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Communicable Disease Toolkit for Angola

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Communicable Disease Toolkit for Angola COMMUNICABLE DISEASE TOOLKIT WHO/CDS/NTD/DCE/2005.a PPRROOFFIILLEE AAA NNN NNN EEE XXX EEE SSS Angola WHO Communicable Diseases Working Group on Emergencies WHO Regional Office for Africa WHO Office, Luanda Communicable disease profile for ANGOLA 2005 © World Health Organization 2005 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The named authors alone are responsible for the views expressed in this publication. Further information is available at: CDS Information Resource Centre, World Health Organization, 1211 Geneva 27, Switzerland; fax: +41 22 791 4285, e-mail: [email protected] or [email protected] 2 World Health Organization Communicable disease profile for ANGOLA 2005 Acknowledgements Edited by Dr Michelle Gayer, Dr Pamela Mbabazi and Dr Máire Connolly of the WHO Programme on Disease Control in Humanitarian Emergencies. This profile is a collaboration between the Communicable Disease Working Group on Emergencies (CD-WGE) at WHO/HQ, the Division of Communicable Disease Prevention and Control (DCD) at WHO/AFRO and the Office of the WHO Representative for Angola. The CD-WGE provides technical and operational support on communicable disease issues to WHO regional and country offices, ministries of health, other United Nations agencies, and nongovernmental and international organizations. The Working Group includes the departments of Neglected Tropical Diseases (NTD), Epidemic and Pandemic Alert and Response (EPR), Special Programme for Research and Training in Tropical Diseases (TDR) in the Communicable Diseases (CDS) cluster; Roll Back Malaria (RBM), Stop TB (STB) and HIV/AIDS in the HIV/AIDS, Tuberculosis and Malaria (HTM) cluster; departments of Child and Adolescent Health and Development (CAH), Immunizations, Vaccines and Biologicals (IVB) in the Family and Community Health (FCH) cluster; Food Safety (FOS), Protection of the Human Environment (PHE) in the Sustainable Development and Healthy Environments (SDE) cluster; Injuries and Violence Prevention (VIP), and Nutrition for Health and Development (NHD) in the Noncommunicable Disease and Mental Health (NMH) cluster; Security and Staff Services (SES) in the General Management (GMG) cluster; and the departments of Health Action in Crises (HAC) and Polio Eradication Initiative (POL). The following people were involved in the development and review of this document, and their contribution is gratefully acknowledged: Samira Aboubaker (FCH/CAH), Henrietta Allen (CDS/NTD), Roberta Andraghetti (CDS/EPR), Ray Arthur (CDS/CSR), Pier Paolo Balladelli (WHO/Angola), Markus Behrend (CDS/NTD), Eric Bertherat (CDS/EPR), Sylvie Briand (CDS/EPR), Claire-Lise Chaignat (CDS/NTD), Claire Chauvin (HTP/VAB), Denis Daumerie (CDS/NTD), Pierre Formenty (CDS/EPR), Micheline Diepart (HTM/HIV), Marta Gacic Dobo (HTP/VAB), Malgosia Grzemska (STB/TBS), Bradley Hersh (HTP/VAB), Htoon Myo (CDS/NTD), Jean Jannin (CDS/NTD), Kande-Bure O’Bai Kamara (CDS/EPR), Daniel Lavanchy (CDS/EPR), Paul Lusamba-Dikassa (WHO/AFRO), Christopher Maddock (CDS/NTD), Colin Mathers (GPE/EBD), François-Xavier Meslin (CDS/CPE), Brian Pazvakavambwa (HIV/TSH), William Perea (CDS/EPR), Aafje Rietveld (CDS/RBM), Francesco A. Rio (CDS/NTD), Cathy Roth (CDS/EPR), Mike Ryan (CDS/EPR), Job Sagbohan (AFRO/DDC), Lorenzo Savioli (CDS/NTD), Tony Ukety (NMH/CHP), Jay Wenger (HTP/VAB), Sergio Yactayo (CDS/NTD), Nevio Zagaria (CDS/NTD). We would like to thank the Government of Ireland and the Office of Foreign Disaster Assistance (OFDA) of the United States Agency for International Development for their support in development of this document. World Health Organization 3 Communicable disease profile for ANGOLA 2005 4 World Health Organization Communicable disease profile for ANGOLA 2005 CONTENTS ACKNOWLEDGEMENTS 3 INTRODUCTION 6 1. ACUTE LOWER RESPIRATORY INFECTIONS (ALRI) 7 2. AFRICAN TRYPANOSOMIASIS (SLEEPING SICKNESS) 10 3. BACILLARY DYSENTERY (SHIGELLOSIS) 15 4. CHOLERA 18 5. DIARRHOEAL DISEASES (OTHERS) 22 6. DIPHTHERIA 25 7. EBOLA AND MARBURG HAEMORRHAGIC FEVERS 29 8. HIV/AIDS 34 9. INFLUENZA 44 10. LEPROSY 49 11. LYMPHATIC FILARIASIS 52 12. MALARIA 56 13. MEASLES 63 14. MENINGOCOCCAL DISEASE 67 15. MONKEYPOX 72 16. ONCHOCERCIASIS (RIVER BLINDNESS) 74 17. PERTUSSIS (WHOOPING COUGH) 79 18. PLAGUE 83 19. POLIOMYELITIS 87 20. RABIES 93 21. SCHISTOSOMIASIS (BILHARZIASIS) 96 22. SOIL-TRANSMITTED HELMINTHIASES 101 23. TUBERCULOSIS 105 24. TYPHOID FEVER 117 25. YELLOW FEVER 119 APPENDIX 1: FLOWCHARTS FOR THE DIAGNOSIS OF COMMUNICABLE DISEASES 122 APPENDIX 2: STEPS IN OUTBREAK MANAGEMENT 128 APPENDIX 3: SAFE WATER AND SANITATION 129 APPENDIX 4: INJECTION SAFETY 130 APPENDIX 5: KEY CONTACTS FOR ANGOLA 131 APPENDIX 6: LIST OF WHO GUIDELINES ON COMMUNICABLE DISEASES 134 APPENDIX 7: IMMUNIZATION SCHEDULE FOR ANGOLA 137 APPENDIX 8: MAP OF ANGOLA 138 APPENDIX 9: POPULATION OF ANGOLA, 2005−2015 139 APPENDIX 10: BASIC HEALTH INDICATORS IN ANGOLA 140 World Health Organization 5 Communicable disease profile for ANGOLA 2005 Introduction The purpose of this document is to provide public health professionals working in Angola with up-to- date information on the major communicable disease threats faced by the population. The list of endemic and epidemic-prone diseases has been selected on the basis of the burden of morbidity and mortality. Diseases for which there are global eradication or elimination goals are also included. The document outlines the burden of communicable diseases in Angola for which data are available, provides data on recent outbreaks in the country and presents disease-specific guidelines on the prevention and control of these diseases. The control of communicable represents a major challenge to those providing health-care services in Angola. It is hoped that this document will facilitate the coordination of communicable disease control activities between all agencies working in the country. 6 World Health Organization Communicable disease profile for ANGOLA 2005 1. ACUTE LOWER RESPIRATORY INFECTIONS (ALRI) CHILDREN LESS THAN FIVE YEARS OF AGE DESCRIPTION Infectious agent Bacteria: the most common are likely to be Streptococcus pneumoniae and Haemophilus influenzae (and Staphylococcus aureus to a lesser extent). Several respiratory viruses. Case definition Clinical description ALRI include bronchitis, bronchiolitis and pneumonia (bronchopneumonia and lobar pneumonia). Pneumonia is the most severe and it is fatal in 10–20% of cases if inappropriately treated. Pneumonia Cough or difficult breathing and Breathing 50 times or more per minute for infants aged 2 months to 1 year Breathing 40 times or more per minute for children aged 1–5 years and No chest indrawing, stridor or general danger signs. Severe pneumonia Cough or difficult breathing and any general danger sign or Chest indrawing or stridor in a calm child. In infants aged less than 2 months the presence of any of the following indicates severe pneumonia: cough or difficult breathing and breathing 60 times or more per minute or grunting or nasal flaring or fever or low body temperature or any general danger sign. General danger signs For children aged 2 months to 5 years: unable to drink or breastfeed; persistent vomiting; convulsions; lethargic or unconscious. Mode of transmission Airborne, by droplets. Incubation Depends on the infective agent. Usually 2–5 days. Period of Depends on the infective agent. Usually during the symptomatic phase. communicability EPIDEMIOLOGY Burden No country-specific incidence data are available at this time. However, pneumonia is reported as being one of the leading causes of death among children less than 5 years of age. The WHO African Region has the second highest ALRI burden globally after the South-East Asian Region and accounts for approximately 33.7 million new episodes every year. Geographical Throughout the country. distribution Seasonality No data available. World Health Organization 7 Communicable disease profile for ANGOLA 2005 Alert threshold An increase in the number of cases above the expected number for that time of the year in a defined area. Recent epidemics in No data available. the country RISK FACTORS FOR INCREASED BURDEN Population movement Yes Movement of populations allows contact between non-immune and infected individuals and increases transmission of the pathogen. Overcrowding Yes Overcrowding increases the risk of transmission. Poor access to health Yes Prompt identification and treatment
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