Health Action in Crisis, Uganda: Weekly Epidemiological Report – Week 32, 4Th – 10Th August 2008
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Health Action in Crisis, Uganda: Weekly Epidemiological Report – Week 32, 4th – 10th August 2008 1. Completeness of Reporting All districts in the sub-region had over 80% completeness of Weekly IDSR reporting of which 8 out of 14 districts registering 100% completeness of reporting. Malaria and dysentery still remains the first and second leading cause of morbidity respectively. 2. Disease Trends 2.1 Malaria Diseases In Lango sub-region, Dokolo district registered a 51% increase in the number of cases of malaria in the last one week. See figure I for details. WHO is supporting the District Health Office to verify the data, analyze trend in malaria positivity rate, conduct anti-malarial drug inventory and conduct on job training of clinicians on the management of malaria. In the district of Apac Figure I; Trends of Weekly Clinical Malaria Incidence Rates per 100,000 Population for Districts in Lango Sub-region: 2008 and Oyam, the weekly incidence of malaria 1,400 remains low. 1,200 In Acholi sub region, the weekly incidence of malaria declined slightly in all district except 1,000 Kitgum. The increase in number of cases in Kitgum can be attributed to the fact that in epi- 800 week 32 Kitgum general hospital submitted the 600 weekly IDSR report. Kitgum General hospital contributes a big proportion to the patient load 400 in the district. Note that the second round of IRS Reported Clinical Malaria Cases per 100,000 Population 100,000 per Cases Malaria Clinical Reported has just been completed in Kitgum district and it 200 is on going in Pader. We expect that in the Lira Apac Oyam Dokolo Amolatar 0 coming week, the weekly incidence of malaria in 1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829303132 the two districts will soon begin to decline. Karamoja sub-region, the incidence of malaria has been steady over the last 6 weeks. See figure I for details. 2.2 Diarrhoea disease The weekly incidence of diarrhoeal disease in Acholi sub-region continues to drop as a result of the ongoing campaign against Hep E. In Lango sub-region, Figure II; WEEKLY DYSENTERY INCIDENCE BY DISTRICT IN LANGO SUB-REGION: 1st Jan. - 10th 60 August 2008 Lira district continues to report high number of cases of dysentery. See figure II for details. WHO 50 is working with the office of the DHO to map the d cases and do stool culture and sensitivity test at 40 Lira Regional Referral Hospital. In Karamoja sub- regions the weekly incidence of dysentery has 30 continued to decline. 20 Cholera No. of Dysentery Cases Cases Reporte Dysentery of No. 10 The epidemic outbreak of cholera is now under control. In epi-week 32, only 3 suspected cases 0 (2 Mbale and 1 Pallisa district) with no deaths 1 2 3 4 5 6 7 8 9 1011121314151617181920212223242526272829303132 th EPI DEM I OL OGI CAL WEEK were registered. As of 13 August 2008 the Lira Apac Oyam Dokolo Amolatar cumulative total number of cases was 532 with 31 deaths (CFR 5.8%), 3 patients are on admission at Kasasiri CTC in Pallisa district. Ongoing response to the epidemic includes community mobilization and sensitization, case management, active cases search and coordination of response through weekly NTF meeting at national and district level. The main challenges still remains lack of funds for social mobilization through the radio, poor commitment by the local leaders, and difficulties in enforcing latrine construction especially among families who live near the swamps. For further information, please contact: Page 1 Dr J.B Tapko, WHO Representative Uganda (a.i.); Tel. +256 41 335500, Mobile +256752728257, Email: [email protected] 2.3 Measles and Meningitis No case of meningitis and measles was reported in the week. 2.4 Hepatitis E The epidemic trend of Hepatitis E has continued to decline in the last 5 weeks. In epi-week 32 of 2008, 232 new cases were registered as compared to 294 new cases registered in epi-week 31. The cumulative number of cases registered in Kitgum district as of 12th August 2008 was 7,122 with 110 deaths (CFR 1.5%). 17 out of 19 sub- counties in Kitgum district have been affected and 72% of the established death was among women. See figure III and IV for details. Figure III: epi-curve of Hepatitis E cases in Kitgum district Figure IV; Weekly incidence of Hep E in Kitgum district by sub- county 800 700 240 600 500 180 400 120 300 # ofcases 200 60 100 0 0 W47 50 W1 W4 W7 W10 W 13 W 16 W 19 W 22 W 25 W 28 W 31 4748495051521234567 891011121314151617181920212223242526272829303132 Epi-week Epi- week Madi Opei Agoro paloga padibe Mucwini In the other Hep E affected districts of Gulu/Amuru, Pader, Lira, Oyam and Amolatar the cumulative number of suspected cases of Hepatitis E are 10 (6 confirmed), 21 (4 confirmed), 2, 4 and 3 respectively. During the week, 4 new cases were registered in Gulu/Amuru district, 1 case from Pader district and 2 cases from Lango sub-region. Response to the epidemic include community mobilization and sensitization using radios, community leaders and VHTs, support to construction of latrines, water chlorination and provision of soap for hand washing facilities. There is need to sustain response even after the epidemic to avoid re-emergence of the epidemic especially in districts that are currently reporting high number of cases. WHO continue to provide, technical, financial and logistic support to the district in surveillance, case management and coordination of response. 3. Conclusion The performance in IDSR reporting in all districts was above 80%. The epidemic outbreak of Hepatitis E in Kitgum district is slowly being contained however, there is need to sustain interventions in Padibe, Mucwini, Agoro and Paloga sub-county. The epidemic outbreak of malaria in Lira district and cholera in Eastern Uganda has been contained. 4. Acknowledgements Production of this weekly update has been made possible by contributions from the following partners: For further information, please contact: Page 2 Dr J.B Tapko, WHO Representative Uganda (a.i.); Tel. +256 41 335500, Mobile +256752728257, Email: [email protected] .