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Epidemiological Week 45 (Week Ending 12Th November, 2017)

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Early Warning Disease Surveillance and Response Bulletin, Somalia 2017

Epidemiological week 45 (Week ending 12th November, 2017)

Cumulative figures as of week 45

Highlights

Reports were received from 226 out of 265 reporting facilities (85.2%) in week 45, a decrease in the reporting completeness compared to 251 (94.7%) in week 44. Total number of consultations increased from 69091 in week 44 to 71206 in week 45 The highest number of consultations in week 44were for other acute diarrhoeas (2,229 cases), influenza like illness (21,00 cases) followed by severe acute respiratory illness (834 cases) AWD cases increased from 77 in week 44 to 170 in week 45 No AWD/cholera deaths reported in all districts in the past 7 weeks The number of measles cases increased from in 323 in week 44 to 358 in week 45

1,363,590 total

consultations

78,596 cumulative cases of

AWD/cholera in 2017

1,159 cumulative deaths

of AWD/Cholera in 2017

55 districts in 19 regions

reported AWD/Cholera cases





20794 cumulative cases of

suspected measles cases

  • Disease
  • Week 44
  • Week 45
  • Cumulative cases (Wk 1 – 45)

  • Total consultations
  • 69367

2287 2240
71206
1801 2234
1363590

  • 50517
  • Influenza Like Illness

  • Other Acute Diarrhoeas
  • 60798

Severe Acute Respiratory Illness suspected measles [1]
890 323
911 358
16581 20436

Confirmed Malaria Acute Watery Diarrhoea [2]
269
77
289 170
11581 78596

Bloody diarrhea Whooping Cough
73 56
32 60
1983
687

Diphtheria Suspected Meningitis
82
11
2
221 225

Acute Jaundice

Neonatal Tetanus Viral Haemorrhagic Fever

000
420
166 173 130

[1] Source of data is CSR, [2] Source of data is Somalia Weekly Epi/POL Updates

The number of EWARN sites reporting decrease from 251 in week 44 to 226 in week 45. This is below the target of 400 health facilities that are targeted for reporting by the end of the year. The number of total consultations also increased from 69091 in week 44 to 71206 in week 45 in the 243 reporting sites (Chart 1 below). Overall, 1367245 consultations have been recorded since the beginning of the year.

Page 1 of 13

Total number of Consultations and number of reporting sites, week 34 to 45, 2017

800 700 600 500 400 300 200 100
0
80000 70000 60000 50000 40000 30000 20000 10000 0
WK 34 WK 35 WK 36 WK 37 WK 38 WK 39 WK 40 WK 41 WK 42 WK 43 WK 44 WK 45

  • Consultations
  • Reporting sites

Proportionate morbidity

The commonest causes of morbidity reported from the sentinel sites in week 45 are; Influenza like illness, other diarrhoeas, Severe Acute Respiratory infection, measles, malaria, AWD, Bloody diarrhoea and whooping cough and acute watery diarrhoea as shown in figure 2 below

Chart 2. Commonest Causes of Morbidty in Somalia, Week 44 and 45, 2017

2500 2000 1500 1000
500
0
Influenza Like
Illness
Other Acute Diarrhoeas
Severe Acute suspected measles Confirmed Malaria Acute Watery

  • Respiratory Illness
  • [1]
  • Diarrhoea [2]

  • Week 44
  • Week 44

Page 2 of 13

Situation update of AWD/Cholera

Epidemic situation

The number of AWD cases declined from 77 in week 44 to 170 in week 45 in all regions (Table 1). No new cholera cases or deaths have been reported in the last 2months in all regions. In all, new cases reported from 7 district in 8 regions across the country.

ChCahratr3t.3M. Caupmouf lAaWtivDe CMaasepsoafsAoWf wDeCeakse4s4a, 2s0o1f7,
Week 45

This icludes; 13 from Baroma district in Awadal regoin, 12 cases from Barao district in Togdher region, 36 cases from Wadajir district in Banadir region, Marka (6) Wanla Weyn (1) in Lower shabelle, and 3 cases from Lasanood in Sool region and 4

Bossaso 4 in Bari region

A total of 78596 cases and 1,159 deaths (CFR 1.47%) have been reported in 55 districts in all the nineteen regions of Somalia. The most affected regions since the beginning of the outbreak include Bay, Banadir, Toghdeer, Bari and Mudug. Most of the affected populations live in IDP camps where access to safe water and sanitation is limited. Of the 55 affected districts, 34 of these have been classified as hard to reach or inaccessible. The Case
Fatality Rate in inaccessible districts is 4 times as in other districts. Overall, children below 5 years constitute more than 58% of the total number of AWD/cholera cases reported since the beginning of year.

Epi_curve showing AWD cases in Somalia, Week 1 - 45, 2017

6,000 5,000 4,000 3,000 2,000 1,000
-
5.00 4.50 4.00 3.50 3.00 2.50 2.00 1.50 1.00 0.50 -

  • Jan
  • Feb
  • March
  • April
  • May
  • June

Deaths

  • July
  • Aug
  • Sept
  • OctNovember

  • Total Cases
  • CFR

Page 3 of 13

Table 2. Activities implemented during the AWD/Cholera outbreak
Thematic area Activities implemented Surveillance and laboratory activities

265 health facilities were included in the EWARNs with plans to expand reporting sites to all districts

16 stool samples collected from Banadir hospital CTC during the week tested negative. A total of 282 stool samples were collected since week 1 for AWD/Cholera of which 111 were positive for V. Cholera, Ogawa.



57 IERT have been deployed in most affected districts during the drought response An alert about AWD/Cholera outbreak was investigated in Adado and was a false alert A review of the implementation of different activities was conducted by regional Surveillance officers and NPHL to identify gaps and lessons learnt so as to plan for the next expected outbreak during the rainy season.

Case Management and OCV



In addition to the 520 health workers so far trained in cholera case management, 30 additional health workers were trained in Banadir in cholera diagnosis Emergency planning meeting was held by the Banadir regional team for AWD/Cholera prevention in high risk districts Weekly coordination meetings between MoH and cluster partners A needs assessment for AWD/Cholera was conducted by the joint WHO and MoH team in Banadir hospital CTC

Coordination and Response



Water, Sanitation and Hygiene



Distribution of hygienic kits to IDP communities in AWD/Chigh risk districts Community education and mobilisation was done in all regions affected by AWD. The activities were implemented in Lower Jubba, Middle Jubba,Banadir and Middle Shabelle.

C4D conducted social mobilisation in hard to reach areas in all the districts affected by AWD/Cholera

Supplies and logistics

Over 167 tonnes of AWD/Cholera supplies and emergency kits were distributed to affected regions since January 2017

Page 4 of 13

Suspected measles cases

The number of suspected measles cases decreased from 323 cases in week 44 to 358 cases in week 45. A total of 20,078 cumulative

Chart 5. Map of Suspected Measles Cases in week 45

suspected measles cases have been reported from all the nineteen regions since the beginning of the year. 83% of the cases are children under 10 years. The most affected regions include Banadir (4,902 cases) Togdher (2,177 cases), Mudug (1,869) Lower Shabelle (1,731 cases), and Bari (1,624) (See Table 3).

Table 2: Summary of Suspected measles cases by region week 43 and 44, 2017

  • Region
  • Week 43
  • Week 44
  • Cumulative cases

Nugal Mudug Bari Banadir Lower Shabelle Bay Lower Juba M. Shabelle Galgadud Bakool

84 73 44 50 44 22 14 15
5
100
64 44 41 32 18 14 12
8
1414 2006 1712 4993 1807
515 357 638 584

  • 76
  • 6
  • 8

Togdher Galbeed Hiran

27
23
7653
2211
735
1287
164

Gedo

9

Sool

  • 2
  • 1
  • 611

Middle Juba Sahil

12
10
60
566

Sanag

  • 5
  • 0
  • 244

Awdal

  • 0
  • 0
  • 98

Grand Total

  • 408
  • 364
  • 20078

Page 5 of 13

Measles outbreak response

WHO in collaboration of with the Federal Ministry of Health have started preparatory activities for the upcoming mass measles campaigns in November 2017 targeting 4,278,083 (6 months-10 years) children. Vaccines have been delivered to the state hubs.

Technical and coordinating structures set up, with weekly meetings at country office and zonal offices. Additionally, to micro planning and TOT trainings have been conducted in South-Central and Puntland.

Regional and district training will be conducted next week. Due to circumstance, a phase wise implementation strategy has been adopted as a best delivery option, to maintain good quality - one zone will be covered at a time.

Page 6 of 13

Table 3. Summary of epidemic prone diseases and syndromes in different districts of Somalia as of week 45

Region
Awdal

  • District
  • SARI
  • ILI
  • AWD
  • BD
  • OAD
  • Diph
  • WC
  • Meas
  • NNT
  • AJS
  • VHF
  • Mal
  • Men
  • Total

consultations

  • Baki
  • 0

000

0

1
11
8
1222 6710
362
1702

9996

0

  • 0
  • 118

97 10 26

251

0

  • 442
  • 0

000

0

000

0

0000

0

  • 6
  • 0

000

0

000

0

0000

0

000
0000

0

000

0

8
62
0
35

105

0
112
93

205

736
5

741

280
3
0000

0

000

0

2311
Borama Lughaya Zeila

Subtotal

Elberde Hudur
1157
0
16

1173

0
3587
309
1020

5358

89
30
07

43

32
128

133

413 532

945

40
1
16132
1481 4794

24718

17096
4975
41824

63895

187518
36673

224191

27891
2080

  • Bakool
  • 0

  • 8
  • 0

0
00

  • 0
  • 60

  • Waajid
  • 28

28

121
4

125

32
0
207

356

5030 2113

7143

907
29
61

69

137
0

137

0

Subtotal

17 Districts Huruwaa

Subtotal

Bossaso Carmo

  • 20
  • 0
  • 0
  • 0

116
0

116

0
2372 1803

4175

44
0
2718 2849

5567

3293
35
798
21

819

73
1
123
0

123

3
169
0

169

0
128
0

128

0
128
2

130

1

Banadir
Bari

  • 0
  • 0
  • 0
  • 0
  • 0
  • 0

Iskushuban Ufeyn
08
12
00
01
41
00
00
00
00
00
00
00
00
1393 1347

Subtotal

Badale

52

0

3331

0

74

0

33

0

941

0

3

0

0

0

41

0

0

0

0

0

0

0

283

8

1

0

32711

1033

Bay

  • Baidoa
  • 329

000
188
0
235
000
55
0
2070
0
266
20
2
105
0
59
0
727
0
12
0
35
90007
14
080
19
00000000
188
0
20000000
00000000
00000000
896 130
8
38
0
00000000
95536
6196 3187 6762 2051 2718
11550
3967
Berdale Bur hakaba Qansahdere Bandarbayla Hafun Qardho Rakko Waciya
0100
0000

  • 0
  • 64
  • 0

542
000
000
80 43
4
263 266
4
253
13

  • 4
  • 0
  • 0
  • 0
  • 0
  • 0
  • 4064

  • Subtotal
  • 517
  • 290
  • 2485
  • 164
  • 1371
  • 38
  • 19
  • 459
  • 2
  • 0
  • 0
  • 1091
  • 0
  • 137064

Page 7 of 13

  • Region
  • District

Abudwak

  • SARI
  • ILI
  • AWD
  • BD
  • OAD

629

  • Diph
  • WC
  • Meas

106

  • NNT
  • AJS
  • VHF
  • Mal

752

  • Men
  • Total

consultations
Galgadud

  • 28
  • 10

172
20 30 31

  • 0
  • 0

15
0000

15

1000000

1

5
10
003

18

4172
14
0
700030

10

0000000

0

00000

0

000200

2

0
44
9005

58

000000
13

13

40 23
000

63

3076
15
0

31

000000

0

0000000

0

00000

0

000000

0

020000

2

0000000

0

00000

0

000000

0

000000

0

0000000

0

00000

0

000000

0

260
16 15
0

39

0000000

0

30000
17726

  • Adado
  • 137

21
115
14
0

315

18
3
124
0
502 220 328 621
17
74
0
18 29
0

227

10
1
1468
0
1193
778
0

4191

74
2
49
5
32
6
55

223

592
14
0
30354
5298
27961 21890
5247

108476

5223
499
Balanbale Dhuusamarreeb El Dere Gelinsor

Subtotal

B/hawo Burdhubo Doolow
10

  • 0
  • 0

263

263
28
268
19

125

0

2317

78

Gedo

000000

0

7
67
9
34 10 71
10
0402
1000
4096
469
3742
821
Elbon Garbahaarey Gedweyne Luuq
176
63
243

1060

2000
392 135
60
112

2699

0

  • 1
  • 4274

19124

87971 26111
8260 3962 8034

134338

3862
58

  • Subtotal
  • 37

3079 1731
973
52
257

6092

2

276

5531 2459 1363
41
209

9603

79
3
60 81
388
2

13

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    Technical Series Report No VI. !" May 20, 2009 Livelihood Baseline Analysis Bay and Bakool Food Security and Nutrition Analysis Unit - Somalia Box 1230, Village Market Nairobi, Kenya Tel: 254-20-4000000 Fax: 254-20-4000555 Website: www.fsnau.org Email: [email protected] Technical and Funding Agencies Managerial Support European Commission FSNAU Technical Series Report No VI. 19 ii Issued May 20, 2009 Acknowledgements These assessments would not have been possible without funding from the European Commission (EC) and the US Office of Foreign Disaster and Assistance (OFDA). FSNAU would like to also thank FEWS NET for their funding contributions and technical support made by Mohamed Yusuf Aw-Dahir, the FEWS NET Representative to Soma- lia, and Sidow Ibrahim Addow, FEWS NET Market and Trade Advisor. Special thanks are to WFP Wajid Office who provided office facilities and venue for planning and analysis workshops prior to, and after fieldwork. FSNAU would also like to extend special thanks to the local authorities and community leaders at both district and village levels who made these studies possible. Special thanks also to Wajid District Commission who was giving support for this assessment. The fieldwork and analysis would not have been possible without the leading baseline expertise and work of the two FSNAU Senior Livelihood Analysts and the FSNAU Livelihoods Baseline Team consisting of 9 analysts, who collected and analyzed the field data and who continue to work and deliver high quality outputs under very difficult conditions in Somalia. This team was led by FSNAU Lead Livelihood Baseline Livelihood Analyst, Abdi Hussein Roble, and Assistant Lead Livelihoods Baseline Analyst, Abdulaziz Moalin Aden, and the team of FSNAU Field Analysts and Consultants included, Ahmed Mohamed Mohamoud, Abdirahaman Mohamed Yusuf, Abdikarim Mohamud Aden, Nur Moalim Ahmed, Yusuf Warsame Mire, Abdulkadir Mohamed Ahmed, Abdulkadir Mo- hamed Egal and Addo Aden Magan.
  • United Nations Assistance Mission in Somalia Unsom

    United Nations Assistance Mission in Somalia Unsom

    UNITED NATIONS NATIONS UNIES UNITED NATIONS ASSISTANCE MISSION IN SOMALIA UNSOM Briefing to the Security Council by Ambassador Nicholas Kay, Special Representative of the Secretary-General (SRSG) for Somalia 11 March 2014 [AS DELIVERED] Madam President, Members of the Council, Thank you for giving me the opportunity to brief the Council from Mogadishu today and for your continued support to Somalia’s peace-building and state-building. I am on the ground in Mogadishu and not with you in New York due to the intensity of events at this moment. I hope you understand. Madam President The best hope for peace and stability in Somalia, the Horn of Africa and beyond remains a united, secure and federal Somalia. This is achievable. Somalia can reach its goal of an agreed constitution, a nation-wide electoral process and increased security by 2016. But times are tough, and in the short term may get tougher. Insecurity in Mogadishu poses challenges for Somalis, the UN and the international community. 2014 is a crucial year. It is marked, I would say, by security and political challenges, which will be overcome if the Federal Government of Somalia and international partners remain united and if both accelerate delivery of their mutual commitments. Madam President As I speak, an expanded AMISOM and the Somali National Army (SNA) are prosecuting a renewed offensive against Al Shabaab, made possible by UN Security Council Resolution 2124. It will be the most significant and geographically extensive military advance since AMISOM started, and there have already been notable successes. I pay tribute to the commitment and sacrifices made by AMISOM and its police and troop contributing states.
  • Afmadow District Detailed Site Assessment Lower Juba Region, Somalia

    Afmadow District Detailed Site Assessment Lower Juba Region, Somalia

    Afmadow district Detailed Site Assessment Lower Juba Region, Somalia Introduction Location map The Detailed Site Assessment (DSA) was triggered in the perspectives of different groups were captured2. KI coordination with the Camp Coordination and Camp responses were aggregated for each site. These were then Management (CCCM) Cluster in order to provide the aggregated further to the district level, with each site having humanitarian community with up-to-date information on an equal weight. Data analysis was done by thematic location of internally displaced person (IDP) sites, the sectors, that is, protection, water, sanitation and hygiene conditions and capacity of the sites and the humanitarian (WASH), shelter, displacement, food security, health and needs of the residents. The first round of the DSA took nutrition, education and communication. place from October 2017 to March 2018 assessing a total of 1,843 sites in 48 districts. The second round of the DSA This factsheet presents a summary of profiles of assessed sites3 in Afmadow District along with needs and priorities of took place from 1 September 2018 to 31 January 2019 IDPs residing in these sites. As the data is captured through assessing a total of 1778 sites in 57 districts. KIs, findings should be considered indicative rather than A grid pattern approach1 was used to identify all IDP generalisable. sites in a specific area. In each identified site, two key Number of assessed sites: 14 informants (KIs) were interviewed: the site manager or community leader and a women’s representative, to ensure Assessed IDP sites in Afmadow4 Coordinates: Lat. 0.6, Long.
  • Somalia Humanitarian Fund 2017 Annual Report

    Somalia Humanitarian Fund 2017 Annual Report

    2017 IN REVIEW: 1 SOMALIA HUMANITARIAN FUND 2 THE SHF THANKS ITS DONORS FOR THEIR GENEROUS SUPPORT IN 2017 CREDITS This document was produced by the United Nations Office for the Coordination of Humanitarian Affairs (OCHA) Somalia. OCHA Somalia wishes to acknowledge the contributions of its committed staff at headquarters and in the field in preparing this document, as well as the SHF implementing partners, cluster coordinators and cluster support staff. The latest version of this document is available on the SHF website at www.unocha.org/somalia/shf. Full project details, financial updates, real-time allocation data and indicator achievements against targets are available at gms.unocha.org/bi. All data correct as of 20 April 2018. For additional information, please contact: Somalia Humanitarian Fund [email protected] | [email protected] Tel: +254 (0) 73 23 910 43 Front Cover An Internally Displaced Person (IDP) draws water from a shallow well rehabilitated by ACTED at Dalxiiska IDP camp, at the outskirts of Kismayo town, Somalia. Credit: ACTED The designations employed and the presentation of material on this publication do not imply the expression of any opinion whatsoever on the part of the Secretariat of the United Nations concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Financial data is provisional and may vary upon certification. 3 TABLE OF CONTENTS 4 FOREWORD 6 2017 IN REVIEW 7 AT A GLANCE 8 HUMANITARIAN CONTEXT 10 ABOUT SOMALIA