Emergency and Humanitarian Action (EHA),

Weekly Activity Report I. General Situation a. Political, Social and Security; • DRC; Joint incursion on LRA base in Garamba by the armed forces from DRC, Sudan Week 11, and Uganda has ended. 1st bunch of Uganda soldiers have returned to Uganda. Report indicates that the incursion has succeeded in reducing the strength of LRA by 80%. • 9th to 15th March Acholi and Lango sub-region; the region is calm; population movement from IDP to 2009 village of origin is ongoing. • Karamoja sub-regio; Cattle raids by armed Karamojong worriers reported. The region is in security phase III. b. Main Events of Interest/Concern for Health • Mop up mass Polio immunization campaign was successfully conducted in in epi-week 11 • Preparation for the first round of mass Polio immunization campaign is ongoing in 29 high risk districts in Uganda. II. Analysis and Health Consequences (Health Problems and Needs of Affected Population) Malaria: Lango; continues to report higher number of cases of clinical malaria in 2009 as compared to 2008. district reports lower numbers of clinical malaria in 2009 as compared to 2008. See figure I below for details.

Acholi, Kitgum and Pader districts continue to register low number of cases of clinical malaria in 2009 as compared to 2008. See figure II below.

Highlights

Polio immunization campaign was successfully conducted in Amuru district. Coverage of 150% was registered. Plans to conduct first round of Polio vaccination in 29 districts in Uganda from 23rd to 26th April is progressing well.

Karamoja sub-regions; The number of cases of clinical malaria reported and the trend in 2009 is similar to that of 2008 for the same epi-week.

Dysentery: Acholi sub-region; registered a declining trend in the number of cases of dysentery in the last four weeks. See figure IV below for details.

Acknowledgement

Production of this weekly activity report has been made possible by contribution from the followings

Lango sub-region; The trend of dysentery in 2009 is similar to that of 2008 Karamoja sub-region; 300 cases of dysentery was reported in epi-week 11 up from 294 cases reported in epi-week 10. The trend in 2009 is similar to that of 2008 and the numbers are also comparable.

Hepatitis E: Epidemic outbreak of Hepatitis E in Kitgum and continues unabated. In epi-week 11, 60 new cases of Hepatitis E were registered up from 52 new cases registered in epi-week 10 representing a 15.3% increase in the number of new cases registered on weekly basis. The cumulative number of cases of Hepatitis E registered to date is 9,831 with 155 deaths (CFR 1.5%). See table I below for details

Table I District New cases New deaths Cumulative cases Cumulative deaths

Kitgum 52 0 9,670 148 (1.5%)

Gulu & Amuru 0 0 18 (9 positive) 0 (0)

Pader 8 0 140 7 (5%)

Lango 0 0 3 0

Total 60 0 9,831 155(1.5%)

Sub counties that registered cases in Epi week 11 of 2009 in Kitgum district are; KTC 9, Lokung 8, Padibe W 6, Mucwini 5, Lagoro 4 and Namukora 3.

In Pader district 16 of the 19 sub-counties reported at least one case. The S/C reporting cases in epi-week 11 were Lapul 5, Acholibur 2 and Lapono 1. Four of the seven samples from Pader district which were taken to UVRI for confirmation are positive.

AFP; One suspected case was reported from district. To date 6 cases of Polio have been confirmed. Measles; No case reported in the week. Meningitis; No case reported in the week

III. Actions (WHO response, Sida grant)

Epidemic Response

Disease surveillance; • Surveillance activity heightened in all district because of the ongoing epidemic of Polio in Amuru district • Weekly epidemiological reports depicting disease trends have been shared with all the districts and partners.

Malaria; • Training of IRS monitors and evaluators complete in Lango sub-region AFP; • Stool samples from the suspect in was sent to UVRI for confirmation. Preparation for mass vaccination in Acholi, Lango and Karamoja sub-regions ongoing Hepatitis E; • Weekly task force meeting in Kitgum district is ongoing. National Task force meeting has resumed. The last one was held on 13th March 2009. • In the last meeting of the NTF, it was recommended that the next NTF meeting which is scheduled for 20th March 2009 will focus exclusively on Hepatitis E. • Continue to support Kitgum and Pader district to respond to epidemic outbreak of Hepatitis E through community sensitization through radio programs, cases management, and support to water chlorination.

Mini UDHS in Acholi and Karamoja sub-region; Preparation for Mini Health and Demographic survey in Acholi and Karamoja sub region is ongoing. Listing of the enumeration area is scheduled to begin in epi-week 13.

Other activities conducted by WHO; • Ongoing rehabilitation works in Lorengechora, Lolachat and Panyagara • Training of VHTs & orientation of health workers on Nutrition surveillance commenced in Orwamuge HC II in • Monthly meeting for the VHTs took place in Nakapiripirit.

IV Action others partners response; • Renovation and expanding laboratories in Bata, Kwera and Kangai HC IIIs all in by NUMAT is ongoing • MSFH, ASB, CESVI, Mediar, Concern, MTI, and AVSI are carry out activities that aim at controlling the epidemic outbreak of Hepatitis E in Pader District • Others doing various health activities are TPO Uganda, AMREF, UNFPA, UNICEF, MSU, Medair, IV. Comments and Conclusions Polio immunization campaign in Amuru district was successfully conducted with coverage of 150%. Similar campaign was also conducted in Southern Sudan. Reports reaching Uganda indicates that the coverage in Southern Sudan was poor. Given that the current epidemic outbreak of Polio in Uganda was imported from Sudan, there is need for close border collaboration with Southern Sudan to ensure that the coverage in the subsequent round is improved to prevent future importation. V. Plan for Coming Week • Support Polio epidemic response activities in Acholi, Lango and Karamoja sub-regions • Support hepatitis E epidemic response in Kitgum and Pader district • Provide technical and financial support to the DHOs in strengthening HMIS/IDSR • Provide technical and financial support to MoH and UBoS in planning and conducting mini-Demographic and Health Survey For further information, please contact:

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