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Somalia Weekly Update Week-48 Ending 03 October 2017 Part -I VDPV2 Situation Update VDPV2 in Mogadishu • Background • VDPV2 was identified in 2 environmental samples collected 10 days apart from the same sewage site in Waberi district of Banadir region in Somalia • The 1st sequencing results were received from the CDC on November 9th • The first VDPV2 was 38 NT different from the parent Sabin • Advisory Group discussion • The Somalia mOPV2 advisory group meeting was held on November 20th • The country program presented detailed risk assessment on the VDPV2 situation • mOPV2 request received by advisory group and was approved as per country program request • Risk Assessment • Virological risk: Medium to high • Contextual risk of further transmission= Medium • Risk for international spread= Medium 3 Preparation for mOPV Campaign • Two rounds of mOPV2 and 1 IPV campaigns were approved by the advisory group • The mOPV2 campaign will target 726,699 under 5 years old children living in Badadir, Middle Shabelle and Lower Shabelle regions of Central zone • The proposed dates for the first round is from 10-14 December • There will be 2 weeks interval between the two mOPV2 rounds and also between the second mOPV2 and the IPV campaign • RPOs and DPOs from neighboring regions will be mobilized to support the intra campaign monitoring • Quality of SIA will be assessed by independent monitoring and LQAS • There will be daily and weekly coordination activities both at Nairobi and Mogadishu levels involving MoH, WHO and UNICEF • Orientation will be given for RPOs, DPOs, DFAs and Vaccinators in Mogadishu about the management of mOPV2 Preparation so far • Micro-plans prepared, revised and validated at DFA and district level • Training for RPOs, DPOs and DFs and data managers on how to use satellite maps to enhance their micro-plans and identify DFA and team areas • DFA level area maps prepared, validated by DPOs and DFAs, and printed • Vaccine arrived in Mogadishu on the 2nd December 2017 • Plans for C4D, Vaccine management and monitoring is being developed Other Activities Related to VDPV2 Response • Heightened AFP surveillance with active case searches in the community and health facilities • Joint visit conducted in selected public and private HFs to see the AFP surveillance activity and also sensitize the health workers about the event • Quick surveillance review both internal and external was conducted to identify any gaps • Review of surveillance and immunization services among special population in Mogadishu (IDPs etc.) • Healthy children Stool samples were collected from randomly selected households in Waberi district (25) as well as from health facilities with pediatric outpatient (24) • Additional ES samples collected from the existing 3 sites and from a new temporary site in one of the busy hospitals. Frequency of sampling from the ES sites was increased from once monthly to once every two weeks. • Mapping the area to narrow our focus and identify upstream catchment population served by the Mogadishu sewage system drained to 21 October site. • Household survey was conducted to ascertain the coverage of the sewage site that yielded the VDPV2s • Collaborating with WHO Malaria team who were conducting malaria indicators survey. Immunization coverage survey was included into the exercise – currently ongoing Part -II AFP-Surveillance Cases 10 12 14 16 18 0 2 4 6 8 2014W01 2014W03 2014W05 2014W07 2014W09 2014W11 2014W13 2014W15 2014W17 2014W19 2014W21 2014W23 2014W25 2014W27 2014W29 2014W31 2014W33 2014W35 2014W37 2014W39 Week 2014W41 2014W43 2014W45 2014W47 2014W49 2014W51 2015W01 2015W03 2015W05 - 2015W07 48 2015W09 2015W11 2015W13 Epidemiological Curve January 1,2014 2015W15 2015W17 Somalia Weekly Somalia EPI/POL Weekly Update 2015W19 2015W21 2015W23 2015W25 2015W27 2015W29 2015W31 2015W33 2015W35 2015W37 Week number of onset of number Week 2015W39 2015W41 2015W44 2015W46 2015W48 2015W50 2015W52 2016W02 2016W04 2016W06 2016W08 2016W10 2016W12 2016W14 2016W16 2016W18 – 2016W20 December 03, 2016W22 2016W24 2016W26 2016W28 2016W30 2016W32 2016W34 2016W36 2016W38 2016W40 2016W42 2017 2016W44 2016W46 2016W48 2016W50 2016W52 2017W02 2017W04 2017W06 2017W08 2017W10 2017W12 2017W14 2017W16 2017W18 2017W20 2017W22 2017W24 2017W26 2017W28 2017W31 2017W33 2017W35 2017W37 2017W39 2017W40 2017W42 2017W44 2017W46 2017W48 2017W50 2017W52 Graph no. 1 Graphno. Pending Pending Lab ERGPending Discarded Compatable WPV aVDPV Week-48 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 2017W08 2017W10 2017W12 2017W14 2017W23 2017W25 2017W27 2017W29 2017W38 2017W40 2017W42 2017W01 2017W02 2017W03 2017W04 2017W05 2017W06 2017W07 2017W09 2017W11 2017W13 2017W15 2017W16 2017W17 2017W18 2017W19 2017W20 2017W21 2017W22 2017W24 2017W26 2017W28 2017W30 2017W31 2017W32 2017W33 2017W34 2017W35 2017W36 2017W37 2017W39 2017W41 2017W43 2017W44 2017W45 2017W46 2017W47 2017W48 2016W49 2016W50 2016W51 2016W52 Total 2017 Total Total2016 BANADIR 1 30 1 1 1 2 1 3 1 2 1 1 1 1 1 2 1 1 2 2 2 1 2 1 1 32 GALGADUD 25 1 1 1 1 1 1 1 2 1 1 1 1 1 2 1 1 2 1 1 1 1 1 25 M. SHABELLE 1 19 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 1 1 1 1 23 L. SHABELLE 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 2 1 29 HIRAN 1 15 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 20 BARI 1 1 24 1 2 1 1 1 2 1 1 1 1 1 2 1 1 1 1 1 1 21 NUGAL 1 1 11 2 1 1 1 1 1 1 1 9 MUDUG 1 1 14 1 2 1 1 1 1 1 1 1 1 1 12 TOGDHER 11 1 1 1 1 1 1 1 1 8 GALBEED 1 1 1 1 19 1 3 1 1 1 1 1 1 1 1 2 1 2 1 2 20 SANAQ 7 1 1 1 1 1 5 AWDAL 1 18 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 17 SAHIL 8 1 1 1 1 1 1 1 1 8 SOOL 5 1 2 1 1 1 1 1 2 10 LOWER JUBA 1 1 26 2 1 1 2 2 1 1 1 1 1 1 1 1 2 2 1 1 1 1 1 1 1 27 1 - BAY 19 3 1 3 1 1 1 1 1 1 1 1 2 2 19 GEDO 1 21 1 2 1 1 1 1 1 1 1 1 1 1 2 2 1 18 MIDDLE JUBA 11 1 1 1 1 2 1 2 1 10 BAKOOL 1 9 1 1 1 1 1 1 1 1 1 9 no. Table Total Somalia 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 8 11 4 5 1 1 322 Silent (not reporting) for > 8 weeks - 4 new AFP cases were reported this week making the total 322 AFP cases reported in 2017. Reported AFP cases - In addition 962 contact samples (3 contacts for each case) and 172 community samples were collected from 24 districts Community Samples collected in silent regions -- 3 regions ( Bay, Gedo and Middle Juba) are silent for not reporting for 8 weeks and are advised to collect community samples Community Samples collected but regions not silent Week-48 Somalia Weekly EPI/POL Update Classification of AFP cases by status (2016 & 2017) 2016 2017 REGION Pending Discarded VDPV Total Discarded Pending Total 322 AFP Cases BANADIR 0 30 0 30 32 0 32 25 0 25 Reported in 2017 GALGADUD 0 25 0 25 HIRAN 0 15 0 15 19 1 20 L. SHABELLE 0 24 0 24 26 3 29 M. SHABELLE 0 19 0 19 22 1 23 BARI 0 24 0 24 20 1 21 MUDUG 0 14 0 14 11 1 12 0 0 NUGAL 0 11 0 11 9 0 9 310 12 0 AWDAL 0 18 0 18 16 1 17 Discarded Compatible WPV Pending VDPV GALBEED 0 19 0 19 20 0 20 SAHIL 0 8 0 8 8 0 8 SANAQ 0 7 0 7 5 0 5 SOOL 0 5 0 5 10 0 10 TOGDHER 0 10 1 11 8 0 8 BAKOOL 0 9 0 9 8 1 9 19 0 19 3 0 BAY 0 19 0 19 2 9 - In process (lab) Pending ERG Pending ITD GEDO 0 21 0 21 18 0 18 LOWER JUBA 0 26 0 26 24 3 27 10 0 10 Chart no. 1 MIDDLE JUBA 0 11 0 11 no. Table Grand Total 0 315 1 316 310 12 322 Week-48 Somalia Weekly EPI/POL Update Surveillance Indicators by Zone and Region 2017 Annualized NP-AFP Rate by Zone, 2017 12.0 10.0 10.2 8.0 6.0 6.2 5.6 4.0 4.9 5.2 2.0 0.0 Central Puntland Somaliland South Total Somalia Graph no. 2 Annualized NP-AFP rate by accessibility status 10.0 8.0 6.0 7.6 4.0 5.4 5.4 5.6 2.0 - In-accessible Partially Accessible Somalia Map no. 1 Acceessible Map no. 2 Graph no. 3 Week-48 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.
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