Emergency and Humanitarian Action (EHA),

Weekly Activity Report I. General Situation a. Political, Social and Security; • DRC; Ongoing incursion on LRA base in Garamba. Success has been recorded with Week 10, reports of capturing and/or killing of LRA top commanders • Acholi and Lango sub-region; Is calm 2nd – 8th March • Karamoja sub-regio; Cattle raids and clashes between Karamojong worriers and the 2009 UPDF b. Main Events of Interest/Concern for Health • Preparation for mass Polio vaccination campaign ongoing in all districts of Acholi, Lango and Karamoja sub-regions, • Training of district IRS monitoring team in , Lira, Apac, Oyam, and ongoing. II. Analysis and Health Consequences (Health Problems and Needs of Affected Population) Malaria: Lango; continues to report higher number of cases of clinical malaria in 2009 as compared to 2008. In the number of cases of malaria reported in 2009 is lower than that of 2008 for the same epi-week. See figure I below for details.

Acholi, Amuru and Gulu districts continue to register high number of cases of clinical malaria in 2009 as compared to 2008. See figure II below.

Highlights

Preparation to conduct mop up Polio vaccination in in Epi week 11 is ongoing. Plans to conduct second round of Polio vaccination in 29 districts in Uganda from 23rd to 26th April is progressing well.

Karamoja sub-regions; The number of cases of clinical malaria reported and the trend in 2009 is similar to that of 2008 for the same epi-week.

Dysentery:

Acholi sub-region; The number of cases of dysentery in this week decreased from 123 in epi-week 9 to 109 in epi week 10 representing a decrease of 8.2%. See figure III for details.

Acknowledgement

Production of this weekly activity report has been made possible by contribution from the followings

Lango sub-region; The trend of dysentery in 2009 is similar to that of Karamoja sub-region;, The incidence of dysentery continued to increase in the sub region from 97 in epi week 1 to 294 in epi-week 10. The trend in 2009 is similar to that of 2008 and the numbers are also comparable.

Hepatitis E: 52 new cases of Hepatitis E were registered in Kitgum and in Epi week 10 of 2009, down from 73 cases registered in epi-week 9. The cumulative number of cases of Hepatitis E registered to date is 9,771 with 155 deaths (CFR 1.5%). No death was registered in epi-week 10. Kitgum district the epicenter of the epidemic has been registering over 40 cases per week for 4 consecutive weeks.

Table I

District New cases New deaths Cumulative cases Cumulative deaths

Kitgum 48 0 9,618 148 (1.5%) Gulu & Amuru 0 0 18 (9 positive) 0 (0)

Pader 4 0 132 7 (5.3%)

Lango 0 0 3 0

Total 52 0 9,771 155(1.5%)

The sub counties that registered cases in Kitgum district in Epi week 10 of 2009 are; Amida[10];Lokung[9]; Padibe E/W [7]; Namukora [5]. In Pader district 15 of the 19 sub- counties reported at least one case (78.95%). The majority of the cases reported are from Pader TC, Atanga S/C, Acholibur S/C, Kilak S/C, Pajule, Paimol & Laguti.

AFP; One suspected case was reported from . To date 5 cases of Polio have been confirmed. Measles; One suspected case reported in . Meningitis; One suspected case from Lira district was reported in the week

III. Actions (WHO response, Sida grant)

Epidemic Response

Disease surveillance;

• Continues to support all districts technically and financially in disease surveillance. • Weekly epidemiological reports depicting disease trends have been shared with all the districts and partners.

Malaria; • All health facilities in and Lango sub-region received medicines including co- artem • Sentinel sites established by the DHO Gulu with support from WHO to determine the proportion of fever cases which are actual malaria are not functioning well. WHO is supporting the district to strengthen support supervision to those sentinel sites. AFP; Stool samples from the suspect in Oyam district was sent to UVRI for confirmation. Preparation for mass vaccination in Acholi, Lango and Karamoja sub-regions ongoing Hepatitis E; • Community sensitization through radio programs (talks shows & spots), chlorination of water jerry cans at water source, discouraging use of wide mouth pots for water storage and distribution of IEC materials in public places is ongoing. • Hepatitis E Control meeting was held in Kitgum district with all the Sub County Stakeholders on 11th/03/2009 in the meeting, the following resolutions were made; ¾ Sub counties resolved to create and enforce by laws that will improve homestead hygiene sanitation ¾ All sub counties resolved to make community leaders have model homes so as to have moral authority to enforce the by laws ¾ All Sub Counties resolved to revive the Sub County Task Force Committee ¾ All Sub Counties resolved to begin campaigning for home improvement at any meetings they will either will be attending or preside over

Mini UDHS in Acholi and Karamoja sub-region; Preparation for Mini Health and Demographic survey in Acholi and Karamoja sub region is ongoing. Draft protocol and data collection tools have been finalized.

Measels; Sample has been sent to UVRI for confirmation

Meningitis; Lumbar puncture done on the patient, CSF was negative

Other activities conducted by WHO; • Ongoing rehabilitation works in Lorengechora, Lolachat and Panyagara • Training of VHTs & orientation of health workers on Nutrition surveillance has commenced in Orwamuge HC II in IV Action others partners response; • NUMAT is supporting Dokolo in renovating and expanding laboratories in Bata, Kwera and Kangai HC IIIs, • NUMAT distributed furniture to HFs in the sub-region & held Continuing Medical Education (CME) with health workers on HCT/PMTCT; • CUAMM continues to support Oyam in implementing comprehensive maternal and child health services (staff development, EmoC, ambulance systems for referrals, immunizations, radio talk shows, support supervision). • MSFH, ASB, CESVI, Mediar, Concern, MTI, AVSI plus the RDC Office Pader continue to carry out activities that aim at controlling the epidemic outbreak of Hepatitis E in Pader District • Others doing various health activities are TPO Uganda, AMREF, UNFPA, UNICEF, MSU, Medair, IV. Comments and Conclusions Response to epidemic outbreak of Polio in Uganda is ongoing with support WHO. V. Plan for Coming Week • Support Polio epidemic response activities in Acholi, Lango and Karamoja sub-regions • Support hepatitis E epidemic response in Kitgum and Pader district • Providing technical and financial support in the above regions to the office of the DHOs in strengthening HMIS/IDSR • Provide technical support to MoH in planning for the mini-Demographic and Health Survey For further information, please contact:

Dr. Joaquim Saweka, WHO Representative Uganda: Tel. +256 41 335500, Mobile +256 752 728 257, Email: [email protected]