DEWS Weekly Report 2Nd June 2014.Pdf
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June 2, 2014 DISEASE EARLY WARNING SYSTEM WER-21 (8th Yr) WEEKLY EPIDEMIOLOGICAL REPORT Summary: The surveillance data collected for this weekly report is from 24 – 30 May 2014. Out of 385 functional Sentinel sites (SS), 382 (99.2%) have submitted reports for Week-21 of 2014. Out of a total of 365,649 consultations (155,175 male, 210,474 female) recorded in Week-21 of 2014, 34.2% or 125,009 (60,156 male, 64,853 female) consultations were reported due to DEWS targeted diseases. Main causes of consultations this week were Acute Respiratory Infections (ARI) (18.9%) and Acute Diarrheal Diseases (ADD) (14.2%) from total clients in a continuing trend from the week before. A total of 57 deaths reported due to DEWS targeted Diseases, which includes 21 deaths (11 male, 10 female) caused by Pneumonia, 16 deaths (6 male, 10 female) caused by Diarrheal Diseases, 16 deaths (9 male, 7 female) caused by Meningitis/Severely Ill Children, 2 deaths (1 male, 1 female) caused by Measles, 1 death (0 male, 1 female) caused by Malaria and 1 death (1 male, 0 female) caused by Acute Viral Hepatitis. In this reporting week, a Suspected Measles Outbreak reported from Paktya, Zabul, Badghis and Kunar provinces, a Suspected Pertussis Outbreak reported from Zabul province and a Suspected CCHF Outbreak reported from Kandahar and Herat provinces. Reports Received From Reporting Sites: As of May 30, 2014, 385 sentinel sites were functioning in eight epidemiological regions, in 34 provinces of Afghanistan. In this reporting week, 382 sentinel sites have sent their reports on new cases of DEWS target diseases recorded during the reporting week. 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-21, 2014 Region Central Central East Central West North North East West South East South East Total No. of Expected Reports from 55 33 58 54 40 51 49 45 385 Sentinel Sites No. of Reports Received in this 54 33 58 53 40 50 48 45 382 week Figure-1 DEWS Sentinel Sites: Table-2: DEWS Epidemiological Regions and Figure-1(Map) shows the Sentinel Sites by type in Week- 21, 2014 distribution of DEWS sentinel sites established in the regions/provinces by May 30, Type of SS 2014. Table-2 shows the SS entral entral East Central West North North East West South East South East Total distribution by type of health C facility. Data on 15 DEWS target CHC/BHC 28 20 43 43 26 41 39 37 277 diseases are being collected from DH 12 9 10 7 9 5 7 4 63 these sentinel sites (SS). The symbols on the map show the PH/RH/SH 13 4 5 4 4 5 3 4 42 number of sentinel sites in each Poly Clinic 2 0 0 0 1 0 0 0 3 region/province, and do not Total 55 33 58 54 40 51 49 45 385 indicate the GPS of the SS CHC=Comprehensive Health Center, DH=District Hospital, PH=Provincial locations. Hospital, RH= Regional Hospital, SH= Specialized Hospital DEWS Data in Epidemiological Week-21 of 2014: Out of a total of 365,649 clients recorded in week- 21 of 2014, 16.3% (59,651) of consultations were Fig-2: Percentages of DEWS Target Diseases by reported due to Cough and Cold and 2.6% (9,396) 20.00 Gender in W21-14 18.00 of consultations was reported due to Pneumonia. In 16.00 14.00 the same reporting period, 14.6% or 52,016 events 12.00 were reported due to diarrheal illnesses (10.5% due 10.00 8.00 to Acute Watery Diarrhea, 2.6% due to Bloody Percentage 6.00 Diarrhea and 1.1% due to Acute Watery Diarrhea 4.00 2.00 with Dehydration). In comparison with the previous 0.00 Men/SI ARI C&C ARI Pn AwD BD AwDw AVHep Measle Malaria week (W20 of 2014) the percentage of ARI disease C has decreased by 0.4% to 18.9%, and the percentage Male 17.92 3.04 12.36 2.95 1.31 0.05 0.05 0.06 0.47 of Acute Diarrheal Disease has increased by 1.5% Female 15.13 2.22 9.11 2.37 0.99 0.03 0.04 0.04 0.36 to 14.2%. These variations could be due to changes Total 16.31 2.57 10.49 2.61 1.13 0.04 0.05 0.05 0.41 in temperature /weather during the reporting week. Figure-2 (right) shows the percentages of DEWS target diseases by gender in week-21 of 2014. Percentage of ARI by Weeks and by Age Groups: In the epidemiological week-21 a total of 69,047 events of ARI were reported. 23.5 % of total clients less than 5 years of age were Cough & Cold patients and 13% were among the age group 5 years and over. The percentage of C&C (<5 years) consultations in week-12, in comparison with the percentage of C&C in week-21 of 2014, decreased by 6.6%, whereas in case of 5 years and above decreased by 4.9% to 13% in this reporting week. The trend of ARI diseases in last 10 weeks can be read in Table-3. The percentages of consultations on Pneumonia cases of age group less than 5 years decreased by 3.6% in last 10 weeks, whereas the percentage of age group 5 years and over decreased by 1.1% to 1.2% . Table-3: Percentages of ARI Diseases during 10 recent weeks by age groups and by weeks Disease Age Week- Week- Week- Week- Week- Week- Week- Week- Week- Week- 12-14 13-14 14-14 15-14 16-14 17-14 18-14 19-14 20-14 21-14 (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) ARI- C&C <5 30.1 31 30.2 28.2 28.3 26.2 25.1 24.2 22.9 23.5 Years ≥5 17.9 17.6 16.2 15.8 15.6 14.8 13.9 13.9 13.4 13 Years ARI- <5 9.1 9.6 8.6 7.5 6.8 6.6 6.6 5.9 5.9 5.5 Pneumonia Years ≥5 2.3 2 1.8 1.7 1.6 1.5 1.5 1.4 1.5 1.2 Years In the reporting week-21 of 2014, the highest percentages of Cough & Cold were recorded in Parwan, Wardak and Khost provinces with 26.1%, 22.7% and 22%, whereas the lowest percentages of C&C were reported from Nimroz, Farah and Ghor provinces with 4.8%, 5.3% and 7.3% respectively. The highest percentages of Pneumonia cases were reported from Bamyan, Saripul and Samangan provinces with 7.1%, 5.5% and 5% respectively, whereas the lowest percentages of Pneumonia cases were recorded in Zabul, Herat and Nimroz provinces with 0.3%, 0.4% and 0.5% respectively. (Fig-3) 35 Fig-3: Percentages of ARI from Total Clients in Week-21 of 2014 30 25 20 15 10 5 Percentage 0 HIL PIA FYB BAL BGL FAR SAR ZAB TAK BDS LAG HER KAP PKA PAR KAB LOG DAY KNR PAN NIM KAN BDG KHO KUN NUR GHA URO JOW NAN GHO SAM BAM WAR Province Pneumonia Cough&Cold Percentages of Diarrheal Diseases by Weeks and by Age Groups: Figure-4 below shows the percentages of diarrheal diseases (Acute Watery Diarrhea, Bloody Diarrhea and Acute Watery Diarrhea with Dehydration) 25 Fig-4: Percentages of Diarrheal Diseases from Total Clients in week-21 of 2014 20 15 10 5 Percentage Percentage 0 HIL PIA FYB BAL BGL FAR SAR ZAB TAK BDS LAG HER KAP PKA PAR KAB LOG DAY KNR PAN NIM KAN BDG KHO KUN GHA NUR URO JOW NAN GHO SAM BAM WAR Provinces AWD BD AWDwD From week-12 to week-21 of 2014 from total clients, Acute Watery Diarrhea among children less than five years of age has increased from 8.3% in week-12 to 20.6% in the reporting week, whereas Acute Watery Diarrhea among age group 5 years and above has been increased by 3.1% to 5.9% (Table-4). Bloody Diarrhea in age group less than 5 years increased by 1.5% in last 10 weeks, while in case of age group 5 years and above has been increased by 0.6%. Acute Watery Diarrhea with Dehydration in age group less than 5 years show an increase by 1.3% in last 10 weeks, while in case of five years and above AWDwD increased by 0.5% in last 10 weeks. Table-4: Percentages of Diarrheal Diseases from Total Clients during 10 recent weeks by age groups Week- Week- Week- Week- Week- Week- Week- Week- Week- Week- Disease Age 12-14 13-14 14-14 15-14 16-14 17-14 18-14 19-14 20-14 21-14 (%) (%) (%) (%) (%) (%) (%) (%) (%) (%) Acute Watery <5 Years 8.3 9.2 10.4 11.1 12.4 14.7 16.7 18 17.6 20.6 Diarrhea ≥5 Years 2.8 2.9 3.1 3.5 3.8 4.5 4.6 5.3 5.3 5.9 <5 Years 2.4 2.4 2.6 2.8 3.1 3.4 3.6 3.7 3.9 3.9 Bloody Diarrhea ≥5 Years 1.4 1.3 1.4 1.5 1.6 1.6 1.7 1.9 2.1 2 Acute Watery <5 Years 0.7 0.6 0.8 1 0.8 1.2 1.4 1.3 1.6 2 Diarrhea with ≥5 Years 0.2 0.2 0.2 0.3 0.3 0.4 0.5 0.5 0.5 0.7 Dehydration Percentages of suspected Meningitis/SIC, Malaria and Typhoid Fever by Region: In the epidemiologic week-21 of Fig-5: Percentages of Meningitis, Malaria & Typhoid Fever from Total 2014, a total of 149 suspected Clients in W21-14 cases of Meningitis/Severely Ill 1 Child were reported from all regions and the highest percentage 0.8 was recorded in North East, North and West regions.