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FIT Sentinel Response Alert Report February 2021 Demography & Sampling The FIT Sentinel Surveillance was designed as a sample- census in which 15 settlements were selected per ward and 5 health facilities per LGA. Data was collected in 5 settlements each in the 139 wards from all the 23 accessible LGAs. The demography of the sample is as indicated in the diagram below; 770 12,607 Settlements Households 19,270 5,170 Total Children Total Children Screened 6-23 Months Screened 9,647 9,623 Male Female Figure 1: Demographic characteristics of the sample Nutrition & Health Status The results of the nutritional status of children 6-59 months using MUAC measurement reveals an overall Global Acute Malnutrition (GAM) rate of 5.2% which represent a decrease of 0.3% when compared to previous round and SAM rate of 0.6% (no change from previous round) for the whole state Figure 2: Severe acute malnutrition rates for children 6-59 months with only Kaga, Magumeri & Mobbar LGAs having a high GAM and 6-23months rate of above 15% while only Shani LGA has SAM rate of more than 2.0%. However, disaggregating the data for the most Alerts Threshold vulnerable age group (6-23 months old) reveals a more than The aim of the surveillance system is to generate alerts that two-fold increase in the rates to 12.5% and 1.5% for GAM will guide the project implementation. The alerts are a form and SAM respectively. Further disaggregation of the data for of early warning system that will flag changes (deterioration 6-23 months old by LGA shows that 7 LGAs (Bayo, Gubio, and improvement) between rounds that will guide the Kaga, Kwaya Kusar, Magumeri, Nganzai and Shani) have SAM project response to emerging crisis and documentation of rates of 2 or more percent while on the other hand, 13 out lessons learnt in improving scenarios. Changes between of 21 LGAs have GAM rates above 10% (figure 2 & Annex I). rounds in GAM (5%), SAM (1%) and diarrhea (5%) as well as outbreak of either measles or cholera are considered as Analysis of diarrhea results shows that none of the 21 LGAs alerts. Positive changes or improvement (decrease from had a number above 10% for children 6-59 months old. previous round) are considered positive alerts while Disaggregating the data for the most vulnerable children (6- deterioration or negative changes (increase from previous 23 months old) reveals that only Damboa LGA has a rate of rounds) are considered as negative alerts. above 10% with the rest having numbers below 10% see Annex I for details. The alerts thresholds are as presented in the chart below; Alerts Legend Normal Positive Alert or Improvement Negative Alert or Deterioration Malnutrition Alert LGA Diarrhea Alert LGA Diarrhea & Malnutrition Alert LGA Two deterioration or negative alerts for malnutrition were registered for Kaga and Magumeri LGAs with changes ≥5% and ≥1% for GAM and SAM. While on the other hand, >5% deterioration was recorded for diarrhea thereby giving rise to diarrhea only alert in Bama, Damboa & Gwoza LGAs. Finally, 5 LGAs (Bayo, Kwaya kusar and Mobbar:-high GAM deterioration & Gubio and Shani:-high SAM deterioration) Alerts Generated should be observed more due to high changes in GAM and Although the caregivers of 287 children 6-59 months of age SAM rates from last round. None of the 21 LGAs showed a in 17 out of 21 LGAs (all except Dikwa, Kala Balge and combined malnutrition and diarrhea alert. In total, 5 LGAs Nganzai) reported that the children have shown signs of have alerts (see the table 1 above for details). None of the measles within the last 2 weeks (see Annex II). There was no LGAs showed improvement across all the 3 indicators when confirmation from the DSNO as the results are currently compared to last round of data collection. being awaited. Thus, no confirmed cases of measles and cholera were reported, hence no alerts were registered for Overall, 5 LGAs have alerts (2 malnutrition and 3 diarrhea them. alerts) which needs to be investigated further with a small study or analysis of additional data. None of the alerts met Table 2: Shows changes in GAM, SAM and Diarrhea as compared to the criteria for an emergency response as there was no the data obtained in the last round confirmed outbreak of cholera or measles. Change from Last Round (%) LGA GAM SAM Diarrhea Recommendations Askira Uba 4.2 0.5 -1.1 Based on the findings above, we recommend that; Bama -11.9 -1.3 5.4 i. The high deterioration in both GAM and SAM numbers in Kaga and Magumeri LGAs makes it imperative to Bayo 11.0 0.9 -1.9 investigate further the drivers of malnutrition in these Biu 0.9 -1.3 1.9 LGAs. Chibok -10.4 -0.8 -2.1 ii. The high deterioration in diarrhea rates in Bama, Damboa Damboa -18.8 -2.6 16.9 and Gwoza LGAs should also be investigated. Gubio -3.8 2.4 -2.1 iii. A meeting of the FIT Implementation Committee be Gwoza -2.0 0.5 8.1 convened immediately to decide possible response implementation strategy to identified alerts. Hawul -8.7 -1.6 2.2 iv. Finally, even though Bama, Kwaya kusar and Mobbar Jere -3.8 -0.5 -2.9 which shows high GAM changes as well as Gubio and Shani Kaga 23.8 2.7 -9.4 LGAs that shows high SAM changes did not meet the Kala Balge -6.7 -1.6 -2.7 criteria of malnutrition alert, the data reveals changes GAM rate and SAM rates of above the set thresholds for Konduga -4.7 -4.3 -4.9 SAM and GAM alert individually. These necessitated the Kwaya Kusar 9.1 0.7 -11.0 need for the nutrition team and partners to keep an eye Mafa -9.7 -1.6 -3.7 these LGAs and ensure that every child that requires treatment is responded to accordingly. Magumeri 39.2 3.5 -1.6 Maiduguri 0.3 -0.9 -4.8 Mobbar 48.5 0.0 0.0 Ngala 1.5 0.0 -14.9 Nganzai 1.2 0.2 -30.8 Shani -1.9 3.4 -0.7 Annex I: Table of GAM, SAM and Diarrhea rates for children 6-23 months and 6-59 months old Change from Last Round Total GAM SAM Diarrhoea Total (%) Children LGA Under 5 6-59 6-23 6-59 6-23 6-59 6-23 6-23 GAM SAM Diarrhea Children Months Months Months Months Months Months Months Askira Uba 5.4 13.5 0.3 0.8 1.4 2.3 4.2 0.5 -1.1 355 1,148 Bama 0.9 3.3 0 0 2.3 5.4 -11.9 -1.3 5.4 92 428 Bayo 6 14.6 0.8 2.1 1.2 2.9 11.0 0.9 -1.9 419 1,387 Biu 3.7 9 0.3 1.2 2.8 5 0.9 -1.3 1.9 323 1,143 Chibok 3.2 5.8 0.2 0.5 0 0 -10.4 -0.8 -2.1 432 1,207 Damboa 2.4 7.3 0.7 1.7 5.9 16.9 -18.8 -2.6 16.9 177 595 Gubio 2.8 6.8 1.8 4.5 0 0 -3.8 2.4 -2.1 44 109 Gwoza 0.3 1.1 0.1 0.5 4.2 8.1 -2.0 0.5 8.1 185 762 Hawul 2.9 7.4 0.5 1.1 1.9 5.9 -8.7 -1.6 2.2 458 1,606 Jere 2.9 11.1 0.4 1.1 2.5 8.5 -3.8 -0.5 -2.9 551 2,539 Kaga 37.8 34.7 1.9 2.7 0.3 0 23.8 2.7 -9.4 75 360 Kala/Balge 7.9 14.9 0.5 1.1 0 0 -6.7 -1.6 -2.7 87 202 Konduga 5.3 19 0.2 1 1.8 3 -4.7 -4.3 -4.9 100 491 Kwaya Kusar 5.8 14.3 0.8 2 1.4 2.9 9.1 0.7 -11.0 587 1,779 Mafa 0.6 5 0 0 0 0 -9.7 -1.6 -3.7 60 487 Magumeri 22.8 70.2 1 3.5 3 5.3 39.2 3.5 -1.6 57 202 Maiduguri 4.8 11.2 0.2 0.6 0.7 1.8 0.3 -0.9 -4.8 616 2,624 Mobbar 15.3 56.5 0 0 1.7 0 48.5 0.0 0.0 23 118 Ngala 3.7 15.7 0 0 1.1 1.1 1.5 0.0 -14.9 89 617 Nganzai 6.6 32 0.7 4 2.2 0 1.2 0.2 -30.8 25 136 Shani 9.3 19.3 2.4 5.1 2.4 4.8 -1.9 3.4 -0.7 415 1,330 Total 5,170 19,270 Annex II: Summary of locations sampled, suspected measles and birth registration reported by LGA Number of Locations Sampled/LGA Birth Registration Reported Self-Reported Measles** Total Certificate Not Sighted LGA Certificate Suspected Confirmed Under 5 Wards Settlements Households* Sighted DoB DoB Unknown / Cases Cases Children Known Not Registered Askira/Uba 12 60 801 11.8 72.2 15.9 35 0 1,148 Bama 3 15 394 10.3 14 75.7 31 0 428 Bayo 10 50 797 7.7 19.1 73.2 0 0 1,387 Biu 9 45 666 12.1 50.5 37.4 13 0 1,143 Chibok 10 65 727 44.6 20.8 34.7 2 0 1,207 Damboa 3 15 215 30.9 1.5 67.6 18 0 595 Gubio 3 15 113 0 0 100 0 0 109 Gwoza 5 25 600 18.4 50 31.6 1 0 762 Hawul 12 60 1,042 46.4 40.3 13.3 55 0 1,606 Jere 11 65 1,413 6.5 20.7 72.8 13 0 2,539 Kaga 4 20 304 1.7 20.8 77.5 1 0 360 Kala/Balge 1 5 132 16.3 82.2 1.5 1 0 202 Konduga 5 25 401 17.5 57 25.5 3 0 491 Kwaya Kusar 10 50 971 45 26.8 28.1 9 0 1,779 Mafa 3 15 352 0 37.4 62.7 0 0 487 Magumeri 3 15 111 0 10.4 89.7 0 0 202 Maiduguri 15 75 2,020 9.3 42 48.8 7 0 2,624 Mobbar 2 10 125 0 1.7 98.3 11 0 118 Ngala 4 20 335 0.8 1.5 97.7 5 0 617 Nganzai 1 5 110 0 0 100 1 0 136 Shani 11 105 978 17 30.9 52.1 81 0 1,330 Total 139 770 12,607 18.7 32.5 48.8 287 0 19,270 *Note: only households with children 6-59 months were visited during data collection.