Somalia Weekly Update Week-45 Ending 12 November 2017 Isolation of VDPV2 from an Environmental Surveillance Site
• A VDPV2 was isolated from an environmental sample from Mogadishu-Somalia • The ES site is ‘21October’ Sewage site in Waberi District, 21October site Banadir Region in Central Somalia. Established on 19th September 2017. The sample was collected on 22nd October, 2017 • KEMRI lab results was received on 1st Nov 2017 as PV2 • Sequencing result from CDC was received on 9th Nov 2017 as VDPV2 with 38 nucleotide difference from the parent Sabin
Response activities so far; • Heightened AFP surveillance with active case searches in the community and health facilities: 1 AFP cases identified and 54 community samples collected • Additional ES samples collected and new site selection in progress • Preparation being finalized to conduct IPV vaccination campaign in 4 catchment districts of the 21October ES site • Request for mOPV being worked on, incase circulation of the VDPV2 is confirmed Part -I
AFP-Surveillance Week-45 Somalia Weekly EPI/POL Update
Epidemiological Curve January 1, 2014 – November 12, 2017 18
16
14
12
10
8
6
4
2
0
Pending Lab Pending ERG Discarded Compatable WPV aVDPV Graph no. 1 Week-45 Somalia Weekly EPI/POL Update
Weekly AFP cases reported by Provinces, 2016-2017 Somalia. (cases are distributed across weeks based on date of onset of paralysis).
PROVINCE
2016W41 2016W42 2016W43 2016W44 2016W45 2016W46 2016W47 2016W48 2016W49 2016W50 2016W51 2016W52 2017W01 2017W02 2017W03 2017W04 2017W05 2017W06 2017W07 2017W08 2017W09 2017W10 2017W11 2017W12 2017W13 2017W14 2017W15 2017W16 2017W17 2017W18 2017W19 2017W20 2017W21 2017W22 2017W23 2017W24 2017W25 2017W26 2017W27 2017W28 2017W29 2017W30 2017W31 2017W32 2017W33 2017W34 2017W35 2017W36 2017W37 2017W38 2017W39 2017W40 2017W41 2017W42 2017W43 2017W44
Total 2016 Total Total 2017 Total BANADIR 2 1 2 1 30 1 1 1 2 1 3 1 2 1 1 1 1 1 2 1 1 2 2 2 1 2 30 GALGADUD 2 1 1 25 1 1 1 1 1 1 1 2 1 1 1 1 1 2 1 1 2 1 1 1 1 24 M. SHABELLE 1 1 19 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 22 L. SHABELLE 1 2 1 24 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 26 HIRAN 1 1 15 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 19 BARI 1 1 2 1 1 24 1 2 1 1 1 2 1 1 1 1 1 2 1 1 1 1 1 20 NUGAL 1 1 1 11 2 1 1 1 1 1 1 1 9 MUDUG 2 1 1 14 1 2 1 1 1 1 1 1 1 1 1 12 TOGDHER 1 1 1 11 1 1 1 1 1 1 1 1 8 GALBEED 1 1 1 1 1 1 1 19 1 3 1 1 1 1 1 1 1 1 2 1 2 1 2 20 SANAQ 2 1 7 1 1 1 1 1 5 AWDAL 1 1 1 18 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 17 SAHIL 1 1 8 1 1 1 1 1 1 1 1 8 SOOL 5 1 2 1 1 1 1 1 2 10
LOWER JUBA 2 1 1 1 1 2 1 1 26 2 1 1 2 2 1 1 1 1 1 1 1 1 2 2 1 1 1 1 24 1 - BAY 2 1 2 19 3 1 3 1 1 1 1 1 1 1 1 2 2 19 GEDO 2 1 1 1 21 1 2 1 1 1 1 1 1 1 1 1 1 2 2 1 18 MIDDLE JUBA 1 11 1 1 1 1 2 1 2 1 10
BAKOOL 1 1 9 1 1 1 1 1 1 1 1 8 Table no. Table Total Somalia 5 11 7 3 4 4 12 7 7 3 5 4 316 6 8 10 6 3 8 9 11 7 12 8 6 9 8 8 4 10 8 6 9 8 5 9 10 2 5 9 3 7 6 7 7 6 9 5 7 10 4 5 7 3 2 7 10 309 Silent (not reporting) for > 8 weeks - 11 new AFP cases were reported this week making the total 309 AFP cases reported in 2017. Reported AFP cases - In addition 923 contact samples (3 contacts for each case) and 167 community samples were collected from 24 districts Community Samples collected in silent regions Community Samples collected but regions not silent Week-45 Somalia Weekly EPI/POL Update
Classification of AFP cases by status (2016 & 2017)
2016 2017 REGION Pending Discarded VDPV Total Discarded Pending Total 309 AFP Cases BANADIR 0 30 0 30 27 3 30 Reported in 2017 GALGADUD 0 25 0 25 24 0 24 HIRAN 0 15 0 15 18 1 19 L. SHABELLE 0 24 0 24 23 3 26 M. SHABELLE 0 19 0 19 20 2 22 BARI 0 24 0 24 19 1 20 MUDUG 0 14 0 14 10 2 12 285 0 24 0 0 NUGAL 0 11 0 11 8 1 9 15 2 17 Discarded WPV Pending Compatible VDPV AWDAL 0 18 0 18 GALBEED 0 19 0 19 17 3 20 SAHIL 0 8 0 8 8 0 8 SANAQ 0 7 0 7 5 0 5 SOOL 0 5 0 5 8 2 10 TOGDHER 0 10 1 11 7 1 8 BAKOOL 0 9 0 9 7 1 8
3 0 18 1 19 2 21 BAY 0 19 0 19 - In process (lab) Pending ERG Pending ITD GEDO 0 21 0 21 18 0 18 LOWER JUBA 0 26 0 26 23 1 24 MIDDLE JUBA 0 11 0 11 10 0 10
Chart no. 1 no. Table Grand Total 0 315 1 316 285 24 309 Week-45 Somalia Weekly EPI/POL Update
Surveillance Indicators by Zone and Region 2017
Annualized NP-AFP Rate by Zone, 2017 12.0 10.0 11.1 8.0
6.0 6.3 5.5 5.8 4.0 4.9 2.0
0.0 Central Puntland Somaliland South Total Somalia
Graph no. 2
Annualized NP-AFP rate by accessibility status 10.0
8.0 7.7 6.0 5.8 4.0 5.5 5.6
2.0
- In-accessible Partially Accessible Somalia Map no. 1 Acceessible Map no. 2 Graph no. 3 Week-45 Somalia Weekly EPI/POL Update
Surveillance Indicators (NP-AFP rate and Stool adequacy) by district, 2017
. All the 115 districts in Somalia have reported at least 1 AFP case since the beginning of 2017. . The NP-AFP rate for 112 districts is >2. The 3 districts that did not meet this indicator are; Badan from Somaliland and Heliwa and Karan from Central. . 112 districts had stool adequacy above 80% while three districts (Badade, Kismayo and Bossaso) did not meet the required stool adequacy rate. Badade and kismayo are partially accessible from south while Bossaso is fully accessible district in Puntland. Map no. 3 Map no. 4 Week-45 Somalia Weekly EPI/POL Update
Distribution of NP-AFP cases and zero-dose cases Vs accessibility of districts
. AFP cases were reported from across
the country from all zones, all regions
and also from the accessible and the
inaccessible parts of the country.
. All but one of the total 39 zero dose
AFP cases reported in 2017 were
reported from access compromised
Map no. 5 districts. Map no.6 Week-45 Somalia Weekly EPI/POL Update
Number of NP-AFP cases reported across years during the same period (2013-2017) by zone
600
500 496
400
367
300 309 274 256 200
164
100 121 131 123 104 100 93 79 68 73 60 56 59 42 36 22 36 54 49 41 41 32 52 48 26 0 CENTRAL Puntland Somaliland SOUTH SOMALIA 2012 2013 2014 2015 2016 2017
. Overall number of AFP cases reported in 2017 exceeded the number of AFP cases reported in 2015 and 2016 in the zones except Puntland for the same period . Week-45 Somalia Weekly EPI/POL Update
CASES AND CONTACT SAMPLES WITH LAB RESULT OF Number of AFP Cases and Contact samples with 18.0% NP-EV AND SLV Entero virus and Sabin like Virus Isolation
16.0% 16.5% NP-AFP Cases Contact Cases
14.0%
EV
- EV
13.8% - 13.6% 13.5% 12.0% 12.5%12.3%
11.7% # SLs #
11.2% result # SLVs #
10.0% 10.8% 10.6% Zone
# Samples from Samples # from Samples # from Samples # from Samples #
Contacts with lab lab with Contacts
cases NP withcases contacts with NP with contacts 8.0% with labresult Cases 8.1% 7.7% 7.1% Central 224 37 8 339 36 20 6.0% 5.9% 5.5% 5.0% Puntland 74 8 5 110 15 6 4.0% 3.9% 4.1% 120 6 7 183 14 3 2.0% 2.7% Somaliland 1.6% 0.0% South 150 19 3 221 31 6 % Specimens from cases with % Specimens from % SL from cases % SL from Contacts NPEV Contactswith NPEV Central Puntland Somaliland South Somalia Somalia 568 70 23 853 96 35 Table no.-3 Week-45 Somalia Weekly EPI/POL Update
Early case detection within 7 days from onset of paralysis at zonal and region levels
Notification within 7 days, Zonal Notification within 7 days, Regional 100% 100% 121 30 24 19 26 22 12 9 17 8 10 8 8 40 66 90% 292 19 19 292 17 9 80% 80% 15 65 4
70% 16 60% 60%
50% 40% 40%
30% 20% 20%
10% 0%
0%
CENTRAL NE NW SOUTH SOMALIA CENTRAL NE NW SOUTH SOMALIA . 94% (n=292/309) of AFP cases reported in 2017 are notified within 7 days of onset. . 17 cases were notified more than seven days after the onset of paralysis from 7 regions {Lower Jubba (8), Gedo (3) , Middle Juba (1), Bari (1), Sanaq (1), Bay (2) and Galbeed (1)}. Week-45 Somalia Weekly EPI/POL Update
Summary of AFP surveillance key indicators by Zone, 2017
with
EV -
ZONE % tool Adq. % inv. within % Notif.
AFP AFP Rate cond.
- 48 hrs. within 7 days
result.
. . Specimen
of samples of samples
Isolated
S L S Virus
Isolation Isolation
lab results lab results
# # AFP cases
# Cases # Cases with
#
NP
# cases # with cases
% Cases % Cases with with NP
stool in stool good
in good cond.
% of cases % of cases with
Cases Cases pending
NP EVIsolated
Cases Cases with lab.
Sabin like virus Sabin like
Adq
Cases Cases with stool % Samples
Central 121 4.9 121 100% 99% 100% 9 112 112 100% 37 17% 8 7%
Puntland 41 11.1 40 98% 100% 98% 4 37 37 100% 8 11% 5 14%
Somaliland 68 5.5 68 100% 100% 97% 8 60 60 100% 6 5% 7 12%
South 79 6.3 77 97% 99% 82% 3 76 76 100% 19 13% 3 4%
Total 309 5.8 306 99% 99% 94% 24 285 285 100% 70 12% 23 8% . Surveillance indicators at national and sub-national level perform above global standard . EV isolation is low in Somaliland and the zonal team are investigating this, with focus on the reverse cold-chain practices . Except 2 AFP cases; one from El-Waq district of Gedo region in South zone and one from Buloburti distrct of Hiran region in Central zone, all the other AFP cases were investigated within 48 hrs of notification . Three cases from Badade, Bosaso and Kismayo districts (one from each) had low stool adequacy levels. Table no.-4 Week-45 Somalia Weekly EPI/POL Update
Summary of AFP surveillance key indicators by Province, 2017
# Cases with Number of AFP cases % inv. within 48 % Notif. within % Stool % Samples with EV % cases with SL ZONE PROVINCE NP-AFP Rate % Stool Adq. late 60 days reported hrs. 7 days condition isolated isolated follow-up
BANADIR 30 3.2 100% 100% 100% 100% 24% 7% 0 GALGADUD 24 10.7 100% 100% 100% 100% 17% 4% 0 CENTRAL HIRAN 19 9.7 100% 95% 100% 100% 3% 0% 2 LOWER SHABELLE 26 3.3 100% 100% 100% 100% 20% 22% 0 MIDDLE SHABELLE 22 7.0 100% 100% 100% 100% 15% 0% 1 BARI 20 13.7 95% 100% 95% 100% 5% 16% 0 PUNTLAND MUDUG 12 8.0 100% 100% 100% 100% 15% 20% 0 NUGAL 9 12.3 100% 100% 100% 100% 19% 0% 0 AWDAL 17 8.6 100% 100% 100% 100% 0% 13% 0 GALBEED 20 4.5 100% 100% 95% 100% 0% 6% 1 SAHIL 8 11.1 100% 100% 100% 100% 0% 25% 0 SOMALILAND SANAQ 5 3.9 100% 100% 80% 100% 10% 0% 1 SOOL 10 9.9 100% 100% 100% 100% 19% 25% 1 TOGDHER 8 3.0 100% 100% 100% 100% 14% 0% 0 BAKOOL 8 5.2 100% 100% 100% 100% 7% 0% 0 BAY 19 4.2 100% 100% 89% 100% 0% 0% 0 SOUTH GEDO 18 6.9 100% 94% 83% 100% 11% 17% 2 LOWER JUBA 24 9.5 92% 100% 67% 100% 26% 0% 1 MIDDLE JUBA 10 7.3 100% 100% 90% 100% 10% 0% 0 SOMALIA 309 5.8 99% 99% 94% 100% 12% 8% 9 Week-45 Somalia Weekly EPI/POL Update
Summary for Somalia Environmental Surveillance
Epidemiological week 2017 Region District Site Name
38 39 40 41 42 43 44 45 46 47 48 49 50 51 52
st NP- Banadir Waberi 21 October VDPV2 EV1 Banadir Shangani Urobo
Banadir Hamerewoini Kawma NP- EV1
1 Not scheduled 6 Sabin 11 WPV1+cVDPV2
2 Pending 7 NPENT + Sabin 12 Sent for sequencing VDPV 2 was isolated from the second sample 3 Negative 8 cVDPV2 13 Scheduled but not collected collected from Waberi district 4 NEV 9 WPV1 14 Sabin 2
5 NPENT 10 WPV3 15 Sabin + NPEV + NEV Week-45 Somalia Weekly EPI/POL Update
Summary of AFP surveillance key indicators for contacts, 2017
% Contact # Contact # Contact # Specimens % Specimens # Contacts % contacts # Contact Average collected with stool in pending lab with NPEV with NPEV with Sabin with Sabin # AFP # % contacts < 5 ZONE samples with contacts per within 7 days Good results isolated Isolated virus like virus Cases CONTACTS age Lab result cases of AFP Condition isolated Isolated notified
Central 121 363 339 3 93% 99% 339 24 36 11% 20 6% Puntland 41 123 110 3 98% 97% 110 13 15 14% 6 5% Somaliland 68 204 183 3 94% 98% 183 21 14 8% 3 2% South 79 233 224 3 94% 97% 224 9 31 14% 6 3% Somalia 309 923 856 3 94% 98% 856 67 96 11% 35 4%
Note: Three specimen are collected for each contact
Community Samples collected from healthy children
Zone Total Samples collected Discarded Samples with NP-EV isolated Samples with SL-isolated Pending for Lab result
Central 54 5 0 0 49 Puntland 25 20 0 1 5 Somaliland 85 80 20 3 5 South 3 3 0 0 0 Total 167 108 20 4 59 Table no.-5 Week-45 Somalia Weekly EPI/POL Update
Distribution of AFP cases by source of case notification, 2017
Source of AFP cases notification 100% Number Number # of cases Proportion of 11 10 90% 7 50 Zone of VPVs of cases Notified by cases reported 22 80% 22 reported VPV by VPV
70% 93 15 CENTRAL
60% 36 20 190 121 88 73% Prop. cases notifed notifed by Prop.cases 50%
40% PUNTLAND 88 105 41 19 46% 30% 166 19 37 20% 22 SOMALILAND 81 68 22 32% 10%
0% Central Puntland Somaliland South Somalia 159 79 37 47% VPV HFs Other SOUTH
Key: 1. VPVs: Village polio volunteers 2. HFs: MCH, Hospitals and Private clinics Somalia 535 309 166 54% 3. Others: community members, district field assistants, traditional healers Table no.-6 Week-45 Somalia Weekly EPI/POL Update
Distribution of AFP cases by life style, age group and sex, 2017
Distribution of AFP cases by Life style Distribution of AFP cases by Age group Distribution AFP cases by Sex . Of the total 309 AFP 100% 100% 100% 19 32 33 37 cases reported in 2017, 90% 90% 72 90% 44% (n=135) and 36% 80% 112 80% 83 80% 65 181 129 135 152 281 171 (n=110) are from Urban 70% 70% 70% 92 324 252 166
60% 60% 60% and Rural population
50% 50% 50% respectively. Nomadic 87 129 249 283 272 117 348 40% 51 144 110 40% 40% communities account for 150 30% 30% 129 30% only 21% (n=64). 164 138 20% 20% 20% 56 221 167 115 . 88% (n=272) of cases are 80 70 10% 31 97 91 64 10% 10% aged less than 5 years. 0% 0% 0% . 2012 2013 2014 2015 2016 2017 2012 2013 2014 2015 2016 2017 2012 2013 2014 2015 2016 2017 45% (n=138) AFP cases Nomadic Rural Urban <5 Yrs ≥ 5 Yrs Female Male are female. Graph no.-10 Graph no.- 11 Graph no.-12 Week-45 Somalia Weekly EPI/POL Update
AFP surveillance indicators by accessibility status of districts # of U-15 Pop # of AFP # of Cases % of Cases NP Number % of % inv. % of % % cases Accessibility districts in this cases reported reported AFP of cases Stool Within Notif. Specime with area Reported by VPVs by VPVs rate with lab adequacy 48 hrs. within 7 ns with Sabin like result days NPEV virus
Inaccessible 17 601,282 40 33 83% 7.7 38 100% 100% 90% 26% 0%
Partially 23 1,670,705 79 36 46% 5.5 73 97% 99% 91% 4% 8% accessible
Accessible 75 3.907,440 190 97 51% 5.6 174 99% 99% 96% 13% 10%
National 115 6,179,427 309 166 54% 5.8 285 99% 99% 94% 12% 8% Table no. -
. VPVs continue to support AFP surveillance and have reported 83% (n=33/40) of cases from inaccessible and 46% (n=36/79) from partially accessible districts. 7 . Most of the surveillance indicators in the accessible and access compromised areas are above global standards; however, SL isolation is very low in the access compromised districts, there are challenges in providing immunization services in those districts Week-45 Somalia Weekly EPI/POL Update
AFP surveillance indicators by Life Style of Population 2017
% of <15 # of AFP # of Cases % of Cases Number % of cases % of % inv. % of % % cases Accessibility populatio cases reported reported of cases with lab Stool Within Notified Specime with Sabin n in the Reported by VPVs by VPVs with lab result adequacy 48 hrs. within 7 ns with like virus result within 14 area days NPEV days
Nomadic 28.8% 64 40 63% 57 86% 97% 98% 93% 11% 7%
Rural 25.9% 110 68 62% 106 85% 100% 99% 94% 14% 8%
Urban 45.3% 135 58 43% 122 90% 99% 99% 94% 11% 8%
National 100% 309 166 54% 285 90% 99% 99% 94% 12% 8%
All major AFP surveillance indicators have met global standard across all life styles Week-45 Somalia Weekly EPI/POL Update
Validation and zero dose investigation of AFP cases, 2017 AFP cases Validation Zero dose Investigation # of AFP cases # of AFP % of AFP # of Zero dose # of Zero dose % of Zero dose Zone Reported cases cases Zone AFP cases AFP cases AFP cases Validated Validated Reported investigated investigated
Central 121 73 60% Central 17 15 88%
Somaliland 68 46 68% Puntland 1 1 100%
South Zone 79 66 84% Somaliland 0 0 0
Puntland 41 24 59% South 21 19 90% Somalia 309 209 68% Somalia 39 35 90% Table no.-8 Table no.-9
. Of the total 309 cases, 68% (n=209) were validated by the RPOs . There were 39 zero OPV dose AFP cases reported in 2017, 90% (n=35/39) were investigated. Week-45 Somalia Weekly EPI/POL Update
Total AFP cases Tracking lab results of AFP cases 309
Tracking AFP with stool specimens Total AFP cases Total AFP cases with stool without stool specimens specimens 24 309 0 62 cVDPV2
Other viruses With lab En route In the lab
neg st results 285 0 24 in lab 223 en route cVSPV2 SL EV -ve 0 23 43 223 Week-45 Somalia Weekly EPI/POL Update
Lab performance indicators for AFP surveillance in Somalia, 2017 Sample # # Specimen # Specimens # Specimen % of specimen Number of % of Number of % of source Specimen with culture pending lab with culture with culture specimen specimen Specimens Specimen collected result result result within result within 14 with NPEV with with Sabin s with days 14 days NPEV isolation Sabin isolation
Cases 618 570 48 513 90% 70 12% 23 8%
Contacts 923 856 67 770 90% 96 11% 35 4%
Total 1541 1426 115 1283 90% 166 12% 58 5%
Table no.-10 Week-45 Somalia Weekly EPI/POL Update
Median and average number of days from onset of paralysis up to final lab result - 2017
Date of Date of Second stool Specimen reached Primary Culture ITD result onset Notification collected to Lab result
Median: 3 days Median: 2 days Median: 3 days Median: 11 days 1 day Average: 3.53 days Average: 1.89 days Average: 3.8 days Average: 11.7 days
Date second Median: 20 days Date final stool ITD results collected Average: 22 days Chart no. 2 Week-45 Somalia Weekly Polio Update
Village polio volunteers weekly house to house visit and AFP cases notified , November 12, 2017
January Feberuary March April May June July Aug Sept Oct Nov ( W 44)
No. of No. of No. of No. of No. of No. of No. of Central No. of No. of No. of AFP No. of No. of No. of No. of No. of No. of No. of No. of No. of AFP AFP No. of HH AFP AFP AFP No. of HH No. of HH AFP HH HH AFP cases cases HH AFP cases HH HH HH AFP cases AFP cases HH HH cases cases visited cases cases cases visited visited cases visited visited notified notifie visited notified visited visited visited notified notified visited visited notifie notified notified notified notified notified d d
31757 6 31780 6 39997 11 35672 12 37438 10 46730 10 38112 6 46205 10 11 4 2 Central 37,881 37,599 10,064
33599 5 32985 3 41237 5 34252 4 33505 4 43001 1 32761 6 41701 3 2 3 1 South 33,641 33,095 8,402
15237 3 15591 1 18903 3 15193 1 15291 2 14887 1 15175 1 19043 1 4 1 1 Puntland 15,393 16,554 4,059
36646 6 36882 4 45971 0 35634 3 35446 2 41710 1 33807 1 43648 2 1 0 2 Somaliland 34,710 32,547 7,905
117239 20 117238 14 146108 19 120751 20 121680 18 146328 13 119855 14 120535 16 151687 18 119795 8 Total 30430 6 Week-45 Somalia Weekly Polio Update
Routine Immunization Services, status of Cold Chain & Vaccine stocks in AFP Surveillance Sites as of November 12, 2017
Expected weekly Health facility have a AFP sites with EPI service and Health facility have EPI Health facility have IPV vaccine Region AFP sites visits routine EPI service functional cold chain vaccine available available
No No. % No. % No. % No. % Nugal 33 19 58% 19 100% 19 100% 17 89% Bari 116 34 29% 32 94% 34 100% 31 91% Mudug 58 39 67% 38 97% 38 97% 32 84% Galbeed 40 23 58% 23 100% 23 100% 23 100% Sahil 24 10 42% 10 100% 10 100% 8 80% Sanag 19 11 58% 11 100% 11 100% 11 100% Sool 28 10 36% 10 100% 10 100% 10 100% Awdal 43 23 53% 23 100% 23 100% 23 100% Togdher 52 21 40% 21 100% 21 100% 21 100% Middle Shabelle 35 18 51% 15 83% 16 89% 15 94% Hiran 24 23 96% 6 26% 23 100% 23 100% Galgadud 36 23 64% 14 61% 23 100% 23 100% Banadir 101 51 50% 22 43% 51 100% 51 100% Lower Shabelle 49 27 55% 13 48% 25 93% 20 80% Middle Juba 15 1 7% 0 0% 1 100% 0 0% Bakool 26 10 38% 10 100% 10 100% 10 100% Gedo 51 20 39% 20 100% 20 100% 17 85% Bay 75 30 40% 30 100% 30 100% 30 100% Lower Juba 46 23 50% 8 35% 23 100% 20 87% Somalia 870 416 48% 325 78% 411 99% 385 94% Part -II
Fever and rash Surveillance Week-45 Somalia Weekly Polio Update
Epi-curve on suspected measles cases by week, Somalia (Week 20, 2015-Week 43, 2017) 800 2015 2016 2017 (n=7498) (n=5657) (n=20,078)
700
720
703
699
696
693
686
685
670
663 657
600
584
560 554
500 538
507
496
488
463
444
441 441 436
400 436
416
410
408
400
399
389
383
373 352
300 330
325
320
309
290
277 255
200 228
222
214
210
208
199
196
182
180
175
174
173
172
170
163
161
158
156
155
154
151
149
145
144
142
141
140 140
134
133 132
100 128
127 127
125 125
124 124
122 122 122
117
116
115 115
113
112
111
109 109
107
105 105
98
97
103
96
102 102 102
95 95
101
100
93 93
92
91
90 90
89
88 88
87 87
86 86
85 85
84 84
83
82
81
79
76 76
74 74
72 72
71
70
67
66 60
0
- After showing a steady decline for about 14 consecutive weeks starting from week 24, the numbers have started to go up in recent weeks. - The cumulative reported cases also still remain higher than the number of cases reported at the same period in the past 4 years. - All regions have reported suspected measles cases in 2017, however, the top 5 reporting regions are Banadir, Togdhere, Hiran, Lower shabelle and Glbeed. Week-45 Somalia Weekly Polio Update
Fever & Rush cases reported by AFP surveillance System, November 12, 2017 Fever and Rash Cases by weekly
Region
W1 W2 W3 W4 W5 W6 W7 W8 W9
W10 W11 W12 W13 W14 W15 W16 W17 W18 W19 W20 W21 W22 W23 W24 W25 W26 W27 W28 W29 W30 W31 W32 W33 W34 W35 W36 W37 W38 W39 W40 W41 W42 W43 W44
Total 2016 Total 2017 Total
Nugal 112 3 1 1 2 2 0 1 1 0 2 0 0 4 3 4 5 15 3 6 18 27 25 23 21 17 22 19 38 42 42 53 70 82 54 46 41 31 44 200 109 91 62 84 100 1414 Bari 202 1 7 5 3 7 0 1 4 4 12 0 11 23 21 31 26 22 47 74 73 74 81 114 85 44 90 98 67 75 47 62 44 34 56 39 26 50 35 38 36 35 22 44 44 1712 Mudug 270 1 3 7 2 1 21 18 15 29 28 16 35 50 24 53 51 27 26 26 45 72 82 78 77 93 73 44 52 70 73 51 42 51 37 32 56 61 49 64 77 85 72 73 64 2006 N/East Zone 584 5 11 13 7 10 21 20 20 33 42 16 46 77 48 88 82 64 76 106 136 173 188 215 183 154 185 161 157 187 162 166 156 167 147 117 123 142 128 302 222 211 156 201 208 5132 Galbeed 45 0 3 1 5 2 7 10 8 8 12 18 19 30 29 50 60 45 63 85 41 44 19 29 19 22 9 11 14 12 13 5 3 2 1 2 1 4 5 2 1 6 7 2 6 735 Sahil 226 12 18 37 25 22 17 28 17 28 18 31 20 27 16 24 10 27 11 11 10 13 17 15 9 39 2 17 7 17 2 3 0 5 0 4 0 2 1 1 0 1 0 2 0 566 Sanag 16 0 3 0 0 1 0 0 0 0 5 0 1 2 1 9 0 11 1 5 5 19 5 11 19 22 11 13 19 10 10 16 0 8 6 3 0 6 5 8 0 2 2 5 0 244 Sool 24 8 11 6 22 26 24 41 20 32 36 37 36 37 40 28 24 14 24 14 13 15 16 5 5 11 13 9 5 3 0 0 2 4 4 1 6 0 4 0 1 8 3 2 1 611 Awdal 56 0 1 4 1 6 0 0 0 0 0 0 0 0 1 0 0 3 0 11 1 2 0 6 4 23 2 24 0 4 0 4 1 0 0 0 0 0 0 0 0 0 0 0 0 98 Togdher 223 42 22 26 18 63 28 103 36 105 66 118 87 88 111 162 87 157 108 141 98 88 31 50 37 23 29 42 13 22 8 29 2 30 7 26 10 13 6 17 6 10 12 27 7 2211 N/West Zone 590 62 58 74 71 120 76 182 81 173 137 204 163 184 198 273 181 257 207 267 168 181 88 116 93 140 66 116 58 68 33 57 8 49 18 36 17 25 21 28 8 27 24 38 14 4465 M/ Shabelle 206 5 10 6 18 7 10 8 11 5 19 23 23 20 20 12 14 25 10 8 7 6 16 18 20 20 16 20 16 28 13 9 14 14 21 8 19 22 16 7 15 16 16 15 12 638 Hiran 107 0 4 9 3 19 15 23 66 28 29 28 37 45 63 78 75 74 76 78 84 57 52 69 24 48 58 15 21 0 21 14 3 3 13 8 7 4 10 4 6 3 5 5 3 1287 Galgadud 261 4 3 2 5 5 6 3 11 4 7 4 5 149 17 28 23 19 17 13 7 9 13 8 12 9 13 29 19 14 17 13 18 5 8 6 9 7 5 8 6 4 7 5 8 584 Banadir 2226 89 78 76 71 95 79 119 128 91 83 93 108 110 65 134 184 172 209 162 225 205 226 202 181 116 138 140 123 117 134 93 71 140 76 62 58 69 68 75 98 58 81 50 41 4993 L/Shabelle 1217 25 27 45 23 37 25 33 42 42 45 36 32 45 53 45 45 59 30 38 47 52 52 49 47 47 40 59 58 45 36 33 43 39 29 30 34 56 49 40 41 40 38 44 32 1807 Central Zone 4017 123 122 138 120 163 135 186 258 170 183 184 205 369 218 297 341 349 342 299 370 329 359 346 284 240 265 263 237 204 221 162 149 201 147 114 127 158 148 134 166 121 147 119 96 9309 Middle Juba 51 0 0 0 0 2 0 0 2 3 3 0 2 0 0 0 3 3 3 0 0 3 5 0 3 0 0 0 0 6 3 0 3 3 0 0 0 0 2 0 4 4 1 1 1 60 Bakool 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 15 5 8 2 4 0 4 2 0 2 2 2 6 6 8 76 Gedo 104 0 0 4 1 1 6 0 0 0 0 0 0 0 0 6 0 5 0 0 12 13 14 2 0 0 0 0 0 0 0 1 0 0 0 0 2 8 8 24 12 24 9 9 3 164 Bay 9 0 0 0 3 0 0 0 0 14 0 23 9 33 19 23 42 3 31 18 12 18 28 12 19 26 22 8 8 12 6 7 1 10 6 7 12 9 3 4 8 5 14 22 18 515 Lower Juba 265 6 19 0 12 15 17 20 14 6 7 1 7 7 8 12 8 4 4 6 5 3 4 2 2 0 0 6 3 1 4 2 0 4 8 3 5 8 10 13 19 22 32 14 14 357 South Zone 466 6 19 4 16 18 23 20 16 23 10 24 18 40 27 41 53 15 38 24 29 37 51 16 24 26 22 14 11 29 28 15 12 19 18 10 23 27 23 43 45 57 62 52 44 1172
Grand Total 5657 196 210 229 214 311 255 408 375 399 372 428 432 670 491 699 657 685 663 696 703 720 686 693 584 560 538 554 463 488 444 400 325 436 330 277 290 352 320 507 441 416 389 410 362 20078 Week-45 Somalia Weekly Polio Update
Distribution of reported fever and rash cases in Somalia , 2014-2017
Fever & Fever & Fever & Fever & rash rash rash rash Region cases cases cases cases (2014) (2015) (2016) (2017)
Nugal 1110 82 112 1414
Bari 1284 226 202 1712
Mudug 542 561 270 2006
Galbeed 121 212 45 735
Sahil 30 60 226 566
Sanag 115 114 16 244
Sool 187 86 24 611
Awdal 1 15 56 98
Togdher 407 864 223 2211
M. Shab. 285 500 206 638
Hiran 63 663 107 1287
Galgadud 299 229 261 584
Banadir 2594 1974 2226 4993
L. Shab. 1978 1611 1217 1807
M. Juba 177 48 51 60
Bakool 3 26 37 76
Gedo 126 8 104 164
Bay 309 145 9 515 L.Juba Map no.7 Map no.8 Map no.9 648 74 265 347 Total 10,279 7,498 5,657 20,078 . Data source: from the Polio surveillance system and CSR. Week-45 Somalia Weekly Polio Update
Fever & Rush cases reported by AFP surveillance System- November 12, 2017
Age-wise distribution of fever and rash cases reported by AFP Zone-wise cases of fever and rash reported by AFP surveivallance system during 2017 surveillance system in 2017 25000
20068 Yrs10+, 3184, <1yr, 3639, 20000 16% 18%
15000 5_9yrs, 3387, 17% 10000 9309 1_4 yrs, 9858, 49% 5132 5000 4465
1162
0 Central North East North West South Total Somalia Week-45 Somalia Weekly Polio Update
Trend of reported fever and rash cases by zone in 2015 /16/17 Source AFP surveillance,
Puntland Somaliland 925 891 909
1000 1000 861 823 25 May) 25
800 - 667 634 800
Measles Campaign (21 510 491 April) 28 503 600 600 459 -
409 Measles Campaign Campaign 282 (24 400 214 400 265 269 243 275 161 140 202 133 115 97 119 83 161 142 132 200 3639 3071 48 70 62 2443 2739 27 33 40 82 104 93 72 99 8796 19 11 12 150 200 14 36 33 35 16 479 2942 47 293752 158 0 0 January February March April May June July AUG Sept. Oct. Nov. Dec
2015 2016 2017 2015 2016 2017
Central South
2000 250 207 25 May) 25
- 1494 Measles
1340Campaign 200 1500 (21 1111 1205 139
136 May) 28
128 -
925 150 115 Measles Campaign 1000 742 659 (24 82 83 86 545 547 568 100 77 75 455503 443 441 450 514 64 367 401 348 388 350383 401 4045 46 46 50 46 500 315 265 324 307 278 271328 281310 2737 2729 30 27 33 142 215 50 22 1921 14 18 1826 30 9 9 7 13 0 0 January February March April May June July AUG Sept. Oct. Nov. Dec January February March April May June July AUG Sept. Oct. Nov. Dec
2015 2016 2017 2015 2016 2017
• Number of fever and rash cases reported has shown decline in recent months compared to the previous month; However, it is still very high/4 times higher than cases reported during the same period in 2015 or 2016. Part -III Population Immunity Supplemental Immunization Activities Week-45 Somalia Weekly EPI/POL Update
Maps showing accessibility and security/ risk level, Somalia
Map no.10 Map no.11 Week-45 Somalia Weekly EPI/POL Update
Summary Strategic features and initiatives in Somalia by accessibility Accessibility AFP active Zones VPV TPVP Settlement Under 15- POP. status Surveillance site Accessible 128 216 147 2354 2,230,697 CENTRAL Inaccessible 62 29 21 1042 619,775 Total 190 245 168 3396 2,850,471 Accessible 105 207 53 1076 446,241 PUNTLAND Inaccessible 0 0 0 0 0 Total 105 207 53 1076 446,241 Accessible 81 206 53 3435 1,426,642 SOMALILAND Inaccessible 0 0 0 0 0 Total 81 206 53 3435 1,426,642 Accessible 75 179 123 2234 1,010,326 SOUTH Inaccessible 84 33 22 1548 445,747 Total 159 212 145 3782 1,456,073 SomaliaAccessible Total 501389 869808 457 37611689 90996,179,4275,113,906 Somalia Inaccessible 146 62 43 2590 1,065,522 Somalia Total 535 870 419 11689 6,179,428 Week-45 Somalia Weekly EPI/POL Update 2017 SIA Calendar, Implementation status and coverage Summary Somalia SIA Callender for 2017 Target Zonal Admin IM Campaign # Reached/ Planned Date Geographic Areas to be covered Age target Implementation date Vaccine Coverage Coverage in Type Vaccinated LQAS Result Group Population in % % All accessible areas of Central zone 904,454 26-29 Feb. 2017 848,340 94% 94% Of 11 lotes, 9=passed and 2=Satisfactory
Puntland all districts Under 5 530,201 05-08 April 2017 b-OPV 546,302 103% 97% Of 31 lotes, 27=Passed, 3= Satisfactory and 1=Failed 26-Feb-17 NIDs R-1 Somaliland all districts years 621786 26-29 Feb. 2017 612,911 99% 97% Of 29 lotes, 19=Passed, 6=satisfactory, 3 =failed and 1 discarded All accessible areas of South zone 385,555 26-29 Feb. 2017 369,517 96% 91% Of 5 lotes, 4=Passed and 1=Failed 2,441,996 2,377,070 97% All accessible areas of Central zone 904,451 02-05 April 2017 850,772 94% 93% Of 11 lots, 9=passed, 2= Satisfactory and 0=failed
02-04, Puntland all districts Under 5 529602 6-9 May 2017 b-OPV 546,673 103% 98% NIDs R-2 April-17 Somaliland all districts years 623462 02-05 April 2017 609,734 98% 97% Of 28 lotes, 25=Passed, 1= Satisfactory and 2=Failed All accessible areas of South zone 398427 02-05 April 2017 385,584 97% 95% Of 5 lotes, 3=Passed, 1= Satisfactory and 1=Failed 2,455,942 2,392,763 97% 73,447 C. Z: 23-26 July 2017 64,160 87% No IM No LQAS Nomadic; Agro pastoral; Scattered, 32,803 S.Z: 23-26 July 2017 31,095 95% No IM No LQAS Under 5 b-OPV 23-Jul-17 HtR - R-1 remote, far settlements & Small 136,929 P.L: 07-10 Sept 2017 122,321 89% No IM No LQAS years villages with difficult / no road access 145,980 SL: 23-26 July 2017 142,794 98% 92% No LQAS 389,159 360,370 93% 73,447 C. Z: 29 Aug-01 Sept. 2017 66,285 90% No IM No LQAS Nomadic; Agro pastoral; Scattered, Under 5 32,803 S.Z: 29- Aug-01 Sept. 2017 b-OPV 32,238 98% No IM No LQAS 14-Aug-17 HtR - R-2 remote, far settlements; & Small years villages with difficult / no road access P.L. 145,980 SL: 11- 14 Sept. 2017 143,750 98% No IM No LQAS
252,230 242,273 96%
14 14 - All accessible areas of Central zone 904,451 Puntland all districts Under 5 526636 Nov-2017 NIDs R-3 b-OPV
Somaliland all districts years 623462 Table no. Table All accessible areas of South zone 398427 All accessible areas of South zone 2,452,976 0 0 A) Target population: includes all accessible areas including the areas/districts that became accessible in 2015 and 3% population growth added 2016. B) Buffer stock: 1 million bOPV doses kept in country for: Transit/Cross Border Permanent Vaccination Teams and SIADs for new areas accessible. C) Country team strategy for newly accessible areas: conduct house to house bOPV vaccination, 4 Rounds at 10 days interval, R-1 target U<5 years, R-2 target U10 years, R-3 target all age groups; R-4 target U 5 years OPV + Measles. Week-45 Somalia Weekly EPI/POL Update NID-1, NID-2 2017 Summary
NID-1 NID-2 HtR-1
ZONE/REGION # U -5 IM # U -5 # U-5 IM # U -5 # U-5 IM # U-5 . NID1 & NID 2 was Targete coverag Targeted Reached coverage Targeted reached coverage reached d e conducted as scheduled in Banadir 424086 398999 96% 424083 399509 95% 19,323 18,056 March and April 2017. Galgadud 100060 91815 86% 100060 91077 86% 25,047 20,559
Hiran 77692 72736 97% 77692 70991 94% 8,025 6,699 No IM L. Shabelle 182368 167848 94% 182368 171852 94% 8,304 7,618 . HtR 1 also conducted in M. Shabelle 120248 116942 98% 120248 117343 98% 12,748 11,228 South, Central and Central Total 904454 848340 94% 904451 850772 93% 73447 64160 Somaliland, Puntland will Ayn 12662 12157 97% 12662 12375 conducted in August Bari 138029 167908 103% 138029 163261 99%
Karkar 48509 47142 99% 48509 47807 98%
Mudug 208301 201496 94% 208401 202736 100% . Cumulatively 5,336,012 Nugal 81659 77952 94% 80961 80267 94% under 5 children were Sanag 27755 26773 96% 27755 27068 96% targeted in the two NIDs Sool 13286 12874 97% 13286 13159 97% and 1 HTR rounds and Puntland Total 530201 546302 98% 529602 546673 99% 5,007,882 million children Awdal 107324 104100 100% 107324 105201 98% 23,910 23,351 92%
Sanag 65777 62900 96% 205431 201208 95% 15,965 15,212 92% were reached.
Sool 59781 64651 98% 46202 44442 96% 14,510 15,843 70%
Togder 138946 134347 99% 65777 61014 97% 30,519 29,294 97% . IM data showed overall
Marodijeh 203756 203756 93% 59781 63193 94% 49,862 48,407 74% national coverage of 95%,
Sahil 46202 43157 100% 138946 134676 100% 11,214 10,687 100% 96% and 92% respectively Somaliland Total 621786 612911 97% 623462 609734 96% 145,980 142,794 92% for NID-1 and NID 2. Bakool 36758 35575 90% 36758 34187 95% 2,088 1,938 Bay 162935 157910 93% 162935 158629 95% 7,275 6,678 . Regional summary and Middle Juba NO NID (Inaccessible Region) No IM Gedo 111491 106423 89% 111491 108737 93% 11,448 10,845 district level IM coverage
Lower Juba 74371 69609 93% 87243 84031 96% 11,992 11,634 is presented on the table South Total 385555 369517 92% 398427 385584 95% 32,803 31,095 and the maps on the left Grand Total 2,441,996 2,377,070 96% 1,926,340 1,846,090 95% 252,230 238,049 92% Week-45 Somalia Weekly EPI/POL Update
Transit Points Vaccination Activities as of November 12, 2017
January February March April May June July August September October November
Zones
vaccinated vaccinated vaccinated vaccinated vaccinated vaccinated vaccinated vaccinated vaccinated vaccinated vaccinated
Zero doses Zero doses Zero doses Zero doses Zero doses Zero doses Zero doses Zero doses Zero doses Zero doses Zero doses Zero
Number of Number of Number of Number of Number of Number of Number of Number of Number of Number of Number of
% Zero doses % Zero doses % Zero doses % Zero doses % Zero doses % Zero doses % Zero doses % Zero doses % Zero doses % Zero doses % Zero doses % Zero
CENTRAL 102390 12082 11.8% 109859 7779 7.1%144262 7777 5.4% 110748 3902 3.5% 102455 2583 2.5% 130637 1742 1.3% 102700 786 0.8% 127897 632 0.5% 104615 418 0.4% 102436 375 0.4% 25491 94 0.4%
PUNTLAND 22653 93 0.4% 21444 71 0.3% 27405 83 0.3% 21282 67 0.3% 20612 59 0.3% 28689 91 0.3% 23886 63 0.3% 27849 76 0.3% 22146 66 0.3% 23933 51 0.2% 5718 14 0.2%
SOMALILAND 14367 208 1.4% 15220 428 2.8% 18818 752 4.0% 14696 426 2.9% 15646 485 3.1% 18904 515 2.7% 15998 477 3.0% 19626 614 3.1% 15714 476 3.0% 15747 482 3.1% 3953 97 2.5%
SOUTH 39301 12498 31.8% 41710 14632 35.1% 39045 2388 6.1% 29791 1125 3.8% 29842 1135 3.8% 38680 1332 3.4% 29127 929 3.2% 35148 1173 3.3% 28224 888 3.1% 27930 843 3.0% 7186 218 3.0%
SOMALIA 178711 24881 13.9% 188233 22910 12.2% 229530 11000 4.8% 176517 5520 3.1% 168555 4262 2.5% 216910 3680 1.7% 171711 2255 1.3% 210520 2495 1.2% 170699 1848 1.1% 170046 1751 1.0% 42348 423 1.0%
. A total of 1,923,780 < 10 years individuals were vaccinated week 44,2017. Among them,81,025 (4%) were vaccinated for the first time.
Table no.-16 Week-45 Somalia Weekly EPI/POL Update
Performance of Permanent Vaccination sites in inaccessible areas of S/C zone and distribution as of November 12, 2017
Number of U-10 Children vaccinated by Newly Established permanent vaccination sites in inaccessible areas of South and Central zones of Somalia. DISTRICT Number of Number of Zero Proportion of Zero ZONE REGION vaccinated kids doses vaccinated doses (%) Elbur 2,928 2,315 79% GALGADU D Galhareri Data not received CENTRAL Elgaras 7,273 6,305 87% Awdegle 36,609 12,022 33% L.Shabelle Sablale 37,215 11,426 31% Hagar 5,397 3,226 60% Jamame East 4,137 3,950 95% L. Jubba Jamame West 3,071 2,857 93% South Kismayo 11,379 2,705 24% Buale 7,800 6,714 86% M. Jubba Sakaw 5,814 4,865 84% TOTAL 121,623 56,385 46%
Since the first weeks of 2017, a total of 121,623 <10 years children were reached through the newly established permanent vaccination sites in fully inaccessible area in South and Central zones. 46% (n=56,385) of the children are vaccinated for the first time. Week-45 Somalia Weekly EPI/POL Update
Immunity Profile of NP-AFP cases (6-59 Months) and Contacts 2013-2017
Immunity Profile of NP-AFP Cases 6-59 Immunity Profile of NP-AFP cases 6- Immunity Profile of NP-AFP Cases 6-23 Immunity Profile of NP-AFP cases 6-23 Immunization Profile of contacts Months, 2013-2017 59 Months by Zone, 2017 Months, 2013-2017 Months by Zone, 2017 (all-2017) 100% 100% 100% 100% 100% 1 90% 90% 27 409 90% 14 90% 90% 69 5 32 35 80% 80% 31 80% 12 80% 80% 9 459 19 127 36 630 492 127 60 17 448 182 127 143 70% 83 37 70% 70% 344 70% 34 70% 19 2 61 60% 60% 60% 60% 60% 50% 50% 33 50% 57 32 11 439 50% 4 50% 28 55 8 40% 15 40% 40% 180 174 55 18 134 189 40% 63 40% 50 43 56 30% 27 30% 10 11 30% 17 164 30% 14 49 30% 29 33 20% 15 14 20% 7 123 173 20% 709 144 29 49 20 21 29 6 20% 37 20% 79 21 10% 10% 6 15 36 4 10% 265 76 5 3 9 110 73 118 117 10% 0% 1 0 10% 0% 0 0 38 37 36 22 9 0% 10 9 0% 0% 2013 2014 2015 2016 2017 2013 2014 2015 2016 2017 2013 2014 2015 2016 2017 0 dose 1-3 doses 0 Dose 1-3 doses 0 dose 1-3 doses 4-6 doses 7+ doses 4-6 doses 7+ doses 0 dose 1-3 doses 4-6 doses 7+ doses 0 dose 1-3 doses 4-6 doses 7+ doses Graph no.-19 Graph no.-20 Graph no.-21 . In 2017, 39 zero-dose NP-AFP cases were reported; 21 from South, 17 from Central and 1 from Puntland. 3 cases are off the age group 6-59 months. . Review of five years data reveals, the proportion of zero dose AFP cases is declining progressively, however, there are significant proportion (32%) of children are under immunized. Week-45 Somalia Weekly EPI/POL Update
Immunity profile of 6-59 months age NP-AFP cases by Zone 2012-2017
Graph no.-22 Graph no.-23
Graph no.-24 Graph no.-25 Routine Immunization Trend of routine EPI coverage by zone, 2014-2017 100
(N.B. 2017 is annualized from 9 months data ) 90
80
70
60
50
40
30
20
10
0 BCG P-1 P-3 Measles OPV-3 BCG P-1 P-3 Measles OPV-3 BCG P-1 P-3 Measles OPV-3 BCG P-1 P-3 Measles OPV-3 PUNTLAND SOMALILAND SOUTH CENTERAL SOMALIA
2014 2015 2016 2017 Nine month
Source: HMIS/DHIS-2 data 2016 and 2017. Week-45 Somalia Weekly EPI/POL Update
Immuinzation monitoring chart, Somalia2016 Somalia Monitoring Chart, 2017 350000 100% 300000 120%
90% 300000 250000 100% 80%
250000 70% 200000 80%
60% 200000 150000 60%
50% Axis Axis Title 150000 40% 100000 40%
100000 30% 50000 20% 20% 50000 10% 0 0% Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec 0 0% Sum of Pent1 31367 61990 89840 119005148901178493215415247586272579 Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Pent1 24215 48781 73263 98229 124707 152394 181148 207148 235011 266781 299618 331481 Sum of Penta3 26790 53670 77763 102433127572152696178791203443225161 Penta3 27543 48616 70816 91732 113674 136589 160723 181282 203464 229673 256554 283080 Sum of Measles 20594 44105 64886 89207 115739139255166186190981210074 Measles 18379 39266 60502 81562 103608 127044 150435 174056 193371 209302 230710 249465 Sum of Montly target on surval% 8% 17% 25% 33% 42% 50% 58% 67% 75% 83% 92% 100% Target 7.50% 15.00% 22.50% 30.00% 37.50% 45.00% 52.50% 60.00% 67.50% 75.00% 82.50% 90.00% Sum of P-1% 8% 16% 23% 31% 38% 46% 55% 64% 70% Penat1% 5% 11% 16% 22% 28% 34% 40% 46% 52% 59% 66% 73% Sum of penta-3% 7% 14% 20% 26% 33% 39% 46% 52% 58% Penta3% 6% 11% 16% 20% 25% 30% 36% 40% 45% 51% 57% 63% measles% 4% 9% 13% 18% 23% 28% 33% 39% 43% 46% 51% 55% Sum of Measless% 5% 11% 17% 23% 30% 36% 43% 49% 54% Part -IV Vaccines and Cold Chain Management Week-45 Somalia Weekly EPI/POL Update
Vaccines and Cold Chain Management
USSC (Country Office) • All measles vaccines and injection materials for the mass campaign have been prepositioned in all respective zones • Plans are under way to conduct a supply chain system redesign introduction workshop in 3rd week of Jan 2018. The draft terms of reference/ scope of work are ready for review • We are expecting 1 million doses of bOPV next week • Logistics plans are under way, as we await the result’s analysis of the PV2 environmental sample from Mogadishu • Taking inventory of all polio vaccines (bOPV, tOPV, IPV) • Gathering data on how to handle and manage mOPV just in case Part -V Communication Week-45 Somalia Weekly EPI/POL Update
Communication for Development
• Development/fine-tuning of response communication plan, including crisis communication • Identification of C4D Team A members for immediate response phase and discussion on modalities of deployment • Preparation/gathering of appropriate materials for initial media briefing, and to prepare national opinion. the end