EWARN & Diseases Surveillance Bulletin
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EWARN: Early Warning Alert and Response Network Libya: EWARN & Diseases Surveillance Bulletin 2018: Epidemiological Week: 14 Reporting Period: 02 April –08 April 2018 Highlights Number of reporting sites in week 14: One hundred and five (105) submitted their weekly reports complete and in timely manner. Total number of consultations in week 14: 43,707 marking an increase of 4,733 to last week consultation of 48,440. The number of consultations for other disease this was week was 36,557. NCDC and WHO | EWARN & Diseases Surveillance Bulletin 1 Leading causes of morbidity in week 14: Acute Upper Respiratory Infections (AURI) (n=4389; 10.04% of consultations number), Acute Lower Respiratory Infections (ALRI) (n=1552; 3.55%) and acute diarrhea (AD) (n=1105; 2.53%) remained the leading causes of morbidity this reporting week. Number of alerts in week 14: Twelve (12) alert were generated through EWARN. (details: see Alerts and Outbreaks Section). The health authorities of each municipality have the capacity to respond to outbreaks. The alerts were discussed with the focal person and respected surveillance officers of the municipalities. (Details: see Alert and Outbreak Section). NOTE: In all the figures below that represent trends, numbers from week 14 in 2018 were compared to three different averages from 2017 representing the following: The average value for epidemiological weeks 01 – 52 in 2017, representing the entirety of 2017. The average value for epidemiological weeks 39 – 52 in 2017, representing the period of reporting that followed the first EWARN training workshop in September of 2017. The average value for epidemiological weeks 49 – 52 in 2017, representing the period of reporting that followed the second EWARN training workshop in December of 2017. No of reporting sites in Libya comparing averages of weeks, week 1 - 52 2017, weeks 39 -52 2017, weeks 49 - 52 2017 and week 01 - 14 2018 140 120 100 80 60 119 121 118 104 40 86 20 40 0 Weeks Weeks Weeks Week Week Week Week Week Week Week Week Week Week Week Week Week Week 1 - 52 39 - 52 49 - 52 01 02 03 04 05 06 07 08 09 10 11 12 13 14 2017 2017 2017 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 Figure 1. Distribution of reporting health facilities NCDC and WHO | EWARN & Diseases Surveillance Bulletin 2 Morbidity Patterns: During week 14, the proportions of AD and ALRI increased in comparison with the previous week as it can be seen in figure 2. Comparing average cases of AURI, ALRI and AD of all of 2017, beyond 1st EWARN workshop, beyond 2nd EWARN workshop and week 01 - 14 2018 7000 6000 5000 4000 3000 2000 1000 0 Weeks Week Week Week Week Week Week Week Week Week Week Week Week Week Week 49 - 52 01 02 03 04 05 06 07 08 09 10 11 12 13 14 2017 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 AURI ALRI AD Figure 2. Distribution of AURI, AD and ALRI in week 1 – 52 2017 and 14 2018 2018 Epidemiological week 14: Below is the distribution of the leading causes of morbidity by municipalities for the epidemiological week 14. NCDC and WHO | EWARN & Diseases Surveillance Bulletin 3 Distribution of common disease by municipalities for week 14, 2018 100% 90% 80% 70% 60% 50% ALRI 40% AD 30% AURI 20% 10% 0% Sert JALO GHAT ZLETIN ZAWIA SABHA Tobruk ZWARA KHOMS ESBEAA MRADA OUBARI GARIAN ALKOBA MORZIG TAZIRBU ALMARIJ ALJOFRA ALBAIDA DARNAH BENGAZI NESMAA MEZDAH ALAJILAT IGDABYA ALABYAR ALKOFRA SUBRATA Ghdames ALJEMAIL TRAGHEN DAWOON TARHUNA REGDALIN IMSALATA MISURATA Aljaghboub BANIWALED ASHATI EASTASHATI ASHATI West ASHATI ABOU ABOU SALEM Souq Eljomaa Souq TRIPOLI central TRIPOLI HAY HAY ALANDALUS Qasir BenGhashir Qasir Figure 3. Distribution of common disease by municipalities for week 14, 2018 Trend of pertussis: In total 430 cases of suspected pertussis have been reported from EWARN sites this year. This week 26 cases were reported and they are distributed as follow: Albaida (3), Subrata (8), Imsalata (12) and Bengazi (3). NCDC and WHO | EWARN & Diseases Surveillance Bulletin 4 Distribution of S. pertussis reported cases by week and by municipality up to week 14, 2018 ALABYAR ALAJILAT ALBAIDA Aljaghboub ALJEMAIL ALJOFRA ALKOBA ALKOFRA ALMARIJ ASHATI ASHATI EAST ASHATI West BANIWALED BENGAZI DARNAH ESBEAA GARIAN GHAT Ghdames IGDABYA IMSALATA JALO KHOMS MEZDAH MISURATA MORZIG MRADA OUBARI Qasir Ben Ghashir REGDALIN SABHA Sert SUBRATA SURMAN TARHUNA TAZIRBU Tobruk TRAGHEN Tripoli YEFRIN ZAWIA ZELTON ZENTAN ZLETIN ZWARA ALZAHRAA TRIPOLI central ALSWANI ALAZIZIYA Souq Eljomaa NESMAA 10 0 0 0 33 0 0 14 0 29 1 0 30 0 14 2 01 0 8 0 24 17 20 7 18 0 0 7 8 12 3 0 16 7 0 0 12 7 12 12 9 0 11 9 3 9 2 7 0 8 0 7 1 3 4 0 3 0 01 01 0 5 4 5 01 01 2 10 10 2 2 3 2 2 0 10 0 3 WEEK 01 WEEK 02 WEEK 03 WEEK 04 WEEK 05 WEEK 06 WEEK 07 WEEK 08 WEEK 09 WEEK 10 WEEK 11 WEEK 12 WEEK 13 WEEK 14 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 2018 Figure 4. Distribution of suspected pertussis cases reported by week and by municipality week 14 2018. Trend of Acute Upper Respiratory Infections During week 14, a total of 4389 cases were reported (10.04 % of total consultations) and are summed up in table 1 below: Municipality AURI cases Municipality AURI cases ALJOFRA 249 Souq Eljomaa 300 ALKOFRA 113 Ghdames 92 ALMARIJ 192 Sert 77 BANIWALED 182 Aljaghboub 1 BENGAZI 554 SUBRATA 195 GARIAN 36 ALKOBA 111 IGDABYA 293 ALBAIDA 70 IMSALATA 255 ALAJILAT 235 NCDC and WHO | EWARN & Diseases Surveillance Bulletin 5 KHOMS 82 ASHATI EAST 89 MISURATA 186 Tobruk 5 MORZIG 73 Qasir Ben Ghashir 82 MRADA 17 MEZDAH 10 REGDALIN 49 TRAGHEN 5 SABHA 48 ALABYAR 24 ZAWIA 193 JALO 20 ZLETIN 38 TAZIRBU 61 ZWARA 157 ABOU SALEM 29 TRIPOLI central 117 37 HAY ALANDALUS DARNAH 101 8 OUBARI ESBEAA 12 Table 1. Summary of AURI cases by Municipality in week 14 Figure 5 below shows the trend of AURI cases in the period from week 01 2017 to week 14/2018 through the EWARN system. Moreover, Figure 6 shows the trend of AURI cases percentage from the total consultations in the period between week 39 and week 14/2018. The cumulative AURI during this year reached 68658 cases. Benghazi reported 15% of all cases (10087). Trend of the disease showed peaks of over the past two months. NCDC and WHO | EWARN & Diseases Surveillance Bulletin 6 DISTRIBUTION OF AURI CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 14, 2018 7000 6000 5000 4000 3000 2000 1000 0 Week 01 Week2017 02 Week2017 03 Week2017 04 Week2017 05 Week2017 06 Week2017 07 Week2017 08 Week2017 09 Week2017 10 Week2017 11 Week2017 12 Week2017 13 Week2017 14 Week2017 15 Week2017 16 Week2017 17 Week2017 18 Week2017 19 Week2017 20 Week2017 21 Week2017 22 Week2017 23 Week2017 24 Week2017 25 Week2017 26 Week2017 27 Week2017 28 Week2017 29 Week2017 30 Week2017 31 Week2017 32 Week2017 33 Week2017 34 Week2017 35 Week2017 36 Week2017 37 Week2017 38 Week2017 39 Week2017 40 Week2017 41 Week2017 42 Week2017 43 Week2017 44 Week2017 45 Week2017 46 Week2017 47 Week2017 48 Week2017 49 Week2017 50 Week2017 51 Week2017 52 2017 WWeek 01WWeek 2018 02WWeek 2018 03WWeek 2018 04WWeek 2018 05WWeek 2018 06WWeek 2018 07WWeek 2018 08WWeek 2018 09WWeek 2018 10WWeek 2018 11WWeek 2018 12WWeek 2018 13WWeek 2018 14 2018 Figure. 5 Distribution of AURI cases by week, week 1 – 52, 2017 and week 14, 2018. Percentage of AURI cases from the total consultation number by week, week 39 - 52, 2017 and week 14, 2018 16.00 14.00 12.00 10.00 8.00 14.79 13.38 13.7513.71 6.00 12.21 12.65 12.25 12.42 11.5411.33 10.9211.53 11.09 10.21 10.04 9.15 9.53 4.00 8.53 8.33 8.64 7.067.52 7.26 6.48 6.40 6.04 5.46 2.00 1.44 0.00 week week week week week week Week Week Week Week Week Week week week Week Week Week Week Week Week Week Week Week Week Week Week Week Week 39 40 41 42 43 44 45 46 47 48 49 50 51 52 01 02 03 04 05 06 07 08 09 10 11 12 13 14 NCDC and WHO | EWARN & Diseases Surveillance Bulletin 7 Figure.6 Distribution of AURI percentage by week, week 39 – 52, 2017 and 14, 2018 Trend of Acute Lower Respiratory Infection: During week 14, a total of 1552 cases of acute lower respiratory infections were reported (3.55% of total consultations) and are summarised by municipality in Table 2 below: Municipality ALRI cases Municipality ALRI cases 51 21 ALJOFRA TRIPOLI central ALKOFRA 1 222 Souq Eljomaa ALMARIJ 63 Ghdames 25 BANIWALED 71 Sert 38 BENGAZI 148 SUBRATA 216 GARIAN 10 ALKOBA 53 IGDABYA 26 ALBAIDA 23 IMSALATA 30 ALAJILAT 65 KHOMS 4 ASHATI EAST 22 MISURATA 94 Tobruk 13 Qasir Ben MORZIG 11 Ghashir 91 REGDALIN 49 MEZDAH 7 SABHA 96 ALABYAR 3 ZAWIA 35 JALO 1 ZLETIN 28 TAZIRBU 3 HAY DARNAH 8 ALANDALUS 14 ESBEAA 10 Table 2. Summary of ALRI cases by Municipality in week 14 Figure 7 below shows the trend of ALRI cases in the period from week 01 2017 to week 14/2018 through the EWARN system.