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Communicable Disease Toolkit Liberia WHO/CDS/2004.24 COMMUNICABLE DISEASE TOOLKIT LIBERIA 1. COMMUNICABLE DISEASE PROFILE World Health Organization 2004 Communicable Disease Working Group on Emergencies, WHO/HQ The WHO Regional Office for Africa (AFRO) WHO Office, Liberia © World Health Organization 2004 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. The World Health Organization does not warrant that the information contained in this publication is complete and correct and shall not be liable for any damages incurred as a result of its use. Further information is available at: CDS Information Resource Centre, World Health Organization, 1211 Geneva 27, Switzerland; fax: (+41) 22 791 4285, e-mail: [email protected] Communicable Disease Toolkit for LIBERIA 2004: Communicable Disease Profile. ACKNOWLEDGMENTS Edited by Dr Michelle Gayer, Dr Katja Schemionek, Dr Monica Guardo, and Dr Máire Connolly of the Programme on Communicable Diseases in Complex Emergencies, WHO/CDS. This Profile is a collaboration between the Communicable Disease Working Group on Emergencies (CD-WGE) at WHO/HQ, the Division of Communicable Disease Prevention and Control (DCD) at WHO/AFRO and the Office of the WHO Representative for Liberia. The CD- WGE provides technical and operational support on communicable disease issues to WHO Regional and Country Offices, MoHs, other UN agencies, NGOs and international organizations. This Working Group includes the Departments of Control, Prevention and Eradication (CPE), Surveillance and Response (CSR) in Communicable diseases (CDS), Roll Back Malaria (RBM), Stop TB (STB) and HIV/AIDS (HIV) in HTM; and the Departments of Child and Adolescent Health and Development (CAH), Immunizations, Vaccines and Biologicals (IVB) and Health and Action in Crisis (HAC). The following people were involved in the development and review of this document and their contribution is gratefully acknowledged: Markus Behrend (CDS/CPE), Julian Bilous (FCH/IVB), Maureen Birmingham (FCH/IVB), Fatorma Bolay (WHO-Liberia), Sylvie Briand (CDS/CPE), Claire Lise Chaignat (CDS/CPE), Claire Chauvin (FCH/IVB), Denis Coulombier (CDS/CSR), Charles Delacollette (HTM/RBM), Philippe Duclos (FCH/IVB), Musu Duworko (WHO/Liberia), Pat Drury (CDS/CSR), Dirk Engels (CDS/CPE), Hans Everts (FCH/IVB), Pierre Formenty (CDS/CSR), Giuliano Gargioni (HTM/STB), Pierre Guillet (CDS/CPE), Tom Grein (CDS/CSR), Bradley Hersh (FCH/IVB), Yvan Hutin (HTP/EHT), Randall Hyer (CDS/CSR), Jean Jannin (CDS/CPE), Kande-bure Kamara (CDS/CSR), Omar Khatib (WHO-Liberia), Thierry Lambrechts (FCH/CAH), Frédérique Marodon (CDS/CPE), Pamela Mbabazi (FCH/IVB), Francois Meslin (CDS/CPE), Antonio Montresor (CDS/CPE), Lulu Muhe (FCH/CAH), Jose Nkuni (HTM/RBM), Salah Ottmani (HTM/STB), William Perea (CDS/CSR), Shamim Qazi (FCH/CAH), Aafje Rietveld (HTM/RBM), Cathy Roth (CDS/CSR), Mike Ryan (CDS/CSR), Michel Tailhades (HTM/TSH), George Tembo (UNAIDS/CRD), Marta Valenciano (CDS/CSR), Renee Van De Weerdt (FCH/IVB), Katelijn Vandemaele (CDS/CSR), Steve Wiersma (FCH,IVB), Sergio Yactayo (CDS/CPE). We would like thank the Government of Ireland and the Office of US Foreign Disaster Assistance (OFDA) of the US Agency for International Development for their support in development of this document. World Health Organization 5 Communicable Disease Toolkit for LIBERIA 2004: Communicable Disease Profile. CONTENTS Introduction.............................................................................................................................. 7 1. Acute lower respiratory infections (ALRI)................................................................ 8 2. African trypanosomiasis (African sleeping sickness).......................................... 11 3. Bacillary dysentry (shigellosis)............................................................................... 16 4. Cholera....................................................................................................................... 19 5. Diarrhoeal diseases (others) ................................................................................... 22 6. Diphtheria .................................................................................................................. 25 7. HIV/AIDS .................................................................................................................... 29 8. Lassa fever ................................................................................................................ 36 9. Lymphatic filariasis .................................................................................................. 41 10. Malaria........................................................................................................................ 45 11. Measles ...................................................................................................................... 49 12. Meningococcal disease (Meningitis and Meningococcal Septicaemia).............. 53 13. Monkeypox ................................................................................................................ 57 14. Onchocerciasis (river blindness)............................................................................ 60 15. Pertussis (whooping cough) ................................................................................... 65 16. Poliomyelitis.............................................................................................................. 69 17. Rabies ........................................................................................................................ 73 18. Schistosomiasis (Bilharziasis).............................................................................. 76 19. Soil-transmitted helminthiasis (ascariasis, hookworm infection, trichuriasis) . 80 20. Tuberculosis.............................................................................................................. 84 21. Typhoid fever ............................................................................................................ 94 22. Yellow fever ............................................................................................................... 96 Annex 1: Flowcharts for the diagnosis of communicable diseases ............................. 100 Annex 2: Steps in outbreak management........................................................................ 105 Annex 3: Safe water and sanitation.................................................................................. 106 Annex 4: Injection safety ................................................................................................... 107 Annex 5: Key contact for Liberia ...................................................................................... 108 Annex 6: List of WHO guidelines on communicable diseases...................................... 110 Annex 7: Immunization schedule for Liberia................................................................... 113 Annex 8: Map of Liberia ..................................................................................................... 114 Annex 9: Basic health indicators for Liberia ................................................................... 115 Annex 10: Population data, 2002 ..................................................................................... 116 World Health Organization 6 Communicable Disease Toolkit for LIBERIA 2004: Communicable Disease Profile. INTRODUCTION The purpose of this document is to provide public health professionals working in Liberia with up to date information on the major communicable disease threats that the population is facing. The list of endemic and epidemic diseases has been selected on the basis of the burden of morbidity and mortality. Diseases which have global eradication or elimination goals are also included. Due to the many years of civil unrest and conflict, data on Liberia are very limited. However, the document tries to outline the burden of communicable diseases in Liberia, provides data on reported outbreaks in the country, and presents disease-specific guidelines on the prevention and control of these diseases. The control of communicable diseases represents a major challenge to those providing health care services in Liberia. It is hoped that this document will facilitate the co-ordination of communicable disease control activities between all agencies working in the country. World Health Organization 7 Communicable Disease Toolkit for LIBERIA 2004: Communicable Disease Profile. 1. ACUTE LOWER RESPIRATORY INFECTIONS (ALRI) CHILDREN UNDER FIVE YEARS OF AGE DESCRIPTION Infectious agent Bacteria: the most common are likely to be Streptococcus pneumoniae and Haemophilus influenzae (and Staphyloccus aureus to a lesser extent). Several respiratory viruses Case definition Clinical description
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