DEWS-WER-10-2012.Pdf (English)
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March 12, 2012 DISEASES EARLY WARNING SYSTEM WER-10 (6th Yr) DEWS WEEKLY EPIDEMIOLOGICAL REPORT EPREPORT SUMMARY: rd th This report includes surveillance data from 3 to 9 March 2012. Out of 290 functional Sentinel sites(SS), 289 (99.6%) have sent their reports in Week-10 of 2012; Out of total 263,908 events recorded in week-10 of 2012, 85,818 (32.5%) consultations were reported due to DEWS target diseases. Main causes of consultations this week are Acute Respiratory Infections/ARI (26.9%) and Acute Diarrheal Diseases/ADD (4.7%) from total clients in a continuing trend from the week before. 73 deaths caused due to Pneumonia, Diarrheal diseases and Meningitis/Severely ill children, so that 59 deaths due to pneumonia, 2 deaths due to diarrheal diseases and 12 deaths reported due to Meningitis and Severely Ill Children. In this reporting week, five Measles outbreaks reported and investigated in Khost, Daikundi, Zabul, Kunar provinces. One mumps Outbreaks in Laghman province and One Pertussis outbreak reported and investigated in Hirat province. REPORTS RECEIVED FROM REPORTING SITES: As of March 9, 2012, 290 sentinel sites were functioning in eight epidemiological regions, in 34 provinces of Afghanistan . In this reporting week, all 289 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. Table-1: Status of Reports Received from DEWS Regions during Epidemiological week-10, 2012 Central East Central West North North East West South East South East Total No. of Expected Reports from 49 30 45 36 33 34 33 30 290 Sentinel Sites No. of Reports Received in this 49 30 45 35* 33 34 33 30 289 week *No report received from Nusaee sentinel site of Darwaz district/Badakhshan province. Page 1 of 9 DEWS Sentinel Sites: Table-2 DEWS Epidemiological Regions and types of Sentinel Sites in Figure-1(Map) shows the distribution of Week-10, 2012 DEWS sentinel sites, already established in the relevant regions/provinces till Type of March 9, 2012 by type of health SS al East Centr al West North North East West South East South East Total facilities. Data on 15 DEWS target Centr diseases are being collected from these CHC/BHC 21 19 30 25 19 25 23 22 184 sentinel sites (SS).The symbols on the DH 12 7 10 7 9 4 7 4 60 map show the number of sentinel sites in PH/RH/SH 14 4 5 4 4 5 3 4 43 each region/province, and do not Poly Clinic 2 0 0 0 1 0 0 0 3 indicating the GPS of the SS locations. Total 49 30 45 36 33 34 33 30 290 DEWS Data in Epidemiological Week- CHC=Comprehensive Health Center, DH=District hospital, 10 of 2012 PH=provincial hospital, RH= Regional hospital, SH= specialized Out of total 263,908 clients recorded in hospital week-10 of 2012, 22% (58291) of consultations were Fig-2: Percentages of DEWS Target reported due to cough and cold and 4.9% (12816) of 14.0% Diseases by age Group in W10 of 2012 consultations was reported due to pneumonia. In the same 12.0% reporting period, 4.7% or 12,524 events were reported due 10.0% to diarrheal illnesses (3.2% due to Acute Watery Diarrhea, 8.0% 1.3% due to Bloody Diarrhea and 0.3% due to acute watery 6.0% diarrhea with dehydration). In comparison with previous 4.0% 2.0% week (W09 of 2012) the percentage of ARI diseases has 0.0% ARI ARI AwD Men/ AVHe Malar TyphF decreased by 2% to 26.9%, whereas the percentage of Acute AwD BD AFP Diarrheal diseases increased by 0.3% to 4.7%.This variation C&C Pn w SIC p ia ev can be due to changes in temperature /weather during the U5% 11.6% 6.5% 2.0% 0.6% 0.1% 0.0% 0.2% 0.2% 0.3% 0.0% reporting week.Figure-2 above shows the percentages of O5% 2.1% 1.8% 1.0% 0.2% 0.0% 0.1% 0.0% 0.2% 0.4% 0.0% DEWS target diseases by age groups in week-10 of 2012. Tot% 4.9% 3.2% 1.3% 0.3% 0.1% 0.1% 0.1% 0.2% 0.4% 0.0% Page 2 of 9 Percentage of ARI by weeks and by Age Groups In the epidemiological week-10, a total of 71,107 events of ARI were reported. 32.4 % of total clients less than 5 years of age were cough & Cold patients and 17.9% 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 52-11 01-12 02-12 03-12 04-12 05-12 06-12 07-12 08-12 09-12 10-12 (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) ARI- C&C <5 Yr. 33.7 34.3 33.9 35.0 34.9 34.8 33.6 32.7 33.5 34.4 32.4 5+ 20.4 20.2 20.6 21.1 21.1 20.7 20.7 19.7 19.8 19.3 17.9 ARI-Pneumonia <5 Yr. 11 11.8 12.1 12.7 12.8 12.9 12.6 13.1 12.1 11.3 11.6 >=5 Yr 2.4 2.4 2.8 2.5 2.7 2.5 2.6 2.7 2.4 2.5 2.1 consultations in week-52 of 2011, in comparison with the percentage of C&C in week-10 of 2012, decreased by 1.3%, whereas in case of 5 years and above decreased by 2.5% to17.9% in 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 increased by 0.6% in last 11 weeks, whereas the percentage of age group 5 years and over decreased by 0.3% to 2.1% in last 11 weeks. In the reporting week-10 of 2012, the highest percentage of Cough & Cold has been recorded in Kapisa and Paktya provinces with 37% and 35% respectively, whereas the lowest percentages of C&C were reported from Farah and Badghis provinces with 16% and 14% respectively. The highest percentages of Pneumonia reported from Baghlan and Sar-i-pol provinces with12% each, whereas the lowest percentage was recorded in Zabul and Nimroz provinces with 1% each. (Fig-3) 50% Percentages of ARI from Total Clients in week-10 of 2012 40% 30% 20% 10% 0% Bad Sa Ba Day Hil Kan Nan Par Wa Bag Pan Uru Lag Nur akh Bal Far Gha Hira Jaw Kho Kun Log Pak Pak ma Sari Tak Zab Kab Bad Far Gho Kap Nim Kun my kun ma dah gar wa rda hla jshe zga hm ista sha kh yab zni t zjan st duz ar tika tya nga Pul har ul ul ghis ah r isa roz ar an di nd ar har n k n r n an n n n Pneumonia 6% 5% 7% 6% 4% 3% 3% 2% 11% 5% 2% 6% 8% 4% 3% 3% 2% 7% 12% 4% 5% 1% 5% 12% 4% 2% 5% 4% 5% 1% 2% 4% 8% 7% Cough&Cold 20% 19% 24% 33% 26% 24% 29% 25% 18% 27% 26% 22% 30% 26% 29% 36% 26% 18% 22% 19% 23% 19% 15% 28% 14% 16% 18% 37% 22% 18% 19% 28% 16% 31% 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 Wee 52-11 01-12 02-12 03-12 04-12 05-12 06-12 07-12 08-12 09- (10-12 (%) (%) (%) (%) (%) (%) (%) (%) (%) 12(%) (%) Acute Watery <5 Years 6.6 6.5 6.0 6.1 5.9 5.6 5.5 5.2 4.8 5.9 6.5 Diarrhea >= 5 Years 1.9 1.9 1.8 1.8 1.7 1.7 1.8 1.7 1.6 1.7 1.8 Bloody Diarrhea <5 Years 2.0 1.9 1.8 1.8 1.7 1.7 1.7 1.4 1.6 1.9 2 >=5 Years 0.9 0.9 0.9 0.9 1.0 0.9 1.0 0.9 1.0 1.0 1 Acute W. Diarrhea <5 Years 0.7 0.7 0.6 0.7 0.6 0.5 0.5 0.5 0.4 0.6 0.6 with Dehydration ≥5 Years 0.1 0.2 0.1 0.2 0.1 0.1 0.1 0.2 0.1 0.1 0.2 diarrhea with dehydration) from week-52 of 2011to week-10 of 2012, from total clients. Acute watery diarrhea among children less than five years has been decreased from 6.6% in week-52 of 2011 to 6.5% in the reporting week, whereas acute watery diarrhea among age group 5 years and above decreased by 0.1% to 1.8% in last 11weeks (Please refer to Table-5, above).Bloody diarrhea, in age group less than 5 years after some small changes during last 11 weeks reached again the level of week-52 of 2011 i.e.