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Uganda Weekly Activity Report

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Emergency and Humanitarian Action (EHA), Uganda Weekly Activity Report I. General Situation a. Political, Social and Security; The security situation in Acholi and Lango sub-region is calm despite the ongoing incursion by government on LRA base in Garamba. In Week 5, Karamoja sub-region there is reported cases of violent crimes and rape in the villages b. Main Events of Interest/Concern for Health Supplementary Polio immunization campaign was successfully implemented in all 26th January – 1st February districts of Acholi. In Lango sub-region child day activities were conducted. 2009 3rd round of IRS ongoing in Kitgum and Pader district Epidemic outbreak of Meningitis in the district of Hoima, Masindi, Arua, Moyo and Adjumani has been contained II. Analysis and Health Consequences (Health Problems and Needs of Affected Population) Malaria: Acholi, Lango and Karamoja sub-regions; The trend of malaria cases in all sub-regions in the last five weeks is similar to that of 2008 for the same epi-week. See figure I for details. Highlights Meningitis; Supplementary Polio Number of cases as of 10th February 2009 immunization campaign District Date 1st Date last Cumulative # Cumulative CFR Number of sub- was successfully case seen case seen of cases deaths counties completed in Acholi sub- affected region Hoima Late 26. 01.09 49 13 27% 1 December Arua 31.12.09 28.01.09 213 19 8.9% 2 Masindi 4.01.09 26. 02.09 25 8 32% 2 Adjumani 30.12.09 26. 01.09 31 3 10% 1 Moyo 07.01.09 29.01.09 18 0 0% 1 Total 337 43 12.7% Acknowledgement 2 suspected cases of meningitis were reported in Lira district and 2 other suspected cases were reported from Amuru district. Production of this weekly No new cases of meningitis were reported from districts which had epidemic activity report has been made possible by contribution from outbreak of meningitis. the followings Cholera, Measles and AFP; No case reported in the week Dysentery: (Acholi, Lango and Karamoja); Over the past five weeks, the number of cases of dysentery reported in Acholi and Lango sub-regions in 2009 is much less than that of 2008 for the same epi-week. For the case of Karamoja region, the number of cases and the trend of dysentery in 2008 are similar to that of 2009 for the same epi-week. See figure II for details. Kitgum district continues to register fewer cases of dysentery in 2009 as compared to 2008 for the same epi-week. See figure III for details Hepatitis E: 50 new cases were registered in epi-week 5 of 2009 down from 53 cases registered in epi-week 4. The cumulative number of cases registered now is 9,523 with 153 deaths (CFR 1.60%). Kitgum district registered 47 new cases with one death. See table I and figure III below for details. Table I District New cases New deaths Cumulative cases Cumulative deaths Kitgum 47 1 9,395 144 (1.53%) Gulu & Amuru 0 0 17 (9 positive) 2 (13.3%) Pader 3 0 108 7 (6.48%) Lango 0 0 3 0 Total 50 1 9,523 153(1.60%) Sub-counties that registered most cases are Padibe East/West 10, Lokung 8, Namukora 7, Kitgum Matidi 5, Layamo 5, Kitgum Town council 5. III. Actions a. WHO Response Epidemic Response (Sida) Disease surveillance; . WHO Supported Gulu district with HMIS data collection tools . WHO continue to provide technical and financial support to disease surveillance in all districts in the region. Weekly epidemiological reports depicting disease trends have been shared with all the districts and partners. Malaria; . Limited stocks of Coartem and oral Quinine in Amolatar, Dokolo, Lira and Apac still hampers prompt and effective case management (only Oyam district has adequate Coartem in the health facilities). In Lira district, the trained VHTs (CMDs) in the 5 out of 9 sub-counties are implementing HBMF using the 14,040 blisters of Coartem received. Continue to provide support to DHO Kitgum and Pader with the ongoing 3rd round IRS activities Measles; No new case was reported in the week. Awaits results of the samples submitted to UVRI for confirmation Hepatitis E; . WHO has provided financial support to 7 DHT members who are deployed to support the sub-counties of Mucwini, Paloga, Padibe E/W, Kitgum Matidi and Lukung for accelerated Hepatitis E control activities. Major areas of support includes; o Support to weekly sub-county task force meeting o Support supervision to VHTs o Conduct door to door inspection of household and community mobilization o Community sensitization on latrine construction . Case management is ongoing in all health facilities, . Support to weekly task force meeting in Kitgum and Pader district on going. Water chlorination at house hold level is ongoing but the coverage and consistencies is poor . Major gaps includes; o Poor access to safe water especially in return areas o Latrine coverage is poor (24%) o Social mobilization is still inadequate . WHO continues to advocate with other cluster members to continue supporting Hepatitis E response. Meningitis; The two suspected cases of meningitis from Lira district were started on antibiotics before investigations. However, Contact tracing is being done in Akalo in Apac and in Adek okwok in Lira where they come from. The two cases from Amuru district was investigated, CSF was negative for N. Meningitis. Polio campaign; Coverage achieved were 97% Kitgum district, 80% Pader district, 128% Amuru district and 103%Gulu district. HAT; WHO continued to provide financial and technical support to HAT control activities in Dokolo districtl. Others; . WHO supported Lira district to train 20 health workers of Lira Regional Referral Hospital on prevention and response to GBV . WHO supported Oyam district during the HMIS training of 20 records clerks / health workers to improve data management. WHO is assisting in compiling the needs for the IDSR and HMIS tools (booklets) including registers, databases and carbonated weekly reporting forms for 2009 for the Lango sub-region. Emergency Health and Nutrition Response in Karamoja (CERF) . Provided additional drugs for outreach activities. Ongoing rehabilitation works in Lorengechora, Lolachat and Panyagara health centres . Supported supervision of VHTs is ongoing in all districts . Supported the districts to order coartem for the VHTs; Kotido has completed. Monthly meeting for the VHTs of Kakomongole in Nakapiripirit took places. The VHTs were provided with the record books to begin their activities Influx of refugees from DRC . WHO continues to support strengthening of EPR and IDSR, in all refugee hosting districts of western Uganda. At national level WHO continue to support coordination of response to refugee influx b. Cluster Partner’s Response . NUMAT is supporting the districts to conduct inventory of medicines especially ARVs and HIV test kits. Funds for routine support supervision by DHT have been availed to the districts and this is going to be combined with collecting ARV / PMTCT filled forms. UNICEF has continued to support the districts with resources to implement various activities in the region. Work plans for 2009 activities have been submitted and reviewed. Funds are soon to be disbursed to Lira as the accountabilities have been completed. 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). CUAMM funded training of health workers / record clerks on HMIS in Oyam district. The training has been jointly conducted by NUMAT, Oyam DHT and WHO. Malaria consortium distributed LLITN to pregnant mothers in Gulu and Amuru district . Others partners include Concern, TPO Uganda, UNFPA, MSU, MTI, ARC, Medair, CPAR, World Vision, ZOA, GOAL and URCS Other partners response to refugees influx from DRC . Partners responding to the refugee crisis include; GTZ, UNHCR, AAH, URCS, AIRD, MSF-F, SCiU, Hope After Rape and CESVI IV. Comments and Conclusions . Response to the epidemic outbreak of Meningitis has been adequate in four out of the 6 affected districts. Better response is specifically documented in districts that had Meningitis epidemics in the last three years. Poor response to epidemics as evidenced by high CFR in Hoima and Masindi are due to lack of institutional memory for meningitis outbreak response. This finding outlines the importance of epidemic preparedness especially for districts that have had no epidemics in the last 2-3 years. With population movements from IDP camps to original homeland, access to safe water is poor, latrine coverage is low (24%). There is urgent need for action to improve access to safe water and sanitation in order to stop the increase in number of cases of Hepatitis E reported on weekly basis in Kitgum district V. Plan for Coming Week . Support hepatitis E epidemic response in Kitgum and Pader district . Support response to the influx of refugees from DRC . Providing technical and financial support in the above regions to the office of the DHOs in strengthening HMIS/IDSR . Continue to support 3rd round of IRS in Kitgum and Pader district . Support Polio vaccination campaign in Kitgum, Gulu and Pader district For further information, please contact: Dr. Joaquim Saweka, WHO Representative Uganda: Tel. +256 41 335500, Mobile +256 752 728 257, Email: [email protected] .
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