Meningococcal Meningitis Situation in Eritrea
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Eritrea Health Weekly 1 Highlights - Weakly out break Monitoring • Report Completeness Timelines July 3 – July 9, 2006 • CSM • Mala ria • Diarrhoea and Bloody Diarrhoea • Other outbreaks • Measles situation - IDSR Monitoring of Diseases of Public Health Importance: - Joint Asses sment conducted in Northern Red Sea Region - World Popu lation Day 2006 Celebrated in Eritrea The motorized well and water reservoirs Weekly Outbreak Monitoring Malaria: rd Malaria reported cases are still below the 3 Report Co mpleteness/Timeliness: quartile threshold level for all Zobas that The 25 weeks average health facility to Zoba report reported as at week 22. completeness is 95 %. The timeliness has fallen to 72.9% mainly due to worsening in Gash Barka where Diarrhoea and Bloody Diarrhoea: the timeliness was 65% but now as drop to 60%. The reported bloody diarrhoea cases have not crossed the 3rd quartile threshold level this Table: Average Health facility to Zoba weekly week at national level. But this does not rule out report completeness and timeliness as at week undetected outbreaks at health facility level. 25: Total Number of No outbreaks of other diarrhoeal diseases were Zoba Population HFs Timeliness Completeness reported. 539 ,447 33 Anseba 98.03 100 Debub 891,505 59 94.07 100 Other Outbreaks: Gash 666,315 59 No outbreaks of other diseases have been Barka 60.32 88.91 Maekel 635,836 31 100 100 reported during the week. NRS 541,782 37 76.07 87.34 SRS 78,289 16 25.22 94.89 Measles Situation: Total 3,353,171 235 72.9 95.19 No suspected measles cases were reported this week. The total suspected measles cases CSM: reported by Zoba as of week 25 are 70. All the No new cases were reported this week. Last Report cases were negative for measles by serology. was week 15 of the year. Total cases reported this year were 2 2 from 6 districts and 3 deaths. Eritrea Health Weekly 2 IDSR Monitoring of Diseases of Schistosomiasis in Eritrea follows Public Health Importance: seasonal trend. The monthly incidence rates as shown in Figure 2 shows peaks Schistosomiasis in the months of August – September. The unusually high peak in 2003 was Schistosomiasis is one of the 19 priority because of a preliminary study done in diseases under IDSR surveillance. The this period by the zone health team and disease is highly prevalent in Gash the figures added to the monthly report. Barka Zoba followed by Anseba, where The peak in 2005 is unusually shorter in there are irrigation fields. In drought 2005 despite increase in report prone areas especially Northern and completeness. This could be due to Southern Red Sea Zobas, the disease is reduction in irrigation activities. rarely reported (Figure 1). Figure 1: Eritrea: Average Monthly Incidence of Schistosomiasis by Zoba in 2006 NRS Incidence/100,000 Popl. Anseba < 1 1 - 2 Gash Barka > 2 Debub SRS Maekel Eritrea Health Weekly 3 Figure 2 Eritrea: Monthly Trend of Schistosomiasis from 2003 to 2006 7 6 0 0 ,0 5 0 0 /1 e 4 t a r 3 e c n e 2 d i c In 1 0 J J J 6 5 4 3 S N S N S N M M M M M M M M J0 J0 J0 J0 Months Joint Assessment conducted in tracks which may disappear with sand Northern Red Sea Region storms on return just after few hours. Due to the sandy terrain, main mode of A team that comprised of members of transportation is camel or on foot. the MoH, WHO, UNICEF, OCHIA, and Shieb sub Zoba (District) is one of the UNFPA conducted a rapid assessment 10 sub-Zobas of Northern Red Sea in Wekiro and Shieb sub-Zoba to consisting of four Kebabis (village assess the threatening emergency administrative areas) and nine villages. conditions of both sub-Zoba, to see their The total population in 2006 is 64836 preparedness, and evaluate their comprising of 9725 (15%) children less response capacity and areas that than 5 years, 2593 (4%) infants and require external inputs. 3242 (5%) pregnant women. The major Weqiro is a sub-Zoba with a total sources of livelihood are agriculture and population of 8,770 comprising of 1,315 pastoralism. More than 90% of the (15%) children less than 5 years, 350 families migrate with the animals from (4%) infants and 438 (5%) pregnant June to September in search of food women. The number of households in and water for the animals and to escape the main village is 675. The major the harsh climatic conditions. The sources of livelihood are agriculture and migration is internal and they move to pastoralism. More than 80% of the Anseba region and other parts of the women and children migrate with the Northern Red Sea Region of Eritrea. animals from June to September in Due to the sandy terrain, the main mode search of food and water for the animals of transportation is camel or on foot. and to escape the harsh climatic Two out of the nine villages in the sub- conditions. The migration is internal and Zoba are not accessible due to rocky they move to Anseba region of Eritrea. and mountainous terrain and distance Access to Weqiro is through desert as such they are covered form Anseba Region in terms of health services. Eritrea Health Weekly 4 Shieb has a health center with six health especially at a very high cost from staff comprising of two nurses, 3 health Weqiro. assistants, one public health technician According to the information from the and 1 laboratory technician. One of the assessment, there is human capacity to nurses is female. In addition there are provide some emergency obstetric care five support staff (one finance officer, in Weqiro but is critically strapped due to one cleaner and three guards). There is lack of equipment. In Sheib, however, no maternity waiting home. Services there is lack of human capacity for offered at the health facility include out emergency obstetrics services. In both patient consultation and maternal child sub-zones there is absence of maternity health services including immunization, waiting homes. deliveries and in-patient emergencies services. IDSR data are not analyzed and utilized locally in both sub-Zobas because the staff in Weqiro is not trained on IDSR, although the staff in Sheib doesn’t utilize it despite their being trained. Hence, outbreaks are easily missed in both situations. IDSR is further made insufficient in Weqiro by the absence of laboratory, lack of ambulance and communication equipment. The diagnosis of outbreaks is made inadequate in Sheib, however, due to the low capacity of the existing laboratory. Other shortcomings that constrain the health facility in Weqiro include chronic shortage of water, non-functional solar batteries and even lack of weighing Shieb Town behind the fence of the scale. This is further worsened by lack health center of emergency plan and emergency drug The assessment revealed that the major stockpiles. emergency in both sub-zones is drought leading to shortage of water and food supply. The assessment also unraveled that chronic malnutrition and micronutrient deficiencies are major problems widely prevalent in both sub- zones. The prevalence of global acute malnutrition in both areas was 11%. In addition, the appraisal disclosed low immunization coverage, high drop-out rate and absence of outreach immunization, poor utilization of maternal health and family planning services as the major health services problems in both sub-Zobas. ANC attendance in both sub-Zobas is also low, and delivery and PNC is none The road to Weqiro existent. Critical emergencies in both sub-Zobas are referred to Massawa- Eritrea Health Weekly 5 Even though there is electricity supply in fresh nutrition prevalence survey, Sheib, it is only for three hours and the addressing the crucial constraints of the solar batteries are weak. Non availability health service delivery- especially of emergency response plan and posting a midwife, provision of emergency drug stockpiles for response equipment and replacement of solar is another major area of concern in battery and refrigerator- was Sheib as well. recommended as a solution. In order to alleviate the problems that these sub-zones face, the report Establish a GMP center for early suggested that there should be detection and referral of acute severely immediate resumption and continued malnourished children in view of the supply of supplementary food; catch up small population of the area, and immunization campaign be supported training of the staff of the health station twice a year (in November and April on IDSR was pointed out as solutions before the women and children migrate) for the problem in Sheib. Moreover, by providing some operational cost; and addressing the crucial constraints of stock of emergency drugs be supplied in emergency obstetric and TBA kits, both sub-zones. weighing scale, and solar battery were Furthermore, it recommended the noted as solutions that would improve immediate resuscitation of the the health service delivery. therapeutic feeding center and strengthening of existing laboratory to do gram stain and culture in Weqiro sub-zone. In addition to conducting World Population Day 2006 Celebrated in Eritrea Asmara, July 11, 2006- Under the theme “Young People”, UNFPA and its partners celebrated World Population Day colorfully with a participation of a great number of people in Eritrea on July 11, 2006 inside the UN compound. This years World Population Day focuses on the challenges faced by the ever increasing number of the young people and the daunting task awaiting the world community to empower them to participate in building a better world. Dr. Charlotte Gardiner, Resident representative UNFPA, opened the ceremony by reading the World Population Day statement of Ms.