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Republic of Liberia Ministry of Health & Social Welfare

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Republic of Liberia Ministry of Health & Social Welfare REPUBLIC OF LIBERIA MINISTRY OF HEALTH & SOCIAL WELFARE P.O.BOX 10-9009 1000 MONROVIA 10, LIBERIA WEST AFRICA WEEKLY SURVEILLANCE ACTIVITIES REPORT FOR WEEK 14 (March 29 to April 4). Table 1. Summary Data for Week 10 to 14 AWD TB lnu STI AFP ABD MNT Conf ALRL Injury malar. Malaria AJS/YF Cholera Measles Trauma/ Meningitis Severe.Ma Week Dates Months CFR CFR Cases Cases Deaths Deaths 01-07 10 1066 2 0.2 349 1 8 30 1 2 2831 6476 2268 734 13 63 15 08-14 11 927 3 0.3 4 0 0 258 0 3 6 1 0 2565 5269 1687 812 16 56 14 15-21 12 935 1 0.1 4 0 0 354 0 3 3 1 0 3746 5571 1579 889 8 37 0 March 22-28 13 703 0 0 1 0 0 204 2 2 3 0 7 1548 3904 1489 731 16 38 25 29-4 14 544 0 0 6 0 0 128 1 4 7 0 5 1328 2731 1221 598 20 43 13 April Source of data by partners: Week 14 data were collected from 38 health facilities. Partners that reported in week 14 included: SCF from 9 clinics, MSF France from 1 emergency hospital, MSF Belgium from 7 facilities, (UNIMIL) Bomi county from 1 hospital, Action Contre La Faim (ACF) from 1 TFC, IRC from 5 clinics, Merlin from 6 clinics, Northwest medical team (NWMT/AEL from 5 clinics and CHT Margibi from 3 clinics. A total of 11983 consultations were recorded Fig. 1 AW D Cur ve, W eek 1 t o 14 2 0 0 4 , from 38 health facilities for all causes in Liber ia Week 14. 1200 Data collected by partners working in 4 (26.7%) out of 15 Counties in Liberia. Acute Watery Diarrhea (AWD): A total of 1000 544 cases of AWD were reported to MOH & SW in week 14 (Table 1 & figure 1). About 4.5% of the total consultations were due to AWD related causes. 50.6 %( 275) of the 800 cases were children less than the age of five years. No death related to AWD was recorded in week 14. (CFR =0%). 600 As seen in figure 1, there is slight decrease in the trend of AWD cases reported in week 14 compared to Week 13 although AWD 400 cases were reported by 38 health facilities in week 14 compared to 50 health facilities in week 13. 200 More AWD cases were reported in Bushrod Island (17.6%), central Monrovia (16.9%), and Margibi (10.1%). 0 1 5 913172125293337414549 E p id e m io lo g ic a l W e e k s 1 Lackayta clinic in Margibi County is the only facility that reported “0” cases in week 14. A total of 297 (54.6%) out of 544 AWD cases were reported from 25 health facilities operating in Monrovia (Montserrado County) and its environs. Figure 2 shows the distribution of cases within Monrovia and other reporting counties. Four clinics reporting more AWD cases in Week 14 include: Mamba point hospital with 78 cases, Soul clinic with 39 cases, New Kru town with 36 cases and Clara town clinic with 30 cases. Fig 2 Incidence of AWD in Weeks 12 to 14 2004. Liberia Cases Week 14 Week 13 Week 12 Bushrod Gardnersvill Careysberg/ Verginia/ST C. Monrovia Paynesville Sinkor Bomi Bong Cape MT Margibi Total Island e Tode Paul Week 12 0 6 79 84 149 0 0 23 200 13 128 935 Week 13 105 91 16 46 6 1 0 30 191 5 36 703 Week 14 96 92 36 18 55 2 5 25 14 0 64 544 Locations Yellow Fever: 4 suspected cases of yellow fever were reported in week 14. The cases were reported from Nimba (2), Montserrado (1) and Grand Bassa (1). Specimens were collected for confirmation. One death was recorded from the 4 suspected cases (CFR=33.3%). Response Action to Yellow fever outbreak: • Active case search by surveillance officers in Montserrado, Bong, Nimba, Grand Bassa and Margibi counties. • Vaccination coverage survey on-going in Salala district (Bong County). • Vaccination campaign in Gbhlay-geh and Zoe-geh districts of Nimba County is completed. Over 138,000 people were vaccinated against yellow fever in the two districts. Neonatal Tetanus: No case of Neonatal tetanus was reported in week 14. Measles: 7 cases of measles were reported in week 14. From the 7 cases, 6 were reported by Pipeline clinic and 1 by Redemption hospital. No measles related mortality in week 14. (CFR=0%). AFP: One case of AFP was reported by Harrisburg clinic (Montserrado County) in week 14. Specimens were collected for confirmation. Meningitis: 5 cases of suspected meningitis were recorded in week 14. 4 cases were reported from Mamba point hospital and one from Redemption hospital. CSF specimens from 4 patients in Mamba point hospital were investigated. Out of the four specimens, 1 was positive for N Meningitidis, 2 positive for S pneumoniae and 1 negative. The positive case of N Meningitidis came from Waterside area. 3 deaths related to meningitis were reported in the same week. 2 deaths from Mamba point hospital and 1 death from Redemption hospital. (CFR=60%). Out of the 2 deaths from Mamba point hospital, 1 was the confirmed case of N Meningitidis. 2 Malaria: Figure 3: Clinical and confimed cases of malaria, Weeks 1 to 14 2004, 38 health facilities reported 2731 Liberia. suspected (clinical) malaria cases in 8000 Week 14. 37.2% (1016) cases were children less than five years of age. 6000 82.2% (2246) of suspected malaria 4000 cases underwent laboratory New cases investigation, out of which 54.4% (1221) 2000 were confirmed malaria cases. 19 health 0 facilities reported to have conducted 1 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 Clinical 5384 5021 5191 5036 6884 7253 5031 6476 5269 5571 3904 2731 confirmatory investigation for clinically Lab Tested 0 2961 3082 3781 4303 4587 3734 2795 3151 2953 2859 2246 suspected malaria cases in week 14. Confirmed 1207 1358 1342 1776 1918 2666 1920 2267 1687 1597 1489 1221 One malaria related death was reported Weeks in week 14. (CFR=0.08% based on confirmed malaria cases). Acute Bloody Diarrhoea (ABD): 128 cases of acute bloody diarrhea were reported in week 14. There is decrease in the trend of ABD in week 14 compared to week 13 as seen in figure 4 and table 1. Reports of ABD were received from 38 health facilities in week 14 compared to 50 health facilities in week 13. As seen in table 1 ABD cases account for 1.1% of all consultations in week 14. From the total caseload of 128 ABD cases, 31.3% (40) are children less than 5 years of age. No reported mortality related to ABD in week 14. (CFR=0%) Clinics reporting more cases of acute bloody diarrhea in week 14 include: Totota in Bong County with Fig. 4 ABD Curve, Week 1 to 14 (14.8%) 19 cases, Mamba point hospital in central 2004, Liberia Monrovia with (9.4%) and Kakata clinic in Margibi County with (8.6%) 11 cases. 400 Action: 1) 19 specimens of ABD were collected for investigation in week 14. Specimens were collected 350 from Freeman Reserve (4), Wilson corner (4), Sinkor (3) and (1) each from Blomo Town, Clay street, New 300 Georgia, Pipeline, Vomo town, Margibi and River Gee. 250 Results: From the 19 specimens, 2 specimens were 200 confirmed positive for vibrio cholerae and shigella dysentariae. The positive vibrio cholerae case came from Vomo town, Todee district while the positive 15 0 shigella dysentariae case from Wilson corner, Brewerville district. 10 0 2) IRC has finalized the plan of action for 50 chlorination of wells in affected communities of Montserrado County. Community sensitization has 0 already started in the identified areas. 1 5 9 13172125293337414549 Cholera: 6 suspected cases of Cholera were E p id e m io lo g ic a l W e e k s managed in MSF Belgium CTU in week 14. The cases came from: central Monrovia (1), Bushrod Island (1), Paynesville (2) and Sinkor (2). 3 specimens from the CTU patients were collected for confirmation in week 14. The specimens were collected from patients residing in Congo town, Clara town and SKD community. 3 Results: Out of the 3 samples from the CTU, 1 sample was positive for vibrio cholerae. The positive case came from 14th street, Sinkor. Action: • Site visits and assessment of the affected areas by MoH. • Awareness campaign by agencies working in the affected communities Other Conditions: See Table 1 Recommendations: C Continuous monitoring and laboratory investigation of causes of acute watery and bloody diarrhea by health partners and Ministry of health. C All partners should report Yellow Fever and AFP cases immediately to MOHSW/WHO for further investigations and specimen collections. C Active case-based search for suspected yellow fever cases in all clinics by surveillance officers C Partners are required to submit weekly surveillance reports from all their clinics. C Health facilities operating in newly accessible areas must start reporting on disease surveillance data. 4.
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