DEWS-WER-22-2012.Pdf (English)
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th June 4, 2012 DISEASES EARLY WARNING SYSTEM WER-22 (6P PYr) DEWS WEEKLY EPIDEMIOLOGICAL REPORT SUMMARY: th st This report includes surveillance data from 26 May to 1 June 2012. Out of 305 functional Sentinel sites(SS), 303 (99) have sent their reports in Week-22 of 2012; Out of total 302,409 Consultations recorded in week-22 of 2012, 98,290 (32.5%) consultations were reported due to DEWS target diseases. Main causes of consultations this week are Acute Respiratory Infections/ARI (18.1%) and Acute Diarrheal Diseases/ADD (12.9%) from total clients in a continuing trend from the week before. 47 deaths caused due to Pneumonia, Diarrheal diseases and Meningitis/Severely ill children, so that 25 deaths due to pneumonia, 8 deaths due to diarrheal diseases and 14 deaths reported due to Meningitis and Severely Ill Children. In this reporting week, seven Measles outbreaks reported and investigated in Paktya, Oruzgan and Ghor provinces. Two suspected Poisoning in Logar and Takhar provinces, one ertussis, one Scabies and one CCHF outbreaks have been reported and investigated in Hirat province. REPORTSU RECEIVED FROM REPORTING SITES: st As of June 1P ,P 2012, 305 sentinel sites were functioning in eight epidemiological regions, in 34 provinces of Afghanistan . In this reporting week, 303 sentinel sites have sent their reports on new cases of DEWS target diseases , recorded during the reporting. Out of all events recorded in DEWS sentinel sites, 15 target diseases (priority diseases) are included in DEWS weekly epidemiological reports. TableU -1:U Status of Reports Received from DEWS Regions during Epidemiological week-22, 2012 Central Central East Central West North North East West South East South East Total No. of Expected Reports from 53 30 48 36 34 38 36 30 305 Sentinel Sites No. of Reports Received in this 53 30 48 36 34 36* 36 30 303 week • In this week two reports from South Region did not receive. Page 1 of 9 DEWS Sentinel Sites: Table-2 DEWS Epidemiological Regions and types of Sentinel Sites in Figure-1(Map) shows the Week-22, 2012 distribution of DEWS sentinel sites, already established in the Type of relevant regions/provinces by June SS Centr al East Centr al North North East West South East South East Total 1st, 2012 by type of health 25 19 33 25 20 29 26 22 199 facilities. Data on 15 DEWS target CHC/BHC diseases are being collected from DH 12 7 10 7 9 4 7 4 60 these sentinel sites (SS).The PH/RH/SH 14 4 5 4 4 5 3 4 43 symbols on the map show the Poly Clinic 2 0 0 0 1 0 0 0 3 number of sentinel sites in each Total 53 30 48 36 34 38 36 30 305 CHC=Comprehensive Health Center, DH=District hospital, PH=provincial region/province, and do not hospital, RH= Regional hospital, SH= specialized hospital indicating the GPS of the SS locations. Fig-2: Percentages of DEWS Target Diseases DEWS Data in Epidemiological Week-22 of 2012 25.0% by age Group in W22 of 2012 Out of total 302,409 clients recorded in week-22 of 2012, 20.0% 15.5% (46785) of consultations were reported due to be cough 15.0% and cold and 2.6% (7908) of consultations were reported due 10.0% to pneumonia. In the same reporting period, 12.9% or 38,899 5.0% events were reported due to diarrheal illnesses (9.5% due to 0.0% ARI ARI AwD Men/ AVHe Meas Malar Typh Acute Watery Diarrhea, 2.2% due to Bloody Diarrhea and AwD BD 1.1% due to acute watery diarrhea with dehydration). In C&C Pn w SIC p le ia Fev comparison with previous week (W21 of 2012) the percentage U5% 22.6% 5.9% 19.2% 3.5% 2.4% 0.1% 0.0% 0.3% 0.6% 0.4% of ARI diseases has decreased by 1.4% to 18.1%, whereas the O5% 12.4% 1.2% 5.4% 1.6% 0.6% 0.0% 0.1% 0.0% 0.6% 0.8% percentage of Acute Diarrheal diseases increased by 1.5% to Tot% 15.5% 2.6% 9.5% 2.2% 1.1% 0.1% 0.1% 0.1% 0.6% 0.7% 12.9%.This variation can be due to changes in temperature /weather during the reporting week. Figure-2 above shows the percentages of DEWS target diseases by age groups in week-22 of 2012. Page 2 of 9 Percentage of ARI by weeks and by Age Groups In the epidemiological week-22, a total of 54,693 events of ARI were reported. 22.6 % of total clients less than 5 years of age were cough & Cold patients and 12.4% among the age group 5 years and over. The percentage of C&C (<5 years) Table-4: 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 12-12 13-12 14-12 15-12 16-12 17-12 18-12 19-12 20-12 21-12 22-12 (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) ARI- C&C <5 Yr. 29.1 30.3 28.3 27.1 27.6 27.8 25.6 25.0 25.4 24.7 22.6 5+ 17.2 16.3 14.6 15.0 14.3 14.6 14.5 13.8 13.3 13.3 12.4 ARI- <5 Yr. 9.7 9.2 9.0 8.6 8.0 7.5 6.7 6.6 6.1 6.4 5.9 Pneumonia >=5 Yr 2.1 1.9 1.8 1.7 1.4 1.5 1.4 1.3 1.4 1.4 1.2 consultations in week-12, in comparison with the percentage of C&C in week-22 of 2012, decreased by 6.5%, whereas in case of 5 years and above decreased by 4.8% to12.4% in this reporting week. The trend of ARI diseases in last 11 weeks can be read in table-4. The percentages of consultations on Pneumonia cases of age group less than 5 years decreased by 3.8% in last 11 weeks, whereas the percentage of age group 5 years and over decreased by 0.9% to 1.2% in last 11 weeks. In the reporting week-22 of 2012, the highest percentage of Cough & Cold has been recorded in Logar and Kapisa provinces with 31% and 26% respectively, whereas the lowest percentages of C&C were reported from Farah and Zabul provinces with 7 % and 9% respectively. The highest percentages of Pneumonia reported from Sar-i- Pul and Jawzjan provinces with 10% and 7% respectively, whereas the lowest percentage of Pneumonia was recorded in Zabul province with less than1%. (Fig-3) 40% Percentages of ARI from Total Clients in week-22 of 2012 35% 30% 25% 20% 15% 10% 5% 0% BA DA GH JO KA KH LO NA SA WA BD GH PA NI UR KN NU BDS BAL FYB HEL HER KDZ PKA PIA PAR SAR TAK ZAB KAB BGL FRA KAP LAG M Y A W N O G N M R G O N M U R R Pneumonia 3% 4% 4% 2% 3% 1% 2% 1% 7% 1% 1% 2% 2% 2% 2% 2% 1% 4% 10% 3% 4% 0% 3% 5% 1% 1% 2% 3% 2% 1% 1% 2% 3% 4% Cough&Cold 13% 21% 17% 21% 20% 16% 12% 16% 15% 10% 17% 17% 31% 16% 12% 17% 15% 17% 19% 12% 21% 9% 13% 17% 12% 7% 14% 26% 18% 9% 9% 19% 12% 20% Percentages of Diarrheal Diseases by weeks and by Age Groups The table-5 below shows the percentages of diarrheal diseases (Acute watery Diarrhea, Bloody Diarrhea and Acute watery Table-5: 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 12-12 13-12 14-12 15-12 16-12 17-12 18-12 19-12 20-12 21-12 22-12 (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) Acute Watery <5 Years 7.2 7.7 9.3 10.6 13.2 13.6 13.6 15.3 16.2 17.8 19.2 Diarrhea >= 5 Years 2.2 2.2 2.4 2.7 3.1 3.2 3.4 3.9 4.1 4.2 5.4 Bloody Diarrhea <5 Years 2.0 2.2 2.5 2.6 3.0 2.6 3 3.6 3.0 3.7 3.5 >=5 Years 1.1 1.1 1.1 1.2 1.3 1.2 1.3 1.9 1.5 1.6 1.6 Acute W. Diarrhea <5 Years 0.7 0.7 1.0 1.1 1.5 1.7 1.6 1.8 1.9 2.2 2.4 with Dehydration ≥5 Years 0.2 0.2 0.2 0.2 0.3 0.3 0.4 0.5 0.5 0.5 0.6 diarrhea with dehydration) from week-12 to week-22 of 2012, from total clients. Acute watery diarrhea among children less than five years has been increased from 7.2% in week-12 to 19.2% in the reporting week, whereas acute watery diarrhea among age group 5 years and above has increased by 3.2% to 5.4%.(Please refer to Table-5, above).Bloody diarrhea, in age group less than 5 years increased by 1.5% in last 11 weeks, Page 3 of 9 while in case of age group 5 years and above increased by 0.5% in the same period.