MINISTRY OF HEALTH • 403 staff in 60 Districts trained on Rapid Response • All regions achieve the annualized Non- Polio AFP rate of 2.0 per 100,000 population VOLUME 4 less than 15 years WEEK 24 16th June, 2019 The Ghana Weekly Epidemiological Report is a publication of the Ghana Health Service and the Ministry of Health, Ghana © Ghana Health Service 2019 ISSN - 2579-0439 i Ghana Weekly Epidemiological Report Vol. 4 Week 24 16 June 2019 Acknowledgement This publication has been made possible with technical and financial support from the Bloomberg Data for Health Initiative (www.bloomberg.org), the CDC Foundation and the World Health Organisation. ii Ghana Weekly Epidemiological Report Vol. 4 Week 24 16 June 2019 Rapid Response Team Training in Selected Districts in Ghana Rapid Response Team Training in Selected Districts in Ghana Introduction Globalization, population growth and migration have increased the challenges that are faced by health services in the event of any public health crises. Public health emergencies and threats have no borders, and this highlights the need to enforce health security at the global, national, regional and sub-regional levels. As part of a continuous effort to build capacity for epidemic preparedness and response, Ghana Health Service (GHS) with support from the Center for Disease Control and Prevention (CDC), and the World Health Organization (WHO), conducted RRT trainings in early 2017 across the northern and southern sectors of Ghana for all regions. Training has also been completed at the district level for 60 selected districts from all regions. The training programs are to support the long-term workforce development requirements for establishing and maintaining rapid response teams at national and sub-national levels. The trainings follow an initial 4-Day Training of Trainers (T.O.T.) involving 40 participants comprising Epidemiologists/Surveillance Officers, Clinicians, Laboratory Scientists and Health Promotion Officers from all the ten (10) regions of country in January 2019. The objective was to train health emergency workforce at the district levels (including facilities) involved in outbreak investigation and deployment to be able to act immediately and adequately respond to any public health emergency in Ghana and support the West Africa Region. Additionally, a data repository for multisectoral rapid response team members, which will be periodically updated to serve as the core technical pool of individuals to be reached during health emergencies, was to be developed. Methods Health Promotion Officer, Epidemiologist, Biomedical A total of 60 districts were selected from all regions (6 Scientist, and Environmental Health Officer. In selected districts each per region) [Figure 1]. Selection was done regions, (6 regions), DDHSs were part of the trainees. A in consultation with the regional directorate and were total of 403 staff from the selected districts were trained based on a combination of the following criteria, viz: [Table 1]. The trainings covered a duration of five days Epidemic-prone district; Border districts; Districts that in each region. The WHO rapid response-training had poorly managed (a) previous outbreak(s); Districts package was adapted for the trainings. The methods that had not been trained in outbreak response; High employed included lectures, case study, demonstrations mobility districts (e.g. districts with big markets); and table top simulation. Pre-test and post-test Districts with poor surveillance indicators; Districts with assessments were conducted at the beginning and closure well-motivated workforce. Each District team trained respectively for all the trainings. All content used in all comprised primarily of 6 members. Participants from regional trainings was adapted from the WHO rapid each district comprised a Clinician, Veterinary Officer, response team training package. The content encouraged participant participation in all sessions Table 1: Summary of Participants Trained by Region Region Sex Grand Total Female Male Ashanti 9 27 36 Brong Ahafo 5 35 40 Eastern 9 33 42 Greater Accra 18 28 46 Northern 2 41 43 Upper East 10 30 40 Upper West 3 35 38 Volta 10 31 41 Western Region 5 31 36 Central 11 30 41 Grand Total 82 321 403 Figure 1: Selected Districts for RRT Training Ghana Weekly Epidemiological Report Vol. 4 Week 24 16 June 2019 1 Rapid Response Team Training in Selected Districts in Ghana Conclusion Next Steps All trainings to improve emergency workforce at the • Development of a national database of all trained regional/ district levels (including facilities) in the 10 RRT members from all districts regions have been successfully completed. Participants • Coordination and organization of regular simulation have been equipped with the knowledge and skill to be exercise to maintain and sharpen skills and monitor and adequately respond to public health knowledge gained during training emergencies. A pool of trained experts has been created to • Preparation and submission of rapid response plas by support public health emergency activities in Ghana and districts to the regional surveillance officers also the West African Sub Region. Ghana Weekly Epidemiological Report Vol. 4 Week 24 16 June 2019 2 Summary of Weekly Epidemiological Data, Week 24, 2019 Summary of Weekly Epidemiological Data for Week 24, 2019 Highlights: • All regions achieve the annualized Non-Polio AFP rate of 2.0 per 100,000 population less than 15 years 1% 1% SUMMARY OF PRIORITY Adverse events following DISEASES AND EVENTS - 1% 2… immunization WEEK 24, 2019 4% Meningitis The total all-cause notifiable disease morbidity for the week (as per IDSR 5% AFP (suspected polio) Weekly Summary Reporting Form) was 2,412 with four maternal deaths. Diarrhoea with blood Acute watery diarrhoea in persons aged 5 years and above was the Yellow fever (suspected) 58% 28% highest proportion of cases reported, contributing to approximately 73% of Measles the notifiable diseases’ caseload during Week 24 [See Figure 1 and Influenza-like illness Annex 1] Acute watery diarrhoea in persons aged ≥5 years Figure 1: Reported notifiable disease conditions, Ghana, Week 24, 2019 REGIONAL PERFORMANCE BASED ON REPORTING The best performing region in Week 24 was Upper West Timeliness and Completeness of reporting for all region with a mean score of 99.6% whilst Central region notifiable conditions for the Week were 96.5% and 99.0% had the lowest mean score of 77.3% [Table 1]. All regions respectively. All regions but Central scored above 90% achieved the expected targets (36.9%) for percentage of for both indicators [Table 1]. districts reporting at least a suspected case of Measles or . Yellow Fever. Table 1: Ranking of Regional Performance based on selected Surveillance reporting indicators, Ghana, Week 24, 2019 Region Timeli- Complete- Measles YF Average ness (%) ness (%) Cum. Annualized AFP % % Score % Position Week Week AFP Non-Polio Score District District 24 24 Cases AFP Rate (%) reporting reporting (A+B+C+ A B Week 24 C D E D+E)/5 Upper West 98.6 99.4 28 16.8 100 100.0 100.0 99.6 1st Western 98.8 98.8 33 4.9 100 100.0 95.5 98.6 2nd Brong-Ahafo 99.3 99.9 36 6.2 100 100.0 88.9 97.6 3rd Greater Accra 89.3 100 41 3.4 100 100.0 93.8 96.6 4th Eastern 99.5 100 22 3.1 100 100.0 80.8 96.1 5th Ashanti 98.2 98.9 40 2.9 100 93.3 86.7 95.4 6th Volta 99.8 100 25 4.6 100 96.0 80.0 95.2 7th Northern 98.8 100 45 6.3 100 88.5 84.6 94.4 8th Upper East 99.7 100 18 7.6 77.0 92.3 76.9 93.8 9th Central 93.4 93.1 21 3.7 100 55.0 45.0 77.3 10th Ghana 96.5 99.0 309 4.6 100 92.6 82.9 94.2 Ghana Weekly Epidemiological Report Vol. 4 Week 24 16 June 2019 4 Summary of Weekly Epidemiological Data, Week 24, 2019 INFLUENZA-LIKE ILLNESS (IDSR Weekly Report) MEASLES A total of 516 cases with no deaths were reported through During the Week, 46 suspected cases of Measles were IDSR weekly reporting [Table 2]. Laboratory samples recorded across the country [Table 4]. Samples were were sent from sentinel sites to Noguchi Memorial Institute taken and sent to the National Public Health and Reference for Medical Research (NMIMR) with results awaited. Laboratory [NPHRL] for testing. Table 2: Reported Influenza-Like Illness cases by Region Table 4: Suspected Measles cases by Region and District, and District, Ghana, Week 24, 2019 Ghana, Week 24, 2019 Region Districts Cases Deaths Region Districts Cases Deaths Ashanti Adansi South 13 0 Ashanti Asante –Akim South 1 0 Asante Akim South 13 0 Kumasi 1 0 Bosomtwe 1 0 Brong- Ejisu Juaben 62 0 Ahafo Asutifi South 1 0 Brong-Ahafo Sunyani 7 0 Jaman North 2 0 Eastern New Juaben 110 0 Jaman South 1 0 Greater Accra Accra 33 0 Techiman South 4 0 Adentan 8 0 Eastern Akwapim North 1 0 Ga Central 20 0 Akyemansa 1 0 Ga East 30 0 Asuogyaman 1 0 Ga West 44 0 Birim South 1 0 La-Dade-Kotopon 26 0 East Akim 1 0 Ledzokuku Krowor 1 0 Lower Manya Krobo 1 0 Shai Osudoku 85 0 Yilo-Krobo 2 0 Tema 46 0 Greater- Upper East Bolgatanga 5 0 Accra Accra 1 0 Volta Ketu South 7 0 Ga East 1 0 Western Sekondi Takoradi 5 0 Ga South 4 0 Total 516 0 Kpone Katamanso 2 0 La-Nkwantanang Madina 1 0 Upper YELLOW FEVER West Nadowli-Kaleo 1 0 Twenty-six suspected cases of Yellow Fever were reported Sissala East 1 0 Upper across the country [Table 3].