Organization (WHO), Emergency Humanitarian Action (EHA) unit, National Park Road, Chak Shahzad, Islamabad, Pakistan. For More Information, please contact: Dr. Ahmed Farah Shadoul, Chief of Operations, EHA, WHO, Pakistan; Shadoula@pak.emro.who.int Dr. Fazal Qayyum, Director Health Services, Department of Health NWFP, Pakistan Dr. Musa Rahim Khan, Senior Public Health Officer (DEWS Coordinator), WHO, EHA, Pakistan; khanm@pak.emro.who.int

2 1. Alert and outbreak investigations and response: During the epidemiological week 39 (19 to 25 Sept. 29) no new alerts/outbreak reported from any area of IDP s hosting districts, and the conflict affected districts Swat and Buner in NWFP. 2. DEWS reporting units and consultations Table 1: Weekly number of reporting units and total consultations from health facilities in IDP camps and outside camp in IDP hosting districts of NWFP from week 36 to 39, 29 Week 36 Week 37 Week 38 Week 39 Consultations Consultations Consultations Consultations Buner 8-5, , ,477 Charsadda , , , ,76 Mardan , , , ,814 Nowshera 42 6,7 7, ,49 8, , ,837 - Peshawar 6 2,152 11, ,135 9,4 54 1,959 9, ,244 2,232 Swabi 24-3, , ,9 33-3,335 Swat , ,887 61, ,191 62, ,54 41,7 18 7,91 27,369 During the week 39 (19 to 25 Sept), 29, total 18 reporting sites shared the weekly DEWS reports on due time. A total of 35,279 patient consultations have been reported in this week reflecting a decrease in number of reports and number of consultations as compared to the previous week. The drop in the weekly consultations is due to Eid-ul-Fitr s holidays. Out of the total reported consultations, 19,15 (54%) patient visits were reported for females and 16,174 (46%) for male patients. During this week 7,217 (2%) of the total consultations were reported in children less than 5 years age. Fourteen DEWS sites reported 191 Ante Natal visits, 332 consultations for chronic non-communicable diseases and 62 injuries. A large number of IDPs from most of the camps have returned to their native places, as a result the number of weekly consultations in the IDP camps has dropped (table 2). Table 2: Weekly total consultations in IDP camps by district, from weeks 36 to 39, 29 IDP camp Consultations Week 36 Week 37 Week 38 Week 39 Buner Karapa Charsadda Palosa Mardan Jalala Nowshera Benazir Complex Jalozai 1, 2, 3, 4 6,563 6,775 7,514 5,69 Peshawar Kacha Garhi 1 & 2 2,152 2,135 1,959 1,

3 3. Morbidity pattern of the seven most common communicable diseases in the IDP hosting and two conflict affected districts of NWFP, during week 39 of 29: Figure 1: Pattern of the seven most common communicable diseases reported in the 5 IDP hosting districts, and Swat and Buner the conflict affected districts, in NWFP as number of consultations during week 39, 29 Number of consultations URTI LRTI AD UF SCB MAL BD Mardan Swabi Peshawar Nowshera Charsadda Buner Swat The number of consultations for the most common communicable diseases is compared to get an idea about the most common currently prevailing communicable diseases under surveillance in the IDP hosting and conflict affected districts of NWFP. During the epidemiological week 39 of 29; Upper Respiratory Tract Infection (URTI) was reported as the most common disease (19%) amongst all the consultations reported and was also the leading cause of morbidity in the IDP camps as well as outside the camps in all the 7 districts (Figure 1). Acute Diarrhoea (AD) was the second common disease (7%) in all the districts except Mardan where Unexplained Fever is the second common cause of consultation. Scabies (SCB) is the third common cause of consultation accounting for (5%) of visits with highest number of consultations in district Mardan and Swabi, Lower Respiratory tract Infection (3%) and Unexplained fever (5%) and. Suspected Malaria was reported in 1,11 (3%) of the cases of the total consultations and compared to the other IDP hosting districts Mardan, Swabi and Buner, reports more cases of suspected Malaria; Bloody Diarrhoea was reported in 273 (1%) patients with higher number of cases from district Mardan. As district Mardan is still hosting a large number of IDP populations with the host community therefore the number of consultations for all the reportable communicable diseases is high. 4. Morbidity pattern of the five most common communicable diseases by number of consultations in the IDP camps of NWFP during week 39 of 29 Figure 2: Pattern of five most common communicable diseases in the IDP camps NWFP, week 39, 29 Number of consultations URTI LRTI AD SCB MAL UF BD Jalozai -3 Jalozai -4 Jalozai -2 Jalozai -1 Jalala KG-II KG-I Palosa B.Complex

4 During week 39, health facilities in most of the IDP camps reported URTI as the leading cause and scabies as the second common cause of consultations. An increasing number of consultations for Scabies have been reported from the health facilities # 3 and 4 in Jalozai camp and the health facility in Jalala Intensive hygiene promotion and water and sanitation interventions are recommended in these camps for the prevention of these waterborne and water related diseases. Similarly, health posts 1 and 4 in the Jalozai IDP camp reporting more cases of suspected Malaria which also needs urgent attention. 5. Weekly Trends of the five most common communicable diseases in the IDP hosting districts NWFP: Figure 3: Weekly morbidity pattern of five most common reported communicable diseases by number of cases per 1 consultations in IDP hosting districts of NWFP from week 1 to week 39 of 29: Number of cases per 1 consultations URTI AD LRTI UF SCB The morbidity trend is proximally represented by the number of consultation of each disease as per 1 consultations during each week. Generally the upper respiratory tract infection (URTI) is the leading cause of consultation throughout the period. In week 39 Acute URTI dropped slightly after having a steadily increasing trend during the last 5 weeks. With a slight weekly fluctuation the overall consultations for Acute Diarrhoea (AD) and LRTI remained steady during the recent weeks. The rest of the commonly reported communicable diseases (unexplained fever and scabies) are also showing a steady trend with a little weekly fluctuation. 6. Weekly morbidity pattern of Acute Diarrhea and LRTI among <5yrs population of IDP hosting districts of NWFP from week 1 to week 39 of 29 Figure 4: Weekly morbidity pattern of Acute Diarrhea and LRTI among <5yrs population as per 1 consultations in the age group, in the IDP hosting districts of NWFP from week 1 to week 39 (1 st January to 25 th September) 29 Number of cases per 1 consultations AD <5 LRTI <5

5 Acute Diarrhea (AD) and Lower Respiratory Tract Infections (LRTI) are the known most common cause of morbidity and leading causes of death among children less than five years age. During week 39, a total of 7,217 consultations reported in the children Under Five years age, out of those, 1,76 (15%) consultations were for Acute Diarrhea and 29 (4%) for LRTI. When the weekly trends of both the diseases were analyzed among children under five years age, as per 1 consultations in the age group; consultations for AD is shows a weekly fluctuation with a declining trend while LRTI reflecting a more steady trend in the recent weeks in children under 5 years age (fig 4). 7. Number of reporting/non-reporting Health Facilities by type and department (Week 38, 29): During the Epidemiological week 39, 29, 18 (51%) of all the assigned DEWS reporting sites reported to the system, reflecting a decrease in the weekly reporting units as compared to the previous week. Due to certain administrative matters the weekly reporting from the IDP hosting districts especially district Nowshera has dropped during the last couple of weeks. DEWS reports from two conflict affected districts Swat and Buner are being received through the health partners who have started services in the district. Training of Health care providers of the health cluster partners have been conducted in both the districts. Training of DoH Health Care providers on DEWS has been planned and the surveillance network will be expanded soon. Table 5: DEWS reporting by type of facility, IDP hosting districts NWFP for week 39, 29 Number of DEWS Reporting Health Department Health Facility Implemented Health Percentage Facilities Facilities PPHI BHU % RHC % DHQ % Dept. Of Health THQ 1 % IDP s % Mobile, CD and CH % % 8. Maternal health care and <5 year Children, Nutrition surveillance: Some of the DEWS sites where few indicators on maternal health care and <5 children nutrition surveillance were introduced have been closed now. The remaining fourteen DEWS sites reported 191 Ante Natal visits, 332 consultations for chronic non-communicable diseases and 62 injuries. The information on Maternal Health Care and <5 children nutrition surveillance by each district during week 39, 29 is presented in table 6. Table 6: No of Pregnant women received Antenatal Care Pregnancy and delivery related Referrals Moderate Acute Malnutrition in children <5 Buner Charsadda Mardan Nowshera Peshawar Swabi Swat