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Weekly Epidemiological Bulletin Electronic Disease Early Warning System & Response (Edews) in Khyber Pakhtunkhwa and FATA Epidemiological Week No

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Weekly Epidemiological Bulletin Electronic Disease Early Warning System & Response (Edews) in Khyber Pakhtunkhwa and FATA Epidemiological Week No Weekly Epidemiological Bulletin Electronic Disease Early Warning System & Response (eDEWS) in Khyber Pakhtunkhwa and FATA Epidemiological Week no. 22 (27 May to 02 Jun, 2012) Priority diseases under surveillance in eDEWS Respiratory Diseases Acute (upper) respiratory infections Pneumonia <5 years Pneumonia > 5 years Suspected Diphtheria Suspected Pertussis Gastro Intestinal Diseases Acute Watery Diarrhea <5 year Acute Watery Diarrhea > 5 year Bloody Diarrhea <5 years Bloody Diarrhea > 5 years Other Acute Diarrhea < 5 years Other Acute Diarrhea > 5 years Suspected Enteric/Typhoid Fever Other Communicable Suspected Malaria Suspected Meningitis Suspected Dengue Fever Suspected Viral Hemorrhagic Fever Pyrexia Of Unknown Origin Vaccine Preventable Suspected Measles Suspected Acute Viral Hepatitis Highlights Chronic Viral Hepatitis 18 districts and 3 agencies provided surveillance data to the eDEWS this week from 519 Neonatal Tetanus health facilities. Acute Flaccid Paralysis A total of 146,779 consultations were reported through eDEWS of which 18% or 25,866 cases Skin Disease were Acute Upper Respiratory Infection, is still the highest cause of morbidity of total Scabies consultations were showing 1% increase in percentage as compared to week 21. Other Acute Diarrhoea shared 11% or 15,862 cases of the total consultations showing 1% Cutaneous Leishmaniasis increase in percentage as compared to previous week. Injuries /Poisoning Pyrexia of Unknown Origin accounted for 5% or 7,288 cases out of total consultations. Injuries Skin Infection (Skin Inf.) reported at 3% or 3,852 cases and suspected Typhoid Fever comprised Snake bite only 0.3% or 462 cases out of total consultations. Other unusual diseases A total of 79 alerts including 4 outbreaks (3 for Measles and 1 for Falciparum Malaria) were received. 68 alerts for suspected Measles, 3 for AWD, 3 for NNT, 2 for BD while 1 each for Other unusual diseases Enteric Fever, Cutaneous Leishmaniasis and suspected Malaria were shared and responded. Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012) Compiled situation in Khyber Pakhtunkhwa & FATA Figure-1: Four years trend of Other Acute Diarrhea (OAD) in Khyber Pakhtunkhwa/FATA (2009, 2010, 2011 and 2012) The above graph shows the trend of Other Acute Diarrhoea (OAD) cases out of total consultations reported to DEWS in 2009, 2010, 2011 and 2012 up until now. In this week 22, 2012 OAD consultations shows 11% or 15,862 cases of total cases which shows 1% increase in percentage as compared to week 21. During this week high percentage of OAD consultations were reported from district Hangu 20%, Kohistan 20%, Buner 17%, Swat 16%, Mohmand agency 16%, Malakand 15%, Haripur 13%, Lower Dir 13%, Charsadda 12% and D.I. Khan 10%. Figure-2: Alerts reported in Khyber Pakhtunkhwa/FATA (year 2011 and 2012 comparison) The above graph shows the different reported alerts to DEWS from year 2011 and 2012. High number of alerts reported in year 2012 due to more active surveillance and response. A cumulative figure for the current year is 1,545 alerts (3,444 cases) including of 110 outbreaks were reported. Measles alerts are leading in Khyber Pakhtunkhwa and FATA with 1,170 alerts (2,036 cases) including 80 outbreaks. Followed by Leishmaniasis 170 alerts (544 cases) including 11 outbreaks, Neonatal Tetanus 87 alerts (89 cases), AWD 18 alerts (38 cases), Diphtheria 17 alerts (17 cases), suspected Typhoid 16 alerts (62 cases) including 4 outbreaks, Pertussis 11 alerts (21 cases) including 1 outbreak, Bloody diarrhoea 10 alerts (55 cases) including 4 outbreaks, AFP 8 alerts (8 cases), suspected Acute Viral Hepatitis 7 alert (58 cases) including 2 outbreaks, Scabies 6 alerts (308 cases) including 5 outbreaks, H1N1 5 alerts (11 cases) including 1 outbreak, Dengue Fever 4 alerts (4 cases), Tetanus 4 alerts (4 cases), Other Acute Diarrhoea 2 alert (164 cases), CCHF 2 alerts (3 cases), Chickenpox 2 alert (5 cases), Dengue Hemorrhagic Fever 1 alerts (4 cases), suspected DHF/CCHF 1 alert (1 case), Falciparum Malaria 2 alert (2 cases) including 1 outbreak, Unexplained Fever 1 alert (1 case) and Rabies 1 outbreak (9 cases) were shared. This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 2 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page: Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012) Figure-3: Number of alerts and alert cases reported in Khyber Pakhtunkhwa/FATA (Week 22, 2012) The above left side graph shows different alerts and their cases reported in KP/FATA and right side graph shows different alerts shared by district wise in week 22, 2012. In this week a total of 79 alerts (140 cases) including 4 outbreaks (3 for Measles and 1 for Falciparum Malaria) were reported and responded. Highest number of alerts reported from district Swat 16 suspected Measles alerts (20 cases) were shared, Followed by district Haripur 14 alerts including 11 suspected Measles while 1 each for Enteric fever, BD and Falciparum Malaria, Abottabad 9 suspected Measles, Bajaur agency 6 alerts including 4 suspected Measles and 2 NNT, D.I. Khan 6 suspected Measles, Mardan 4 alerts including 3 suspected Measles and 1 AWD, Shangla 4 alerts including 3 suspected Measles and 1 CL, Mansehra 4 suspected Measles, Swabi 3 suspected Measles, Battagram 2 suspected Measles, Charsadda 2 suspected Measles, Khyber agency 2 suspected Measles, Kohat 2 alerts including 1 each for AWD and BD, Malakand 2 suspected Measles, Bannu 1 NNT, FR Banuu 1 suspected Measles and Hangu 1 AWD were reported and responded. 4 outbreaks (Measles 3 and Falciparum Malaria 1) were reported in this week. 1 Measles and 1 Falciparum Malaria were shared from district Haripur . A total of 9 suspected measles cases were reported from village Kotehra. Gave vitamin A. Field investigation found 7 childlren with no BCG scar and no routine immunization activity. Missed children sent to nearest health facility for vaccination. Outreach vaccination scheduled for current week. EDO Health and EPI coordinator informed about outbreak. 1 cases of Falciparum malaria confirmed by both RDT and microscopy. Patient developed complications and referred to hospital where he was treated. No travel history to malaria endemic area. Active surveillance conducted in area. 8 cases with fever identified. Slides were taken for examination. Health session conducted for the affected family. Bed nets distributed by CHWs. Larvicidal activity in the camp carried out. Fog spray is planned for 2nd week of June. 1 Measles outbreak was shared from district Mardan . A suspected Measles case was reported from MMC Mardan, case was investigation at hospital and received complete doses of routine vaccination. Active surveillance conducted in the area, surrounding houses were checked for identification of more cases and routine vaccination status, 5 more cases were identified in the family and surrounding. BCG coverage was 83% and Measles was 66% in the area. Vit-A was given, EPI team also requested for outreach immunization in the area. Blood Sample Collected for confirmation of antibodies, Health education session conducted with the family members and community, patient isolated, EDO-H Focal person & EPI Coordinator were informed. 1 Measles outbreak was shared from district Swabi . A total of 5 suspected cases of Measles were reported from BUH Fazal Abad. Cases were investigated and responded in the presence of Health department personal. During investigation 4 more cases were found in the same locality. Vit.A given, health education sessions conducted, EDO H and EPI coordinator Informed, Measles Vaccination done in the relevant houses. Table-1: Leading causes of seeking health care in flood affected districts, compiled weekly reports Total Consultations Disease name Week-19 Week-20 Week-21 Week-22 (1st Jan to 02nd Jun, 2012) Acute Diarrhoea 16,890 (11%) 17,861 (11%) 17,631 (10%) 15,862 (11%) 218,387 (7.4%) Bloody Diarrhoea 1,727 (1%) 1,379 (1%) 1,544 (1%) 1,068 (1%) 22,218 (1%) Suspected Malaria 3,350 (2%) 3,868 (2%) 4,098 (2%) 3,200 (2%) 44,705 (1.5%) Skin Diseases 4,464 (3%) 4,514 (3%) 4,639 (3%) 3,852 (3%) 79,641 (3%) Pyrexia of Unknown Origin 8,538 (5%) 8,213 (5%) 8,174 (5%) 7,288 (5%) 137,346 (5%) Acute Respiratory Infection 29,966 (19%) 29,947 (18%) 30,490 (17%) 25,866 (18%) 719,525 (24%) Total Consultations 159,890 161,900 176,830 146,779 2,946,630 This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early 3 Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected]. Page: Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.22 (27th May to 02nd Jun, 2012) The above table shows compiled communicable diseases cases from weekly reports and proportional morbidity through eDEWS reported. Since January 1, 2012, approximately 2,946,630 patient consultations have been reported to the eDEWS from Khyber Pukhtunkhwa province and Federal Administered Tribal Areas (FATA). In this week 22, 2012 (27th May to 02nd Jun, 2012) reports were received from 519 health centres and the major causes for seeking health care by the communities in almost all of the regions were diarrhoeal diseases 15,862 cases or 11%, acute respiratory infections 25,866 cases or 18%, skin diseases 3,852 cases or 3% and suspected malaria 3,200 cases or 2%. Figure-4: Total number of HFs reported and consultations Figure‐5: Leading communicable diseases percentage trend in Khyber (Week no.1 to 22, 2012) Pakhtunkhwa and FATA (Week no.1 to 22, 2012) Figure 4 shows the number of health facilities and total number of consultations reported.
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