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MINISTRY OF HEALTH Influenza A H3N2 constitutes 84% of all confirmed ILI and SARI cases All regions achieve the surveillance reporting targets for both Measles and Yellow Fever VOLUME 4 WEEK 14 th 7 April, 2019 The Ghana Weekly Epidemiological Report is a publication of the Ghana Health Service and the Ministry of Health, Ghana © Ghana Health Service 2018 ISSN - 2579-0439 Ghana Weekly Epidemiological Report Vol. 4 Week 14 07 April 2019 i Acknowledgement This publication has been made possible with technical and financial support from the Bloomberg Data for Health Initiative, the CDC Foundation and the World Health Organisation Ghana Weekly Epidemiological Report Vol. 4 Week 14 07 April 2019 ii Summary of Weekly Epidemiological Data, Week 14, 2019 Summary of Weekly Epidemiological Data for Week 14, 2019 Highlights: Influenza A H3N2 constitutes 84% of all confirmed ILI and SARI cases All regions achieve the surveillance reporting targets for both Measles and Yellow Fever SUMMARY OF PRIORITY Acute watery diarrhoea in persons… 751 DISEASES AND EVENTS - Influenza-like illness 356 WEEK 14, 2019 Measles 73 The total all-cause notifiable disease morbidity for the week (as per IDSR Diarrhoea with blood 29 Weekly Summary Reporting Form) Meningitis 24 was 1,280 with one maternal death Yellow fever (suspected) 19 and a death each from Meningitis, AFP (suspected polio) 13 Neonatal Tetanus and Human Rabies. Disease/Health Event Disease/Health Adverse events following… 12 Acute watery diarrhoea in persons aged 5 years and above was the Neonatal tetanus 2 highest proportion of cases reported, Human rabies 1 contributing 59% of the notifiable diseases case load during Week 14 0 200 400 600 800 [See Figure 1 and Annex 1] Number of Cases Figure 1: Reported notifiable disease conditions, Ghana, Week 14, 2019 REGIONAL PERFORMANCE BASED ON REPORTING The best performing region was Upper West with a mean Timeliness and Completeness of reporting for all notifiable score of 96.1% whilst the Ashanti region had the lowest conditions for the Week were 97.9% and 99.1% respectively. mean score of 72.9%. All regions achieved the expected All regions scored above 85% for both timeliness and target (21.5%) for percentage of districts reporting at least completeness of reporting. a suspected case of Measles and Yellow Fever [Table 1]. Table 1: Ranking of Regional Performance based on selected Surveillance reporting indicators, Ghana, Week 14, 2019 Region Timeli- Complete- Measles YF Average ness (%) ness (%) Cum. Annualized AFP % % Score % Position Week Week AFP Non-Polio Score District District 14 14 Cases AFP Rate (%) reporting reporting (A+B+C+ A B Week 14 C D E D+E)/5 Upper West 99.2 99.4 21 19.6 100 100.0 81.8 96.1 1st Brong-Ahafo 99.6 99.6 21 3.4 100 96.3 55.6 90.2 2nd Eastern 100 100 16 2.8 100 100.0 46.2 89.2 3rd Upper East 100 100 8 2.9 100 76.9 53.8 86.2 4th Greater Accra 90.7 98.1 20 1.7 86 100.0 50.0 85.0 5th Western 99.9 100 12 3.1 100 68.2 54.5 84.5 6th Northern 99.1 99.4 18 3.3 100 57.7 46.2 80.5 7th Volta 99.8 100 12 1.6 82 68.0 44.0 78.8 8th Central 86.4 93.6 14 3.3 100 65.0 30.0 75.0 9th Ashanti 98.8 99.1 16 1.0 50 70.0 46.7 72.9 10th Ghana 97.9 99.1 158 2.8 100 78.7 49.1 85.0 Ghana Weekly Epidemiological Report Vol. 4 Week 14 07 April 2019 1 Summary of Weekly Epidemiological Data, Week 14, 2019 INFLUENZA-LIKE ILLNESS (IDSR Weekly Report) A total of 356 cases with no deaths were reported through IDSR weekly reporting [Table 2]. Laboratory samples were sent from sentinel sites to Noguchi Memorial Institute for Medical Research (NMIMR). Table 2: Reported Influenza-Like Illness cases by Region 6% 10% and District, Ghana, Week 14, 2019 Region Districts Cases Deaths Brong-Ahafo Sunyani 10 0 Flu B VIC Central Cape Coast 26 0 H3N2 Greater Accra Accra 21 0 H1N1 Adentan 8 0 Ga Central 10 0 84% Ga East 45 0 Ga West 31 0 La-Dade-Kotopon 10 0 Ledzokuku Krowor 10 0 Shai Osudoku 82 0 Tema 93 0 Upper East Bolgatanga 5 0 Volta Ketu South 5 0 Figure 2: Distribution of Confirmed cases of ILI & SARI, Total 356 0 Ghana, Week 1 – 14, 2019 Sentinel Reporting As at the end of Week 14 total of 1,223 samples have been YELLOW FEVER taken from Sentinel sites in all regions that included 1057 Nineteen suspected cases of Yellow Fever were reported across samples from Influenza Like –Illnesses (ILI) and 166 from the country [Table 4]. Samples were sent to the National Public Severe Acute Respiratory Infection (SARI) patients [Table Health and Reference Laboratory with results pending due to 3]. Only 4.1% (51) of the samples collected have been lack of reagents. confirmed positive. Forty-four (44) of the ILI and seven (7) of the SARI cases were confirmed. Influenza A H3N2 has Table 4: Suspected Yellow Fever cases by Region, Ghana, constituted 84% of all confirmed cases since Week 1 [Figure Week 14, 2019 2]. Region District Cases Deaths Ashanti Amansie Central 3 0 Table 3: Cumulative Reported ILI and SARI cases by Bekwai 1 0 Region, Ghana, Week 1 -14, 2019 Brong-Ahafo Asutifi North 1 0 Number of Samples Banda 2 0 Region Dormaa East 2 0 ILI Confirmed SARI Confirmed Sunyani 1 0 Ashanti 116 7 13 2 Sunyani West 1 0 Tano North 2 0 Brong- 111 0 16 1 Eastern New Juaben 2 0 Ahafo Greater-Accra Ada East 1 0 Central 32 1 12 0 Upper East Nabdam 1 0 Eastern 79 2 16 0 Upper West Sissala West 1 0 Greater Western Bia West 1 0 234 9 25 0 Accra Total 19 0 Northern 154 2 19 3 Upper East 65 4 16 0 CHOLERA Upper West 14 4 0 0 No cholera case was reported during the Week. Volta 100 6 1 0 Western 152 9 48 1 NEONATAL TETANUS Ghana 1057 44 166 7 Two cases of Neonatal Tetanus with were recorded in the New Juaben Municipality with one death in Week 14. MATERNAL DEATHS HUMAN RABIES During the Week, one maternal death was recorded in the A case of Human Rabies was recorded in the Wassa- Accra Metropolis. Amenfi West district during the week. The case died. Ghana Weekly Epidemiological Report Vol. 4 Week 14 07 April 2019 2 Summary of Weekly Epidemiological Data, Week 14, 2019 MEASLES HIGH CASES OF SUSPECTED MEASLES IN THREE DISTRICTS During the Week, a total of 73 suspected cases of During the week, three districts namely; Upper West Akim and Sissala West Measles were reported across the country [Table 5]. each recorded four (4) suspected cases and Ketu North recording six (6) Samples were taken and sent to the National Public suspected cases of measles [Table 5]. There were no clustering of cases in Health and Reference Laboratory [NPHRL] for any of the districts. However, the cases were all followed up and investigations with results pending. investigated by the district teams within 24-48 hours. Samples have been taken and sent to the National Public Health and Reference Laboratory [NPHRL] for investigation. Table 5: Reported Suspected Measles cases by Region and District, Ghana, Week 14, 2019 Region Districts Cases Deaths Region Districts Cases Deaths Ashanti Asante Akim North 1 0 Northern Bunkpurugu-Yunyoo 1 0 Kumasi 2 0 Central Gonja 1 0 Brong- Asunafo North 1 0 Chereponi 1 0 Ahafo Asutifi South 1 0 Kumbungu 1 0 Banda 1 0 Tatale-Sanguli 1 0 Berekum 1 0 West Gonja 1 0 Dormaa West 3 0 Upper East Kassena Nankana West 3 0 Sunyani 2 0 Nabdam 1 0 Sunyani West 1 0 Upper Daffiama-Bussie-Issa 1 0 Central Abura-Asebu- West 1 0 Nandom 1 0 Kwamankese Eastern Birim Central 2 0 Sissala West 4 0 Birim South 1 0 Wa East 1 0 East Akim 2 0 Volta Biakoye 3 0 Kwaebibirem 1 0 Ketu North 6 0 Kwahu South 1 0 Krachi West 1 0 Lower Manya Krobo 2 0 Western Aowin 1 0 New Juaben 2 0 Ellembelle 2 0 Nsawam Adoagyiri 3 0 Prestea-Huni Valley 1 0 Upper Manya Krobo 1 0 Sekondi Takoradi 1 0 Upper West Akim 4 0 Tarkwa Nsuaem 1 0 Greater Accra 1 0 Accra Ada East 1 0 Ada West 1 0 Total 73 0 Ga South 1 0 Shai Osudoku 1 0 Tema 2 0 MENINGITIS In Week 14, a total of 24 cases of meningitis were recorded with one death [Table 6]. Nandom district recorded 4 cases and crossed the alert threshold with an attack rate of 7.5 cases per 100,000 population. Kassena-Nankana in the Upper East region also recorded 4 cases and crossed the alert threshold with an attack rate of 3.3 cases per 100,000 population respectively. Lumbar Puncture was done for all 24 cases recorded with four (4) confirmed as positive for meningitis [Table 6]. Table 6: Meningitis cases and deaths by Region, Ghana, Week 14, 2019 Cerebrospinal Cerebrospinal CFR District in District in Region Cases Fluid (CSF) Lab Deaths Fluid (CSF) (%) Alert Epidemic Test Positive Ashanti 0 0 0 0 - 0 0 Brong-Ahafo 2 2 0 0 0 0 0 Central 0 0 0 0 - 0 0 Eastern 1 1 0 0 0 0 0 Greater Accra 0 0 0 0 - 0 0 Northern 0 0 0 0 - 0 0 Upper East† 14 14 4 1 7.1 1 0 Upper West† 6 6 0 0 0 1 0 Volta 0 0 0 0 - 0 0 Western 1 1 0 0 0 0 0 Total (Ghana) 24 24 4 1 4.2 2 0 † Attack Rate per 100,000 population [District; Kassena Nankana; 4 cases (AR= 3.3), Nandom; 4 cases (AR=7.5)] Ghana Weekly Epidemiological Report Vol.
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    D I S T R I C T M A P O F G H A N A 3°0'0"W 2°30'0"W 2°0'0"W 1°30'0"W 1°0'0"W 0°30'0"W 0°0'0" 0°30'0"E 1°0'0"E B U R K I N A F A S O BAWKU MUNICIPAL Pusiga Zawli Hills Bawku J" J" Zawli Hills PUSIGA Uppe Bli 11°0'0"N Gwollu 11°0'0"N J" Paga Binduri Tapania Tributries J" J" Kulpawn H'Waters Ghira Navrongo North Zebilla Chasi BONGO Pudo J" BINDURI J"Bongo Nandom KASENA NANKANA WEST KN WEST Tumu Chana Hills J" Kambo Tumu Ü J" Garu NANDOM LAMBUSSIE KARNI Navrongo J" J" J" J" Nangodi SISSALA WEST BOLGATANGA BAWKU WEST Nandom Lambusie NABDAM GARU TEMPANE Bopong MUNICIPAL Polli KASENA NANKANA J" Sandema Bolgatanga J" EAST Tongo BUILSA NORTH J" TALENSI Kandembelli Lawra Sissili Central J" LAWRA SISSALA EAST Ankwai East Red & White Volta East Wiaga Red & White Volta east Wiaga Kandembelli Gambaga Scarp E&W JIRAPA Red & White Volta West Jirapa Gambaga J" J" Gbele Game Prod. resv. Mawbia J" 10°30'0"N 10°30'0"N BUILSA SOUTH Bunkpurugu Fumbisi Fumbesi " MAMPRUSI EAST Daffiama J BUNKPURUGU YONYO J" Pogi DAFFIAMA BUSSIE Nadawli WEST MAMPRUSI J" Gia J" Walewale Funsi NADOWLI-KALEO J" MAMPRUGU MOAGDURI Kulpawn Tributries J" Yagaba CHEREPONI Chereponi WA EAST J" Wa J" Nasia Tributries WA MUNICIPAL Ambalalai 10°0'0"N 10°0'0"N KARAGA Karanja Tanja J" GJ"USHIEGU Karaga R WA WEST Daka H'waters Wenchiau J" Nuale E KUMBUMGU SABOBA Sephe P NORTH GONJA J" SAVELUGU NANTON Saboba Mole National Park Savelugu J" U Kumbungu Daboya J" J" TOLON B 9°30'0"N SAWLA/TUNA/KALBA YENDI MUNICIPAL 9°30'0"N Bilisu Tolon SAGNERIGU Yendi Sagnarigu Sang J" J" J" Sinsableswani J" L J" Tamale Tatale TAMALE NORTH SUB METRO MION J" I C Zabzugu Sawla J" J" Dunwli O C TATALE T WEST GONJA Kani Kani ZABZUGU E Damongo Scarp J" Laboni Damongo Bole O J" 9°0'0"N 9°0'0"N NANUMBA NORTH F D' GONJA CENTRAL Kumbo Bimbila J" I Buipe T V J" Yakombo Lambo NANUMBA SOUTH BOLE O Wulensi O J" Yerada I G Salaga NKWANTA NORTH R J" Kpasa 8°30'0"N 8°30'0"N O E EAST GONJA Kpandai J" Bui Nat.