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WEEK 32: 3Rd –9Th Aug 2020

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WEEK 32: 3Rd –9Th Aug 2020 MINISTRY OF HEALTH THE WEEKLY EPIDEMIOLOGICAL BULLETIN WEEK 32: 3rd –9th Aug 2020 Dear Reader, Current public health threats We are pleased to share our 32nd weekly epidemiological bulletin COVID-19 as 0f 9th Aug 2020 for the year 2020. 1,297 Cumulative cases of COVID-19 confirmed This epidemiological bulletin serves to inform all stakeholders at cases in the country among Ugandan nationals district, national, and global levels on disease trends, public health 299,036 specimens collected and tested surveillance and interventions undertaken in detecting, preventing 1137 cumulative total recoveries and responding to public health events in the country on a weekly 145 cases on admission basis. 16349 Cumulative contacts listed 1,294 contacts under follow-up This issue, we showcase the following updates among others 9 deaths among confirmed cases Uganda updates on COVID-19 Suspected rabies (Animal bites_dog bites) Fig 1a: Distribution of COVID-19 Local Transmission Rift Valley Fever in Mbarara National trends of suspected epidemic prone diseases National, regional and district weekly surveillance reporting Iganga District success story in weekly reporting Public health events in border countries For comments please contact: Dr. Allan Muruta, Commissioner, De- partment of Integrated Epidemiology, Surveillance and Public Health Emergencies - MoH; P.O BOX 7272 Kampala, Tel: 080010066 (toll free); Email: [email protected] or [email protected] Fig 1b: Epidemic curve of COVID-19 as of 9th Aug 2020 (n=1297) 19 Surveillance data Surveillance 19 - Source: COVID Source: Page 1 Health Workers who contract COVID 19 During the response as 9th Aug 2020 (n=41) The criteria for determining Front Line Health Work- Fig 3: Distribution of Health workers by workplace ers includes all staff involved in the provision of care to a COVID-19 patient or working in a health care facil- ity caring for COVID-19 patients These may include; Clinicians, Physicians other Allied Health Professionals and auxiliary health workers such as cleaning and laundry personnel, x-ray physicians among others Fig 2 : Distribution of Health workers by workplace Malaria 47698 Malaria cases reported 21 deaths reported country wide Fig 5 : Distribution of Malaria outbreak status, week 32 Suspected Rabies (Animal Bites) There is a gradual increase in number of animal bites Mbarara (13)reported the highest number of animal bites followed by Ntugamo (12) and Masindi (12) Fig 4: Distribution of Animal bites, week 32 (n=167) Rift Valley Fever Outbreak in Mbarara On 11th Aug 2020, MoH conformed a RVF Outbreak A 46 year old man from Kiruhura District Presented with Un explained hemorrhagic symptoms such as bloody urine, nose bleeding, vomiting and high grade fever These symptoms started on 1st Aug 2020 and was admit- ted in Mbarara Regional Referral Hospital on 2nd Aug 20 Actions taken Contact listing and follow up of people including health workers that handled the patient Case management is still on going at Mbarara RRH Mentorship of the hospital ward staff The MoH submitted the IHR Notification to WHO Page 2 Priority Diseases Acute Flaccid Paralysis (AFP) Surveillance The data presented in table 1 consists of suspected cases. The data shows high numbers of water borne diseases such as; 17 AFP cases were reported during week 32 typhoid, Malaria, and cholera, dysentery in different parts of The 17 cases were reported from; Bugiri (1), Bugweri (1), the country. Iganga (1), Kalangala (1), Kamwenge (2), Kwania (2), Luuka (1), Mbarara (1), Mityana (1), Nakapiripirit (1), Tab 1: Suspected Cases of epidemic prone Diseases, wk 32 Ngora (1), Ntoroko (1), Obongi (1) and Yumbe (2). Conditions Cases Deaths CFR(%) The Non-polio AFP rate is 1.04/100,000 children 0 - 14 AFP 17 0 0.0 years compared with 1.97/100,000 children 0 -14 years in AEFIs 7 0 0.0 2019 Animal bites 172 0 0.0 The adequate samples collection rate is 94.20% com- Bacterial Meningitis 7 0 0.0 pared with 89.20% in 2019 Cholera 17 0 0.0 Dysentery 55 0 0.0 NPENT rate is 14.50% compared with NPENT rate of 14.48% in 2019 Guinea Worm 0 0 0.0 Malaria 46,916 22 0.04 Ninety two (96) districts have detected and investigated Hepatitis B 0 at least one AFP case (fig 6) 0 0.0 Measles 36 0 0.0 Fig 6: Total AFP cases by District, week 32 NNT 9 0 0.0 Plague 0 0 0.0 Other Suspected 2 VHFs 0 0.0 SARI 128 0 0.0 Typhoid fever 900 0 0.0 Yellow fever 0 0 0.0 Data source: DHIS2 Anthrax 2 0 0.0 Leprosy 0 0 0.0 RR T.B 2 0 0.0 Severe Acute Respiratory Infection (SARI), Viral Haemorrhagic Fevers (VHF), Neonatal Tetanus (NNT), source:Data EPI lab Tuberculosis (T.B), Acute Flaccid Paralysis (AFP), Adverse Events Following Immunisation Measles (Confirmed cases) Cumulatively, Seventy-nine (79) districts have detected and investigated at least one suspected measles case. 34/79 districts reporting measles cases have had at least one positive IgM case Fig 7. Trends of maternal and perinatal deaths week 1– 32, 2020 Data Data source: DHIS2 Page 3 Table 2: Distribution of maternal deaths (09) and perinatal deaths (225), week 32 Maternal Deaths Perinatal Deaths Maternal Neonatal Name of Health Fa- Macerated Fresh Still District death- District District District deaths (0-7 cility Still births Birth Deaths days ) Kampala Kawempe NRH 3 Kampala 18 Kampala 22 Kampala 18 Lira Pag Mission HC III 1 Mbarara 7 Mubende 8 Masaka 12 Kotido Kotido HC IV 1 Iganga 6 Mbale 6 Hoima 6 Mayuge Mayuge HC III 1 Mbale 5 Gulu 5 Bushenyi 6 Sheema Kitagata Hosp 1 Kabarole 5 Hoima 4 Kabale 4 Luwero Luwero Hosp 1 Luwero 4 Lira 3 Lira 3 Kabarole Fort Portal RRH 1 Rukungiri 3 Pakwach 3 Nebbi 3 Maracha 0 Nebbi 3 Mayuge 3 Yumbe 2 Kyotera 0 Gulu 3 Luwero 3 Kamuli 2 Buyende 0 Mubende 3 Kisoro 3 Agago 2 Amudat 0 Kasese 2 Mbarara 3 Kisoro 2 Pakwach 0 Kagadi 2 Kabarole 3 Mpigi 2 Abim 0 Ntungamo 2 Kabale 3 Pakwach 1 Yumbe 0 Hoima 2 Iganga 2 Kole 1 Kibuku 0 Kabale 2 Kasese 2 Nakapiripirit 1 Napak 0 Mpigi 2 Nebbi 2 Iganga 1 Kaabong 0 Katakwi 2 Kagadi 2 Rukungiri 1 Bukedea 0 Kazo 2 Busia 2 Kasese 1 Kole 0 Tororo 2 Bushenyi 2 Mbale 1 Fig 8: Completeness and Timeliness of weekly reporting per region, Epi week 32, 2020 There is a general improvement in completeness of reporting with the highest reporting rates recorded in Karamoja (100), Kigezi (89), Tooro (90), Busoga (85), West Nile (90), Lango (89), and Bugisu (89) while Kampala at (32), South central (70)% and North central (75). National average reporting rate declined to 76% Timeliness is still a challenge across the country. The regions with the highest reporting rates on time include Kara- moja (74), Kigezi (65), Tooro (56), Busoga (57), West Nile (64) and Lango (45). While those with the least reporting rates include Kampala(18) South Central (48), North Central(53) and Bunyoro (51) (refer to fig 7). National average Timeliness of reporting is 53% Data source: DHIS2 source: Data Page 4 Fig 10: Distribution of suspected SARI, 2020 Completeness and Timeliness of reporting by District There is a great improvement in completeness of re- porting across all Districts (fig 7a) Majority of the districts reported late (fig 7b) Fig 9a: Completeness of reporting, week 32, 2020 Public Health Emergencies in neighboring countries Fig 9b: Timeliness of reporting, week 32, 2020 Severe acute Respiratory Infections (SARI) amidst COVID SARIs are a significant cause of infectious disease mor- bidity and mortality Private health centers are reporting a surge of SARI espe- cially in Kampala Differentiating COVID-19 from other SARIs is challeng- ing Clinicians should be on the alert during assessments Source: WHO EPI bulletin week 32 Page 5 Improvement in Weekly Reporting Experience from Iganga District Hands on training on MTRAC sending For a long time Iganga District was struggling with poor Weekly reminders on reporting by Biostatistician. reporting rates in weekly reporting. Support supervision was Challenge for not achieving 100%. not yielding results, until the team performed a bottle neck analysis (fig 11). 3 prison facilities do not exist in Iganga District alt- Findings from bottleneck analysis hough they are registered in DHIS2 system Some facilities were not enrolled on mTrac (Namungalwe, Iganga and Busesa) Some had old versions of reporting tools Limited knowledge on weekly reporting Lesson Learnt Actions taken Positive change comes from within staff Extracted non reporting facilities from DHIS2 and scheduled visits including clinics Continuous reminding of staff has a beneficial effect Enrolled missing facilities onto MTRAC Platform Recommendation We mentored staff on HMIS 033b filling Need for data quality support supervision Supplied facilities visited with revised HMIS tools Division of Health Information should update the list of Fig 11: Trends of weekly reporting, in Iganga District active health facilities in Iganga District Acknowledgement and Recommendations MOH acknowledges all efforts made by all districts and health facilities in surveillance activities. Regions of; Lango, Kigezi, West Nile, Tooro, Karamoja, Ankole and Bugisu achieved the national targets for the last two weeks UNEPI reminds and encourages all the districts to carry out active search for AFP, NNT, EAFI and measles cases in their health facilities and communities. Maternal deaths and perinatal deaths audits should be Data source: DHIS2 conducted to address issues of excessive deaths of moth- IGANGA TEAM; (R-L) Mwondha Isaac ers and newborns especially for Kampala region. (Surveillance FP), Magala Dickson (Biostatistician) Districts with ongoing outbreaks should submit their and Ms.
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