Emergency and Humanitarian Action (EHA),

Weekly Activity Report I. General Situation • Political, Social and Security; • DRC: Pursuit of the LRA continues in Garamba forest by the joint UPDF and Week 27, DRC army. • Acholi and Lango sub-region: is calm despite rumors of a new rebel group being formed. 29th June -5th July • Karamoja sub-region; Disarmament of armed Karamojong by UPDF continues. An 2009 NGO vehicle was ambushed in , no death recorded in the ambush. • Main Events of Interest/Concern for Health; • Acholi, Lango, Teso and Karamoja sub-region continues to receive irregular rain fall with reports of people dying from starvation. WFP is conducting nutrition assessment in Acholi sub-region. • 13 suspected cases of HINI were investigated in Uganda since the beginning of the epidemic. So far one case has been tested positive. II. Analysis and Health Consequences (Health Problems and Needs of Affected Population) Malaria: Lango; There is a general decline in the number of cases of malaria reported from all districts in Lango sub-region in epi-week 27 as compared to epi-week 26. See figure I below for details

Highlights

• The districts of , Amuru and Abim continue to register

high number of cases of malaria in 2009 as compared Acholi, Gulu and continues to register high number of cases in 2009 as to 2008. compared to 2008. See figure II below for details.

• One suspected case of Hepatitis E was registered in . The last time Gulu district registered suspected case of Hepatitis E was in September 2008.

Acknowledgement Karamoja, In epi week 27 of 2009, reported 3,400 cases per 100,000 populations as compared to 1,500 cases per 100,000 populations reported in epi-week 19. Production of this weekly activity It is also worth notting that the number of cases of malaria reported in Abim district in report has been made possible by 2009 is higher than that of 2008. contribution from the followings

Dysentery:

Acholi, Lango and Karamoja sub-region; Dysentery incidence in 2009 remains low as compared to 2008. See figure IV below.

Hepatitis E; 47 new cases of Hepatitis E were registered in in epi-week 27 up from 24 cases registered in epi-week 26. 2 deaths were also registered in the week. The cumulative number of cases of Hepatitis E registered in Kitgum district since the beginning of the outbreak is 10,243 with 162 deaths (CFR 1.58%). The sub counties that registered most cases in epi-week 27 of 2009 are; Lokung, Mucwini, Kitgum Matidi, Padibe West, layamo and Kitgum Town Council.

District New cases New deaths Cumulative cases Cumulative deaths

Kitgum 47 2 10,243 162 (1.58%)

Gulu & Amuru 1 0 41 (9 positive) 0 (0)

Pader 8 0 187 8 (4.3%)

Lango 0 0 3 0

Total 56 2 10,474 170(1.62%)

Eight cases of Hepatitis E were registered in in epi-week 27up from one case registered in the district in epi-week 26. One suspected case was registered in Gulu district in the week.

AFP; • No suspected case reported

HAT and Meningitis; • No new case reported in the week Measles;

• One suspected case reported from each of the districts of Pader, Oyam and Lira

III. Actions (WHO response, Sida grant)

Epidemic Response

Disease surveillance; • On job training of newly recruited health workers in Gulu district on HMIS/IDSR to begin next week Malaria; • Shortage of first line anti malarial drugs in most health facilities. WHO has supported Gulu and Amuru district to collect supplies from NMS • NUMAT is training CMD (community medicine distributers) on new malaria treatment policy • UNICEF is distributing ITNs one per household in selected sub-counties in • WHO supported Lira district to distribute 640 boxes of ACTs to health facilities reporting high number of cases

Diarrheal disease; Community mobilization on latrine construction and improve hygiene is ongoing in all district.

Measles; Samples from the suspects have been sent to UVRI for confirmation. HINI; • Response; o Weekly task force meeting at MoH o Daily meeting of WHO core team o Active case search at Entebbe international airport o Routine surveillance o Daily reporting to Afro and partners • Gaps o No funding for the response o Supplies (gloves, mask and other protective gears) low AFP; • Results from spacemen sent to UVRI has not yet returned

Hepatitis E; • Ongoing activities; o District Task force meeting ongoing in Pader and Kitgum district o Community sensitization through radio programs, o Cases management, and o Support to water chlorination ongoing however, the coverage and consistence of this activity is poor.

HAT; WHO continues to support to respond to HAT.

Mini UDHS in Acholi and Karamoja sub-region; • Data collection ongoing in all districts in Acholi and Karamoja sub-region • Trained 40 health workers in Abim and on TB/HIV and AIDS collaboration

Other activities conducted by WHO; • Ongoing rehabilitation works in Lorengechora, Lolachat and Panyagara in Karamoja sub-region IV Response from others partners; • ASB, CESVI, Concern, MTI, AVSI, AIS and Mercy Corps are supporting response to epidemic outbreak of Hepatitis E in Pader District • UNFPA is continuing on supporting the DHT Pader district to conduct support supervision and training of health workers in family planning and life savings skills • UNFPA continue supporting PSI (PACE) in Pader district to implement a HCT programs targeting youth, UPDF, Police and CSWs. • GOAL continues carrying out HIV/AIDS preventive activities in the sub counties of Paimol, Parabongo, Wol, Lapono & Lukole in Pader district. • Malaria consortium is supporting the HC III & HC IV in Pader district to distribute ITNs to pregnant mothers attending ANCs. IV. Comments and Conclusions General decline in the number of cases of malaria registered in all sub-region in eoi-week 27 as compared to epi-week 26. WHO is continuing to support MoH and the office of the DHO to respond to malaria epidemic. V. Plan for Coming Week • Support MOH to respond to Influenza A H1N1 pandemic • Support hepatitis E epidemic response in Kitgum and Pader district • Support MoH and the districts of Lira and Gulu to respond to upsurge in the number of cases of malaria being reported. • Provide technical and financial support to the DHOs in strengthening HMIS/IDSR Provide technical and financial support to MoH and UBoS in conducting mini- Demographic and Health Survey For further information, please contact:

Dr. Joaquim Saweka, WHO Representative Uganda: Tel. +256 41 335500, Mobile +256 752 728 257, Email: [email protected]