CORE Group Polio & Global Health Security, Horn of Africa Weekly Bulletin: FY21 Q2 Week 4 (18-24 Jan, 2021) POLIO UPDATES: () POLIO UPDATES: () GLOBAL HEALTH SECURITY—PRIORITY ZOONOTIC (KENYA) • The project supported 13 Routine Immunization outreaches session • In Somalia, no outreaches were conducted during the reporting DISEASES: reaching children under the age of 1 year with various routine period. UPDATES ON RVF: vaccination antigens ( 23 zero doses, 40 OPV Birth doses, 57 OPV 3, 54 IPV doses, 38 Penta 1, 54 Penta 3 doses, and 39 Measles doses) in the • The project’s supported Community Volunteers (CVs) conducted • 1 human case reported in county and investi- far-flung project counties of (, , Mandera, , social mobilization and sensitized the communities on AFP (Polio), gated with positive lab tests. Sample collection for ani- , Turkana, ). and COVID-19. The CVs visited 1,980 households, 2,309 under 5 mals were taken for investigation, with 4 camel deaths years, 439 one on one contact and reaching 269 during group reported in the same herd as the confirmed human • The project’s supported Community Volunteers (CVs) conducted social meetings while observing COVID-19 prevention protocols e.g. physi- case. mobilization and sensitized the communities on AFP (Polio), Priority cal distancing, washing of hands, and wearing of masks. Zoonotic diseases as well as COVID-19. The CVs visited 5,162 house- • In , sample collection of around 40 cam- holds, 4,202 under 5 years, 3,323 one on one contact and reaching 999 • During the week, border health facilities in Somalia reported that 53 els were collected for investigation , out of which 4 during group meetings while observing COVID-19 prevention protocols children under the age of five failed to complete their routine were confirmed cases. e.g. physical distancing, washing of hands, and wearing of masks. immunizations respectively. The CVs traced 22 (42%) and referred them to the health facilities to complete/continue their immuniza- • No cases reported in the Turkana, Marsabit, Wajir and • Border health facilities in Kenya reported that 362 children under the

age of five failed to complete their routine immunizations respectively. tion schedule. Lamu counties, with ongoing sensitization of border The CVs traced 201 (56%) children and referred them to the health communities on the risk factors and reporting of sus- facilities to complete/continue their immunization schedule. pected RVF cases. Coordination meeting at the sub county and county level ongoing with preparedness

Sample collection, community sensitization as well as ques- tionnaires for the line listed patients done in . Photo credit, Mohamed—ADRA. Outreach sessioni at dugo location Wajir North border. Outreach session in Degaga village in Afmadow district, lower juba Photo credit, Abdul-Aziz region, Somalia. Photo credit, Yusuf-ARC Strengthening of immunization systems: Outreach services to hard to reach border, nomadic pastoralist. (28/12/2020 – 24/01/2021)

Country County/ # Outreach Zero Dose Birth Dose OPV 3 IPV Penta 1 Penta 3 Measles Region Outreach Outreach Static Outreach Static Outreach Static Outreach Static Outreach Static Outreach Static

KENYA Garissa 10 45 108 54 151 223 146 211 149 240 149 230 118 217

Lamu 1 1 0 2 0 6 2 8 0 7 0 8 4 14

Mandera 11 37 55 38 61 140 65 143 55 150 60 142 37 129

Marsabit 4 28 38 41 42 186 37 170 22 169 38 166 5 131

Nairobi 0 0 0 0 0 0 0 0 0 0 0 0 0 7

Turkana 4 0 2 25 4 88 42 93 26 91 29 90 21 54

Wajir 6 17 15 19 32 73 32 53 27 66 32 67 38 61

Total 36 128 218 179 290 716 324 678 279 723 308 703 223 613

SOMALIA Bakool 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Gedo 1 0 0 95 9 721 9 707 11 795 10 716 14 914

Lower Juba 1 0 0 15 0 19 0 36 0 13 0 42 3 24

Total 2 0 0 110 9 740 9 743 11 808 10 758 17 938

Grand Total 38 128 218 289 299 1456 333 1421 290 1531 318 1461 240 1551

Source: CGPP program data

The CGPP project support 97 border health facilities in Kenya and 27 border health facilities in Somalia. The border health facilities are required to analyze their catchment populations needs and immunization coverage hence plan for two integrated outreach sessions in the facility micro-plans. This outreach clinics should target the nomadic and hard to reach population and other vulnerable populations e.g. minorities/IDPs. The community mobilizers and community volunteers conduct social mobilization in the outreach sites for maximum utilization of the services including sensitization on vaccine preventable diseases. Active case search for AFP is also integrated during social mobilization/community sen- sitizations. A reward of KES 1000 ($10) is given to any community mobilizer/community informants who reports a suspected AFP case that meets the lay case definition. The project supports a maximum of 12 cases per County/region.

During migration of the pastoralist, parents are advised to complete their immunization schedule for their children in health facilities along their migratory routes. Facility-in- charges with the help of community mobilizers, also coordinate on children who have KENYA: Total # of children Defaulted = 1273 Total # of children traced= 649 (51%) defaulted so that they can be traced to complete the uptake of the remaining antigens. SOMALIA: Total # of children Defaulted = 184 Total # of children traced= 98 (53%) Community Based Disease Surveillance on Human Alerts/Active Case Search

AFP Active case search by Country (01/01/2021- 24/01/2021) Country County # HH Visited # Suspected AFP

KENYA Garissa 481 1

Lamu 330 0

Mandera 528 0

Marsabit 1390 0

Nairobi 2756 0

Turkana 1704 2

Wajir 610 0

Total 7799 3

SOMALIA Bakool 306 0

Gedo 6804 0

Lower_Juba 2632 0

Total 9742 0

• In strengthening community disease surveillance, the community mobilizers conduct active surveillance visits to villages, nomadic settlements, traditional healers on the need to report suspected dis- ease conditions e.g. AFP, Measles, Cholera/AWDs. Any suspected disease conditions immediately are reported to health facilities in- charges and disease surveillance coordinators for follow up and veri- fications.

• The community mobilizers keep record of the all the suspected dis- ease conditions reported to health facilities. Community Based Disease Surveillance on Priority Zoonotic Diseases.

Rumour and Zero Reports as from 01/10/2020 - 24/01/2021 County/Region Rumour Zero reporting KENYA Garissa 3 114 Lamu 9 67 Mandera 4 137 Marsabit 10 371 Nairobi 16 80 Turkana 16 2127 Wajir 18 1518 SOMALIA Bakool 0 0 Gedo 0 0 Lower_Juba 0 0 Grand Total 76 4414

WEEKLY GHSA UPDATES: • A total of 21 new animal alerts received this week with 7 progressive loss of weight, and 2 Cluster of abortions or deaths of young animals, 4 cluster of animal death, 4 abortion in late pregnancy; retained placenta; swelling of testicles and, 1 death with unusual bleeding 3 aggressive animal bite. • 14 new human diseases alerts reported this week: 2 cluster of unusual ill- nesses or death of people , 4 acute watery diarrhea, 4 hotness of the body and rash , 1 fever, cough or breathing problems and 3 sudden paralysis. • Cumulatively, over the reporting period (01/10 to 24/01/2021) there have been an increase in progressive loss of weight as well as Cluster of abortions or deaths of young animals having recorded 105 and 44 alerts respectively with having the highest alert with 62 alerts for progressive loss of weight and 29 cluster of abortions. • 273 zero reports as well 6 rumor reports received from the community vol- unteers this week.

Social Mobilization Activities

• Social mobilizations is to sensitize communities on the importance of personal hygiene, regular hand- washing, physical distancing and wearing of masks (especially in this period of COVID-19) in disease Summary- Social Mobilization Activities prevention at community level. Also community mobilizers & Community Disease Reporters (CMs/

CDRs) are looking for suspected AFP & Zoonotic cases using simplified lay case definitions to identify # of times HH visited # of children < 5 yrs. reached suspected AFP cases and other disease conditions ( e.g. measles, Acute Watery Diarrhea—AWDs). • Kenya = 11,066 Kenya = 11,202 This is done through one to one meeting at household level or group meeting organized at the com- • Somalia = 7,612 Somalia = 8,466 # reached (one on one contact) # reached (Group Meeting) munity level. The community mobilizers are required to generate reports to the project supervisors • Kenya= 8,892 Kenya= 3,668 and also CHAs or border health facility in-charges. • Somalia= 2,108` Somalia= 1,299 • The CMs engage in community mobilization for RI services especially during outreach clinic sessions and in RI defaulter tracing. COVID-19 SITUATIONAL UPDATES. COORDINATION MEETINGS

KENYA • Health stakeholders forum meeting in Garissa . Discussed on the RVF outbreak in county and

Confirmed 100,193 Counties supported Confirmed cases. also preparedness plan for the outbreak. cases by CGPP • Community sensitisation on RVF and other priority zoonotic diseases in Wajir Male cases 63,553 Nairobi 42,948 Female cases 36,640 Mandera 107 • Program review and surveillance update in Kamkunji Death 1,750 Wajir 84 RUMOR REPORTS (CFR=1.7%) Garissa 708 • “Coronavirus pandemic is finished in Kenya because there are no more sign Recoveries & 83,625 Turkana 976 and symptoms.“ Kamkunji, Nairobi. discharges Marsabit 147 A total 1,162,491 COVID-19 • “Corona virus is a project.” tests have been conducted. Lamu 310 PLANNED ACTIVITES Source: MoH Kenya

SOMALIA • CM/CHVs active participation in tracing children who have defaulted inmmunization I • Participate in covid-19 screening and sensitization of the community on AFP, zoonotic C onfirmed cases 4,784 and Routine immunization Male cases 3,540 • Active case search (AFP, other Priority conditions & Zoonotic Priority disease) Female cases 1,244 • Cross border quarterly meeting in Lower Juba. Death (CFR=2.7%) 130 Recoveries & discharges 3,700 • Support supervision in Gedo A total 77,652 COVID-19 tests have been conducted. • Conduct polio coordination meeting with MoH, WHO and other stakeholdersn i Gedo

CHALLENGES Regions supported by CGPP Confirmed cases. • Poor network connectivity in some areas Lower Juba 165 • Insecurity along the Kenya Somalia border due to Insurgents activities. Gedo 41 • Closure of health facilities in Somalia (Tula Amin and Malkariye) Bakool 8 • High turnover of trained health facility staffs in Lower Juba region. • Heightened insurgency activities along the border areas in the recent weeks interrupting move- Source: WHO Somalia ments along Somalia Kenya border. PICTURE SPEAK

Training of CDR from 19/01/2021-23/01/2021 by Veterinary Staff Turkana North and Kibish Sub County on Zoonosis. The CDRs Pastoralist community sensitization on RFV and other priority zoonotic diseases along wajir-Isiolo and Wajir-Marsabit are from Kokuro, Meyan, Liwan and Maisa Kraals. border in . Photo credit Andrew - IRC Photo credit, Hujale