Emergency and Humanitarian Action (EHA),

Weekly Activity Report I. General Situation a. Political, Social and Security; • DRC; The pursuit of the LRA rebels in DRC continues Week 15, • Acholi and Lango sub-region; the region is calm. • Karamoja sub-region: 6th to 12th April 2009 ¾ Six incidences of cattle raid reported and 3 people were murders by armed Karamojongs in the reporting week. ¾ Disarmament of armed Karamojong by government of Uganda is still continuing. b. Main Events of Interest/Concern for Health; • Preparation for mini DHS in Acholi and Karamoja sub-region ongoing with technical and financial support from WHO • Preparation for integrated Child Health day and second round of mass Polio immunization campaign is ongoing in 29 districts in Uganda. This activity is planned for 25th to 27th April 2009. II. Analysis and Health Consequences (Health Problems and Needs of Affected Population) Malaria: Lango; The weekly incidence of malaria reported from in epi-week 15 is comparable to that of 2009. continues to report fewer numbers of clinical malaria cases in 2009 as compared to 2008. See figure I for details.

Highlights

• Preparation for the Mini Demographic and Health survey in Acholi and Karamoja sub-region is Acholi, The number of cases of malaria reported from and in epi-week 15 is going on as planned. comparable to that of 2008. Kitgum and has reported fewer numbers of cases of malaria in 2009 as compared to 2008. See figure II below.

Karamoja, Malaria incidence declined from 6,548 in epi-week 11 to 4466 in epi-week 15 representing a 31% decline. The decline in the number of cases of malaria registered on weekly basis can partially be attributed to the ITNs which were distributed to 90% of the population in November 2008, the ongoing campaign on malaria prevention which started in January 2009 or poor submission of IDSR from . See figure III below.

Acknowledgement

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

Dysentery: Acholi sub-region; The number of cases of dysentery registered in Amuru and Pader district in 2009 is less than that of 2008 however, the trends in the two years are similar. See figure IV below for details.

Lango sub-region; Dysentery incidence in Lango sub-region in 2009 is slightly less than that of 2008 for the same epi-week however, the trends in the two years are similar. See figure V below for details

Karamoja; The incidence of dysentery in Karamoja sub-region in epi-week 15 is comparable to that of epi week 14 and that of epi-week 15 of 2008.

Hepatitis E: 49 cases of Hepatitis E with 2 deaths were registered in the week from both Kitgum and Pader districts. The total number of cases of hepatitis E registered since the beginning of the

outbreak in November 2007 is 10,057 with 163 deaths (CFR 1.6)

Table I District New cases New deaths Cumulative cases Cumulative deaths

Kitgum 44 2 9,869 156 (1.6%)

Gulu & Amuru 1 0 20 (9 positive) 0 (0)

Pader 4 0 165 7 (4.2%)

Lango 0 0 3 0

Total 49 2 10,057 163(1.6%)

The sub counties that registered most cases in Epi week 14, 2009 are; Lokung [6]; Palabek Gem [6]; Mucwini [6 ];Amida [5]; Kitgum Matidi [5];Padibe West [4];KTC [3].

The majority of the cases reported are from Pader TC, Atanga S/C, Acholibur S/C, Kilak S/C, Pajule, Paimol & Lapul.

AFP; One suspected case was registered from Amuru district, HAT and Meningitis; No new case reported in the week Measles; Six suspected cases of measles were identified in the week of which five suspected were reported from Abim district and one from . III. Actions (WHO response, Sida grant)

Epidemic Response

Disease surveillance; WHO continues to support surveillance activity in all district of Acholi, Lango and Karamoja sub-region. Malaria; The weekly number of cases of malaria in all districts in Acholi and Karamoja sub- region region has been either similar to that of last year or less than that of last year however, with the onset of rainy season we expect the number of cases of malaria to rise. AFP; Stool sample from the suspected case of AFP has been taken to UVRI for confirmation Diarrheal disease; With the onset of rain we expect to see an increase in number of cases of dysentery especially in return area Measles; Samples sent to UVRI for confirmation.

Hepatitis E; • WHO is supporting MoH to send a team to to evaluate Hep E response and make recommendations for the way forward. • Other interventions ongoing; o District Task force meeting ongoing in Pader and Kitgum district o Community sensitization through radio programs, o Cases management, and o Support to water chlorination ongoing however, the coverage and consistence of this activity is poor as most of the activities of the NGOs are in development mode.

HAT; WHO continues to support Dokolo district to respond to HAT.

Mini UDHS in Acholi and Karamoja sub-region; • Listing of enumeration areas almost complete, • Translation of data collection tools into local languages complete • Training of data collectors complete, field practice by data collectors done • Pre-testing of data collection tools started last week • The survey is planned for May 2009. Preliminary result of the survey to be released by end of July

Other activities conducted by WHO; • Ongoing rehabilitation works in Lorengechora, Lolachat and Panyagara in Karamoja sub- region • Construction of temporary shelters for nutrition screening and actual screening of all children is ongoing in Abim and Nakapiripirit • Monthly meeting with the VHTs were conducted in Nakapiripirit during the reporting week • Additional VHT training for 100 VHTs is ongoing in Kotido and is the final lot of VHTs to be trained in the district. The district will then have coverage of 100%. The VHTs have been provided with T shirts, Caps and badges to improve their identity in the community. • Preparation is underway to complete training of VHTs in the resettlement camp of Apetolim in Moroto. IV Response from others partners; • ASB, CESVI, Concern, MTI, AVSI, AIS plus the RDC Office Pader continue to carry out activities that aim at controlling the Hepatitis E outbreak in Pader District. • Others doing various health activities are TPO Uganda, Madair, UNICEF, MSU, CPAR, NUMAT, PSI, URCS, ICRC, AMREF IV. Comments and Conclusions Preparations for the mini UDHS in Acholi and Karamoja sub-regions is going on as planned. The survey is scheduled for May 2009 and preliminary results will be ready by the end of July. Findings from the survey will inform planning and monitoring of implementation of PRDP in both Acholi and Karamoja sub-regions. 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 • Provide technical and financial support to the DHOs in strengthening HMIS/IDSR • Provide technical and financial support to MoH and UBoS in planning and conducting 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]