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Libya: EWARN & Diseases Surveillance Bulletin

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Libya: EWARN & Diseases Surveillance Bulletin EWARN: Early Warning Alert and Response Network Libya: EWARN & Diseases Surveillance Bulletin 2018: Epidemiological Week: 04 Reporting Period: 22 January – 28 January 2018 Highlights Number of reporting sites in week 04: One hundred and eighteen (116) submitted their weekly reports complete and in timely manner. Total number of consultations in week 04: 40,678 marking an decrease of 2,570 to last week consultation of 43,248. The number of consultations for other disease this was week was 33,437. NCDC and WHO | EWARN & Diseases Surveillance Bulletin 1 Leading causes of morbidity in week 04: Acute Upper Respiratory Infections (AURI) (n=4649; 11.54% of consultations number), Acute Lower Respiratory Infections (ALRI) (n=1282; 3.15%) and acute diarrhea (AD) (n=1048; 2.58%) remained the leading causes of morbidity this reporting week. Number of alerts in week 04: Sixteen (16) alert were generated through EWARN. (details: see Alerts and Outbreaks Section). The health authorities of each municipality have the capacity to respond to outbreaks. The alerts were discussed with the focal person and respected surveillance officers of the municipalities. (Details: see Alert and Outbreak Section). NOTE: In all the figures below that represent trends, numbers from week 4 in 2018 were compared to three different averages from 2017 representing the following: The average value for epidemiological weeks 01 – 52 in 2017, representing the entirety of 2017. The average value for epidemiological weeks 39 – 52 in 2017, representing the period of reporting that followed the first EWARN training workshop in September of 2017. The average value for epidemiological weeks 49 – 52 in 2017, representing the period of reporting that followed the second EWARN training workshop in December of 2017. No of reporting sites in Libya comparing averages of weeks, week 1 - 52 2017, weeks 39 -52 2017, weeks 49 - 52 2017 and week 01 - 04 2018 140 120 100 80 60 119 121 118 104 40 86 20 40 0 Weeks 1 - 52 Weeks 39 - 52 Weeks 49 - 52 Week 01 2018 Week 02 2018 Week 03 2018 Week 04 2018 2017 2017 2017 Figure 1. Distribution of reporting health facilities NCDC and WHO | EWARN & Diseases Surveillance Bulletin 2 Morbidity Patterns: During week 04, the proportions of AURI , ALRI and AD decreased in comparison with the previous week as it can be seen in figure 2. Comparing average cases of AURI, ALRI and AD of all of 2017, beyond 1st EWARN workshop, beyond 2nd EWARN workshop and week 01 - 04 2018 6000 5000 4000 3000 2000 1000 0 Weeks 1 - 52 Weeks 39 - 52 Weeks 49 - 52 Week 01 2018 Week 02 2018 Week 03 2018 Week 04 2018 2017 2017 2017 AURI ALRI AD Figure 2. Distribution of AURI, AD and ALRI in week 1 – 52 2017 and 04 2018 2018 Epidemiological week 04: Below is the distribution of the leading causes of morbidity by municipalities for the epidemiological week 04. NCDC and WHO | EWARN & Diseases Surveillance Bulletin 3 Distribution of common disease by municipalities for week 04, 2018 100% 90% 80% 70% 60% 50% 40% ALRI 30% AD 20% AURI 10% 0% Sert JALO GHAT ZAWIA Tobruk ZWARA ESBEAA OUBARI GARIAN ZENTAN MORZIG ALBAIDA ALKOFRA SUBRATA ALJEMAIL TRAGHEN DAWOON ALAZIZIYA REGDALIN IMSALATA BANIWALED ASHATI EAST Souq Eljomaa HAY ALANDALUS Qasir Ben Ghashir Figure 3. Distribution of common disease by municipalities for week 04, 2018 Trend of pertussis: In total 109 cases of suspected pertussis have been reported from EWARN sites this year. The cases are distributed as follow: Imsalata (9), Bengazi (1), Subrata (8) and Albaida (1). NCDC and WHO | EWARN & Diseases Surveillance Bulletin 4 Distribution of S. pertussis reported cases by week and by municipality up to week 04, 2018 ALABYAR ALAJILAT ALBAIDA Aljaghboub ALJEMAIL ALJOFRA ALKOBA ALKOFRA ALMARIJ ASHATI ASHATI EAST ASHATI West BANIWALED BENGAZI DARNAH ESBEAA GARIAN GHAT Ghdames IGDABYA IMSALATA JALO KHOMS MEZDAH MISURATA MORZIG MRADA OUBARI Qasir Ben Ghashir REGDALIN SABHA Sert SUBRATA SURMAN TARHUNA TAZIRBU Tobruk TRAGHEN Tripoli YEFRIN ZAWIA ZELTON ZENTAN ZLETIN ZWARA ALZAHRAA TRIPOLI central ALSWANI ALAZIZIYA Souq Eljomaa NESMAA 0 14 0 3 0 14 2 7 7 0 0 8 3 7 0 0 7 11 9 7 0 4 1 01 01 2 1 WEEK 01 2018 WEEK 02 2018 WEEK 03 2018 WEEK 04 2018 Figure 4. Distribution of suspected pertussis cases reported by week and by municipality week 04 2018. Trend of Acute Upper Respiratory Infections During week 04, a total of 4694 cases were reported (11.54% of total consultations) and are summed up in table 1 below: Municipality AURI cases Municipality AURI cases ALJEMAIL 11 SUBRATA 174 ALJOFRA 278 ALKOBA 194 ALKOFRA 72 ALBAIDA 96 ALMARIJ 25 ALAJILAT 175 BANIWALED 303 ALSWANI 25 BENGAZI 1026 ASHATI EAST 170 GARIAN 105 ASHATI West 29 IMSALATA 200 Tobruk 3 NCDC and WHO | EWARN & Diseases Surveillance Bulletin 5 KHOMS 33 SURMAN 52 MISURATA 30 Qasir Ben Ghashir 104 MORZIG 60 MEZDAH 19 MRADA 18 TRAGHEN 55 REGDALIN 44 ALABYAR 97 SABHA 64 ALZAHRAA 8 ZAWIA 173 JALO 59 ZLETIN 23 TAZIRBU 68 ZWARA 159 ZENTAN 90 TRIPOLI central 84 DARNAH 197 40 45 Souq Eljomaa ESBEAA 89 42 Ghdames ABOU SALEM 124 31 Sert HAY ALANDALUS Table 1. Summary of AURI cases by Municipality in week 04 Figure 5 below shows the trend of AURI cases in the period from week 01 2017 to week 04/2018 through the EWARN system. Moreover, Figure 6 shows the trend of AURI cases percentage from the total consultations in the period between week 39 and week 04/2018. The cumulative AURI during this year reached 19244 cases. Benghazi reported 18% of all cases (3394). Trend of the disease showed peaks of over the past two months. NCDC and WHO | EWARN & Diseases Surveillance Bulletin 6 DISTRIBUTION OF AURI CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 04, 2018 7000 6000 5000 4000 3000 2000 1000 0 Week 31 2017 Week 01 2017 Week 03 2017 Week 05 2017 Week 07 2017 Week 09 2017 Week 11 2017 Week 13 2017 Week 15 2017 Week 17 2017 Week 19 2017 Week 21 2017 Week 23 2017 Week 25 2017 Week 27 2017 Week 29 2017 Week 33 2017 Week 35 2017 Week 37 2017 Week 39 2017 Week 41 2017 Week 43 2017 Week 45 2017 Week 47 2017 Week 49 2017 Week 51 2017 WWeek 01 2018 WWeek 03 2018 Figure. 5 Distribution of AURI cases by week, week 1 – 52, 2017 and week 04, 2018. Percentage of AURI cases from the total consultation number by week, week 39 - 52, 2017 and week 04, 2018 16.00 14.00 12.00 10.00 8.00 13.38 13.75 13.71 12.21 12.65 12.25 6.00 11.54 9.15 4.00 8.53 8.33 7.06 7.52 7.26 6.48 6.40 6.04 5.46 2.00 1.44 0.00 week week week week week week Week Week Week Week Week Week week week Week Week Week Week 39 40 41 42 43 44 45 46 47 48 49 50 51 52 01 02 03 04 NCDC and WHO | EWARN & Diseases Surveillance Bulletin 7 Figure.6 Distribution of AURI percentage by week, week 39 – 52, 2017 and 04, 2018 Trend of Acute Lower Respiratory Infection: During week 04, a total of 1282 cases of acute lower respiratory infections were reported (3.15% of total consultations) and are summarised by municipality in Table 2 below: Municipality ALRI cases Municipality ALRI cases 10 41 ALJEMAIL Ghdames ALJOFRA 66 34 Sert ALKOFRA 5 SUBRATA 155 ALMARIJ 4 ALKOBA 96 BANIWALED 96 ALBAIDA 15 BENGAZI 93 ALAJILAT 35 GARIAN 6 ASHATI EAST 32 IMSALATA 14 Tobruk 9 KHOMS 8 SURMAN 44 Qasir Ben MISURATA 43 Ghashir 90 REGDALIN 29 MEZDAH 8 SABHA 52 TRAGHEN 11 ZAWIA 61 ALABYAR 8 ZLETIN 26 JALO 21 ZWARA 3 TAZIRBU 29 TRIPOLI central 40 ZENTAN 16 Souq Eljomaa 32 DARNAH 9 HAY ESBEAA 40 ALANDALUS 1 Table 2. Summary of ALRI cases by Municipality in week 04 Figure 7 below shows the trend of ALRI cases in the period from week 01 2017 to week 04/2018 through the EWARN system. Moreover, Figure 8 shows the trend of ALRI cases percentage from the total consultations in the period between week 39 and week 04/2018. The cumulative ALRI during this year reached 5398 cases. Baniwaled reported 15% of all cases (796). Trend of the disease showed peaks of cases reported over the past two months. NCDC and WHO | EWARN & Diseases Surveillance Bulletin 8 DISTRIBUTION OF ALRI CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 04, 2018 2000 1800 1600 1400 1200 1000 800 600 400 200 0 Week 31 2017 Week 01 2017 Week 03 2017 Week 05 2017 Week 07 2017 Week 09 2017 Week 11 2017 Week 13 2017 Week 15 2017 Week 17 2017 Week 19 2017 Week 21 2017 Week 23 2017 Week 25 2017 Week 27 2017 Week 29 2017 Week 33 2017 Week 35 2017 Week 37 2017 Week 39 2017 Week 41 2017 Week 43 2017 Week 45 2017 Week 47 2017 Week 49 2017 Week 51 2017 WWeek 03 2018 WWeek 01 2018 Figure. 7 Distribution of ALRI cases by week, week 1 – 52, 2017 and week 04, 2018. NCDC and WHO | EWARN & Diseases Surveillance Bulletin 9 Percentage of ALRI cases from the total consultation number by week, week 39 - 52, 2017 and week 04, 2018 5.00 4.50 4.00 3.50 3.00 2.50 4.37 2.00 3.72 3.28 3.38 1.50 3.15 2.60 2.59 2.12 2.21 1.00 1.90 1.96 1.72 1.78 1.67 1.54 1.34 1.40 0.50 0.46 0.00 week week week week week week Week Week Week Week Week Week week week Week Week Week Week 39 40 41 42 43 44 45 46 47 48 49 50 51 52 01 02 03 04 Figure.8 Distribution of ALRI percentage by week, week 39 – 52, 2017 and week 04, 2018 Trend of Acute Diarrhea During week 04, a total of 1048 (2.58% of total consultations) cases of Acute Diarrhea were reported and are summerised per municipality in Table 3 below: Municipality AD cases Municipality AD cases ALJEMAIL 11 SUBRATA 57 ALJOFRA 34 ALKOBA 78 ALMARIJ 10 ALBAIDA 31 BANIWALED 116 ALSWANI 7 BENGAZI 303 ASHATI EAST 18 GARIAN 4 Tobruk 3 100 22 IMSALATA SURMAN KHOMS 4 16 MEZDAH NCDC and WHO | EWARN & Diseases Surveillance Bulletin 10 MISURATA 40 ALABYAR 8 REGDALIN 42 ALZAHRAA 2 SABHA 36 JALO 2 ZAWIA 23 15 TAZIRBU ZLETIN 14 12 ZENTAN TRIPOLI central 8 DARNAH 11 Souq Eljomaa 4 ABOU SALEM 5 HAY Ghdames 8 ALANDALUS 4 Table 3.
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