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3A7b666d3616ccc5492576df DISEASES EARLY WARNING SYSTEM th February 22, 2010 WEEKLY MORBIDITY & MORTALITY REPORT 4 Year , Issue –07 Flu Updates: The following Activities have been done Epid Week 07, 2010 HIGHLIGHTS - So far we have 953 confirmed cases of AH1N1 in the country. ¾ Out of 182 Sentinel sites, 182 sentinel sites have sent their -The total number of deaths reported till now is 17. reports in Week-07 of 2010; 22 treatment sites activated in Kabul province and all provincial and regional ¾ Out of total 169,766 events recorded in week-07 of 2010, hospitals have facilities for treatment and sample collection, the tamiflu and PPEs distributed to all provinces. 53,311(31.4%) consultations were reported due to DEWS target diseases. The positive cases reported from the below provinces: Kabul,Balkh,Hirat,Kandahar,Nangarhar,Bamyan,Hilmand,Takhar, ¾ Main causes of consultations this week are ARI (26.5%) and Panjsher,Baghlan,,Ghazni,Parwan,Kundoz,Badakhshan,Faryab,Ghor, ADD (3.9%) from total clients in a continuing trend from Badghis,Jawzjan,Nooristan,Konar, Daikundi, Samangan the week before. - CCC (command and control center) is functional ¾ 80 death cases caused due to Pneumonia, Meningitis/SIC - Three telephone hotlines are open to help people, 0798644004 and Diarrheal diseases, so that 67 cases due to 0798665085 – 0798660829 - Intensive surveillance to detect A H1N1 in the country is functional; daily pneumonia/ARI, 1 death cases due to diarrheal diseases and 12 deaths cases reported due to Meningitis and Severely reports are allocated, compiled and shared with all stakeholders. - 177 sentinel sites are functional in the country and reporting on the Ill Children. weekly basis Reported/Investigated Outbreaks in this Week: - All rapid response teams are on alert to investigate /detect the A H1N1 cases throughout the country Sus. Disease District/province in which OB took place in - About 1196 Health Care workers have been trained concerning the AI Outbreaks (OB) this week H5N1 and A H1N1 case management during the fourth quarter of 2009. Measles OB In Zormat district of Paktia, In Gurboz district of - All the needed data regarding training of AH5N1 and AH1N1 collected, Khost, in Panjab/Waras districts of Bamyan, in analyzed and compiled as country wise by training Coordinator of AI Rodat district of Nangarhar and in Alishing district project. of Laghman province. Reports received from reporting Sites: As of February 19, 2010, 182 sentinel sites were functioning in eight epidemiological regions, in 34 provinces of Afghanistan. In the reporting week, all sentinel sites have sent their reports on new cases of DEWS target diseases that were recorded during the reporting period (Week-07 of 2010 or 13th to 19th February 2010). Out of all events recorded in DEWS sentinel sites, 15 target diseases (priority diseases) are being included in weekly reports. The status of reports in the reporting week has been indicated in the table below: Table-1: Status of Reports Received from DEWS Regions During Epidemiological week-07, 2010 Kabul Bamya Balkh Badakhsha Herat Kandah Nangarh Pakt Total n n ar ar ia No. of Expected Reports from Sentinel Sites 36 19 23 19 22 20 22 21 182 No. of Reports 36 19 23 18 22 20 22 21 182(100%) Received in this week DEWS Sentinel Sites: The Epidemiological map indicates the DEWS sentinel sites, already established in the relevant regions/ provinces till February 19, 2010 by type of health facilities, from which data on 15 DEWS target diseases are being collected. The symbols on the map showing the number of sentinel sites in each region/province and not the GPS of the locations. Table-2: DEWS Epidemiological Regions and types of Sentinel Sites in Week 07 of 2010 Type of Kabul Bamyan Balkh Badak Herat Kand Nanha Pakti Total DEWS Data at a Glance W7: SS h ar r a Dis/Cases <5 5+ Tot CHC 9 11 9 8 12 12 14 13 88 C&C 16115 20459 36574 DH 11 4 9 7 5 3 5 4 48 Pneumonia 6296 2264 8560 Pn(Deaths) 64 3 67 PH/RH/ 14 4 5 4 4 5 3 4 43 Tot Clients 49150 120616 169766 NH DEWS 26544 26767 53311 Poly 2 0 0 0 1 0 0 0 3 Diseases Clinic Total 36 19 23 19 22 20 22 21 182 DEWS Data in Epidemiological Week No.07 of 2010 Out of total, 169,766 clients recorded in week-07 of 2010, 21.5% (36564) of consultations were reported due to cough and cold and 5.5% (8560) of consultations was reported due to pneumonia. In the same week, 3.9% or 6582 events were reported due to diarrheal Illnesses (2.5% due to Acute Watery Diarrhea, 1.2% due to Bloody Diarrhea and 0.2% due to acute watery diarrhea with dehydration). In comparison with previous week (W06) of 2010, the percentage of ARI diseases has increased slightly from 26.0 to 26.5%, whereas the percentages of Acute Diarrheal diseases decreased from 4.1% to 3.9%.The percentages of total cases of DEWS target diseases reported by all regions in week-07 of 2010 makes 31.4% of total clients. The chart above shows the events of DEWS target diseases as percentages of total clients, by age groups in Week-07 of 2010. Percentage of ARI Morbidities from all consultations during last 11 weeks In the epidemiological week-07 (13th to 19th February 2010), a total of 45,134 events of ARI were reported. 32.8% of total clients less than 5 years of age were cough & Cold patients and 17.0% among the age group 5 years and over. The percentage of Table-3: Percentages of ARI Diseases during 11 recent weeks by age groups and by weeks Disease Age Week Week Week Week Week Week Week Week Week Week Week 49-09 50-09 51-09 52-09 01-2010 02-2010 03-10 04-10 05-10 06-10 07-10 (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) ARI- C&C <5 Yr. 31.9 33.4 34.1 32.2 33.0 38.4 31.1 32.8 32.0 30.6 32.8 5+ 15.6 14.8 18.2 17.1 17.2 17.4 16.3 15.8 16.0 16.5 17.0 ARI-Pneumonia <5 Yr. 9.1 9.4 9.1 9.0 9.6 10.2 9.8 11.0 10.9 13.3 12.8 >=5 Yr 1.7 1.7 1.9 2.0 1.8 1.9 1.7 1.7 1.8 2.0 1.9 C&C (<5 years) consultations in week-49 of 2009 in comparison with the percentage of C&C in week-7 of 2010, increased by 0.9%, whereas in case of 5 years and above increased by 1.4% in last 11weeks. The trend of ARI diseases in last 11 weeks can be read in table-3. The percentages of consultations on Pneumonia cases of age group less than 5 years increased by 3.7% in last 11 weeks, whereas the percentage of age group 5 years and over increased by 0.2% in last 11 weeks. In the reporting week, the highest percentage of ARI-C&C has been recorded in Badghis and Parwan provinces with 32% and 31% respectively, whereas the lowest percentages of ARI-C&C has been recorded in Urozgzn and Nimroz provinces with 14% each of total clients. The highest percentages of pneumonia have been recorded in Jawzjan province with 12%, whereas the lowest percentage of pneumonia has been recorded in Urozgan province with 1.1%. Among the DEWS regions Bamyan region recorded the highest percentage of ARI with30.3%, whereas Kandahar region recorded the lowest %( 22) of ARI in W07 of 2010. Percentage of Diarrheal Diseases by weeks and by Age Groups The table-4 below shows the percentages of diarrheal diseases (Acute watery Diarrhea, Bloody Diarrhea and Acute watery diarrhea with dehydration) from week-49 of 2009 to week-07 of 2010 from the total clients. Acute watery diarrhea among children less than five years, decreased from 7.4% in week-49 of 2009 to 5.2% in week-07 of 2010, whereas acute watery diarrhea among age group 5 years and above remains almost the same from week-49 of 2009 to week-07 of 2010 by 1.4% (Please refer to Table #4, below). Bloody diarrhea, in age group less than 5 years decreased from 1.9% in week-49 to 1.7 % in week-07 of 2010, whereas in age group 5 years and above increased slightly from 0.7% in week 49 of 2009 to 1% in week-07 of 2010. Acute watery diarrhea with dehydration among age group less than five years has remained the same in last 11 weeks by 0.5%, whereas the percentages of age group greater and equal 5 years decreased by 0.1 % in the same period. Tabl-4: Percentages of Diarrheal Diseases from Total Clients during 11 recent weeks by age groups. Disease Age Week Week Week Week Week Week Week Week Week Week Week 49-09 50-09 51-09 52-09 01-10 02-10 03-10 04-10 05-10 06-10 07-10 (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) Acute Watery <5 Years 7.4 6.9 7.6 6.4 6.3 6.0 5.6 6.2 5.6 5.8 5.2 Diarrhea >= 5 Years 1.4 1.2 1.5 1.5 1.4 1.4 1.2 1.3 1.2 1.4 1.4 Bloody Diarrhea <5 Years 1.9 2.1 1.7 2.0 1.8 1.7 1.6 1.6 1.7 1.7 1.7 >=5 Years .7 0.7 0.9 0.9 .9 0.8 0.9 0.8 0.9 1.0 1.0 Acute W.
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