جمهىری اسالمی افغانستان وزارت صحت عامه ریاست عمىمی ارزیابی و معلىمات صحی

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1 Islamic Republic f Afghanistan Ministry f Public Health Evaluatin & Health Infrmatin Summary: DISEASE EARLY WARNING SYSTEM -Plus (DEWS-Plus) Weekly Epidemilgical Reprt 51 Out f 503 functinal DEWS plus sentinel sites, 500 (99.4%) have submitted reprts this week. Out f a ttal f 402,014 new cnsultatins (172,692 male, 229,322 female) this week, 39% r 156,799 (75,407 male, 81,392 female) cnsultatins were reprted due t DEWS targeted diseases. Main causes f cnsultatins in this week were Pneumnia, 22,662 cases (5.6% ut f ttal new cnsultatins) and Diarrheal Diseases, 24,448 cases (6.1% ut f ttal new cnsultatins). A ttal f 265 deaths were reprted this week, f which 81 were due t DEWS targeted diseases, which includes 58 Pneumnia deaths, 13 Meningitis/SIC deaths and 8 Diarrheal Diseases deaths and 2 viral hepatitis deaths. Ttal f 3 utbreaks reprted this week; f which 1 was suspected Pertussis utbreak reprted frm Ghr prvince, 1 suspected Scabies utbreak reprted frm Kuner prvince and 1 was CCHF utbreak reprted frm Kabul prvince. Figure1: Surveillance/DEWS-Plus Sentinel Sites with GPS lcatin by type f Health Facility د افغانستان اسالمی جمهىریت د عامه روغتیا وزارت د ارزونی او روغتیائی معلىماتى لىی ریاست جمهىری اسالمی افغانستان وزارت صحت عامه ریاست عمىمی ارزیابی و معلىمات صحی Dec 2015 Table 1: Cverage f DEWS-Plus Surveillance System Type f Health Facility Ttal Health Facilities (HF) HF cvered by DEWS-Plus RH/PH DH CHC/BHC Plyclinic Private Hspital Special Hspital Ttal , ,

2 Disease Number f cases Disease % ut f ttal cnsultatins Indicatr based Surveillance: The Indicatr-based surveillance cmpnent f DEWS-plus reprts n weekly bases n 15 pririty infectius diseases frm sentinel sites. The data is cmpared with previus weeks and crrespnding week f previus years and the alert and epidemic threshld is checked t see if disease incidence has crssed these levels and necessary actin is initiated. Figure 2: DEWS targeted diseases Percentage f Diseases ut f ttal cnsultatin during week 51 Pneum nia with Dehydrat in Bldy Diarrhea Meningit is Viral Hepatitis Measles Nenatal Tetanus < 5 years 5 years Malaria Typhid Fever < 5 years years Number f cases f diseases during week < 5 years 5 years Pneum nia with Dehydra tin Bldy Diarrhe a Meningi tis Viral Hepatiti s Measles Nenat al Tetanus Malaria Typhid Fever < 5 years years

3 Percentage Precentage Percentage Percentage Vaccine Preventable Diseases (VPDs): Table 2: Cases and deaths due t VPDs by age grup during week 51, 2015 Diseases Cases Deaths <5 years 5 years Ttal <5 years 5 years Ttal CFR/100 Measles Pertussis Diphtheria Nenatal tetanus Tetanus Seasnal Diseases: Trend f Pneumnia percentage ut f ttal cnsultatin in recent weeks-2015 Current situatin Trend f with severe dehydratin percentage ut f ttal cnsultatin in recent weeks-2015 Current situatin Average f 3 years data ( ) Average f 3 years data ( ) Trend f Measles percentage ut f ttal cnsultatin in recent weeks Current situatin Average f 3 years data ( ) Trend f Malaria percentage ut f ttal cnsultatin in recent weeks Current situatin Average f 3 years data ( )

4 Event-Based Surveillance: During week 51 a ttal f 3utbreaks detected, investigated and respnded t by DEWS-plus. The details are as belw: 1. CCHF Outbreaks 1.1 CCHF Outbreak: Suspected CCHF case was reprted by DEWS FP in Infectius Diseases hspital n 24 th December The case is resident f Khair Khana area f Kabul district, Kabul prvince. The case is having cntact with the animals. Investigatin team cllected bld specimen and send it t CPHL fr lab cnfirmatin (the result is nt yet received frm lab and is pending). Treatment was started and health educatin sessin was cnducted t the patient and the family members. 2. Suspected Scabies Outbreaks 2.1 Scabies utbreak was reprted frm Jawaherul Quran Madrasa f Sawkai district, Kunar prvince n 20 th December The team investigated the area, during the investigatin there were 84 cases (all cases in age grup ver five). The patients were treated and health educatin sessin cnducted in affected area. The active surveillance has been established fr investigatin f further cases. 3. Pertussis Outbreaks 3.1 Suspected Pertussis utbreak was reprted n 19 th December 2015 frm Parjmlan village f Taywarah district, Herat prvince with 22 suspected cases (11 cases in age grup under five and 11 cases in age grup ver five). The investigatin team visited the area and cllected 3 bld specimens and sends it t CPHL fr lab cnfirmatin. The vaccinatin cverage f the area was lw%. Active surveillance has been established fr detectin and investigatin f further cases. Health. Figure 3: Outbreaks investigated during the week 51,

5 Table 2: Updates n the utbreaks reprted during 2015 (01 Jan t 26 December) Disease/event N. f utbreaks N. f lab cnfd. Outbreaks N. f cases N. f deaths Measles CCHF Pertussis Suspected Rabies/dg bites Mass psychgenic illness Mumps Scabies Viral Hepatitis Fd pisning Chickenpx Pneumnia Cnjunctivitis Watery Diarrhea Malaria Chlera Anthrax Leishmaniasis Ttal Labratry surveillance: In this week a ttal f 95 different specimens/samples were received by CPHL, all specimens are under the prcess. (Fllw-up by CPHL). Recmmendatins: High number f cases (abve alert threshld) and deaths due t Pneumnia in the age grup less than 5 years (10.7 % Pneumnia cases amng ttal cnsultatins and 58 deaths) is a cause f cncern. This shuld be analyzed and discussed at prvincial level amng stakehlders t find ut the reasns fr high mrbidity and mrtality and take apprpriate actins. The increase in the malaria cases (as cmpared t the average f last three years) and its utbreaks shuld be given cnsideratin at the central and field levels. The increase in the cases and deaths due t CCHF shuld be taken by the cncerned departments at varius levels. Early reprting and hspitalizatin f CCHF cases, IEC and strng crdinatin 5

6 with animal health department and actins t be taken by them t cntrl the ticks n the animals.( CDC department f MPH shuld implement the cntrl measures in human) 6