Emergency and Humanitarian Action (EHA),

Weekly Activity Report

Week 41 th th 5 ‐12 October 2008 I. General Situation a. Political, Social and Security ƒ The security situation in northern Uganda remains stable despite the stalled peace negotiations while in Karamoja the situation is precarious ƒ Ongoing population movements from IDP camps back to villages of origin; in Lango sub‐region all IDPs have returned while in Acholi only 9% of the original IDPs have returned

b. Main Events of Interest/Concern for Health ƒ Ongoing epidemic outbreaks of Hepatitis E in Kitgum

II. Analysis and Health Consequences (Health Problems and Needs of Affected Highlights Population)

ƒ Ongoing response to Disease Trend hepatitis E outbreak in Malaria: Sharp decrease in the number of cases of malaria reported in week 41 in all Acholi sub‐region ƒ 2009 CHAP CAP regions (Acholi, Lango and Karamoja) under survey (see figure I) Finalized Cholera: No cases reported during the week ƒ Planning for modified Measles: One clinical case of measles reported from of Lango sub‐region, mortality survey blood samples have been sent for laboratory confirmation commenced Meningitis: Zero report during the week ƒ Support provided to draft Uganda Annual Hepatitis E: The epidemic outbreak of Hepatitis E is gradually being contained in all Health Sector districts. To date the cumulative number of cases registered in all districts is 8,690 with Performance Report 136 deaths (CFR 1.586%). See table I for details. which is the epi‐centre of 2007/08 the epidemic continues to register declining number of cases of Hepatitis E. In epi‐week 41, 64 new cases of Hep E were registered down from 93 new cases registered in epi‐week 40 reflecting a 32% reduction in the number of cases. As of 12th October 2008 the cumulative number of cases registered in Kitgum district was 8,617 with 127deaths (CFR 1.5%). Sub counties that registered most cases were Layamo, Agoro, Padibe and Kitgum Town Council.

In one new case of HEV was reported. (see table I for details of HEV)

Table I: New Hepatitis E Cases by District in Week 41 District New cases New Cumulative Cumulative

deaths Cases deaths (Case

Fatality Rate CFR) Kitgum 64 1 8,617 127 (1.5%) Gulu & 0 0 15 (8 2 (11.7%)

Amuru confirmed)

Pader 1 0 55 cases (7 7(12.7%) confirmed) Lango 0 0 3 0

Total 65 1 8,690 136 (1.56%)

Acknowledgements

Production of this weekly activity report has been made possible by contributions from the following partners:

WHO/HAC National Professional Officer handing over a desktop computer to the District Health Officer of District

Training of Trainers for Village Health Team (VHT) Roll out in

Karamoja Region

III. Actions a. WHO Response

Epidemic Response (Sida) ƒ Provided ongoing technical support to district health teasm to coordinate, supervise, monitor and evaluate the hepatitis E epidemic response in Acholi sub‐region ƒ Provided additional health workers for case management, social mobilization and hygiene education in Kitgum district ƒ Ongoing support to active data collection, analysis and dissemination

Flood Risk and Vulnerability Reduction Project in Teso and Mount Elgon Regions (Italian Grant) ƒ Twenty four (24) newly recruited health workers trained in Emergency Preparedness and Response (EPR) and Integrated Disease Surveillance and Response in ƒ Sensitization of sub‐county local authorities and selection of Village Health Teams (VHTs) to be trained conducted in Buwagogo sub‐county of district ƒ Refresher training conducted for 85 previously trained VHTs in ƒ A desktop computer with accessories (printer and UPS power back‐up) delivered to Bukwo district to strengthen IDSR data analysis and dissemination

Emergency Health and Nutrition Response in Karamoja (CERF) ƒ Two professional officers deployed to support the District Health Officers of Kotido, Abim and Kaboong districts to implement project ƒ Assessment of 5 health facilities to be rehabilitated under this grant finalized and Bills of Quantities (BOQ) developed ƒ Technical and financial support provided to strengthen IDSR in all districts ƒ Training of trainers for VHT roll‐out ongoing ƒ Technical and financial support provided to to conduct outreaches to return and resettlement sites in the district

Others ƒ Finalized the health, nutrition and HIV/AIDS component of the 2009 CHAP and CAP ƒ Commenced plan for a mini Demographic and Household Survey (DHS) to evaluate the emergency health response in the IDP camps and to provide baseline data for monitoring the health recovery activites ƒ Participated in the drafting of the emergency section of the Annual Health Sector Performance Report for 2007/08

b. Cluster Partner’s Response ƒ Other cluster partners like UNICEF, AVSI, AMREF, IRC, OXFAM, URCS and MSF are also supporting the HEV epidemic response activities in the areas of community mobilization and sensitization, latrine construction, water chlorination and cases management.

IV. Comments and Conclusions ƒ IDSR reporting in all districts was above 80%. The epidemic outbreak of Hepatitis E in the Acholi sub‐region still persists though the number of new cases are on the downward trend V. Plan for Coming Week ƒ Continue supporting the hepatitis E epidemic response in Acholi sub‐region ƒ Complete training of VHTs in Teso and Mount Elgon sub‐regions ƒ Commence training of VHTs in Karamoja

For further information, please contact:

Dr. Joaquim Saweka, WHO Representative Uganda: Tel. +256 41 335500, Mobile +256 752 728 257, Email: [email protected]