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Weekly Epidemiological Bulletin Weekly Epidemiological Bulletin Ministary of public Health Papulation Electronic Disease Early Warning and Response System Primary Health Care Sector DG for Disease Contraol Surveillance Volume 03, Issue 42, Epi week 42, 12 - 18 Oct 2015 H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 42, 2015 96%97 % 100% 93% 94% 100,000 94% 94%92 %93 % 9392% % 94% 88% 90% 92% 82%82 % 85% 82% 90,000 ● During week no. 42, 2015;88% (402/354) health facilities from 16 governorates provided 78% 81% 80% 79% 81%79 % 80% 72% 74% 80,000 70% 68%70 %69 %68 % 70%70 % 66% 66% valid surveillance data. 70% 64% 64%62 % 64%64 % 62% 70,000 60% 54% 51% 60,000 50% 50,000 40% 40,000 30% 30,000 P e r c e n t a ge a t e n c r e P ● The total number of consultations reported during the week in 16 governorates was 20% 20,000 C o n s u l a t i t o n s 72269 compared to 66933 the previous reporting week. Acute respiratory tract infections 10% 10,000 0% - (ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of Wk 1 Wk 2 Wk 4 Wk 5 Wk 7 Wk 8 Wk Wk 3 Wk 6 Wk 9 Wk 10 Wk 11 Wk 13 Wk 14 Wk 16 Wk 17 Wk 19 Wk 20 Wk 22 Wk 23 Wk 24 Wk 26 Wk 27 Wk 29 Wk 30 Wk 32 Wk 33 Wk 35 Wk 36 Wk 38 Wk 39 Wk 41 Wk 42 Wk Wk 15 Wk 18 Wk 21 Wk 25 Wk 28 Wk 31 Wk 34 Wk 37 Wk 40 morbidity this week. Wk 12 Reporting Rate Consultations Distribution of Reporting Rates by Governorates (Epi-week 42, 2015) 100% 80% ● A total of 137 alerts were generated by eDEWS system in week 42, 2015; Of these 129 % 60% % % % % % % % % % % alerts were verified as true for further investigations with appropriate response. % % % % 40% 88 100 88 91 92 96 100 % 100 64 100 92 88 100 100 100 20% 8 N o. H F R e p o r t t s por e R F H o. N 0% ● Altogether 26 alerts for Acute viral hepatitis, 21 Measles, 19 Dengue Fever, 16 Bloody diarrhea, 12 Acute Flaccid Paralysis, 11 Pertussis, 10 Cut.Leishmaniasis, 6 Meningitis, 3 Reporting Rate Target Schistosomiasis, 2 Pneumonia, 1 each for Other acute diarrhea, Viral hemorrhagic fever and Note: The cause of reporting rates decline in Taiz and Sa'da are the armed conflict, as well as the reasons to Neonatal Tetanus were received and responded in system generated. the others ( Aden. Lahj, Abyan, Amran and Al-Mahrah); lack of electricity, fuels, and access to the net . Suspected Dengue outbreak ● Online disease surveillance and response system was launched in 4 governorates (Aden, Abyan, Lahj and Taiz) in March 2013 and the expansion phase has stared in 6 Governorates (Sana'a City, Hodaidah, Hajjah, Ibb,Al-Mukalla and Sa'da ) in November 2013. The next expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov., HadramoutAl- wady and Dhamar) in April 2015 Ongoing on site trainings to improve weekly reporting and immediate notification are underway in all governorates. Leading causes of morbidity and mortality in Epi-week 42, 2015 Suspected dengue outbreak in Shabwah, Al-Mahrah Gov., Epi weeks 14 to 42, 2015 a). Suspected dengue outbreak 250 DF - Shabwah Gov. • 158 suspected dengue cases were reported in 7 governorates, out of these 50 cases Cases 200 Death reported from Shabwah and 56 cases from A-Mahra. 1 cases with hemorrhagic 150 manifestations were reported in Aden governorate through the eDEWS sentinel sites. 100 NO. NO. of cases 50 0 • Shabwah and Al-Mahra governorates having increase number of reporting DF cases. Some Wk 14 Wk 16 Wk 18 Wk 20 Wk 21 Wk 23 Wk 25 Wk 27 Wk 29 Wk 31 Wk 34 Wk 36 Wk 38 Wk 40 Wk 42 Wk 15 Wk 17 Wk 19 Wk 22 Wk 24 Wk 26 Wk 28 Wk 30 Wk 32 Wk 33 Wk 35 Wk 37 Wk 39 Wk 41 governorates (especially Taiz) lost all communication tools and still its reporting rates is low. 70 60 Cases DF - Al-Mahra Gov. 50 Death 40 • Surveillance is being intensified to ensure that the ongoing dengue outbreak is effectively 30 20 monitored and other priority communicable disease are reported through alternative NO. of cases 10 sources including private health facilities, mobile clinics, NGO partners on the ground, 0 health workers in the community, and the general public Wk 16 Wk 19 Wk 21 Wk 22 Wk 24 Wk 25 Wk 27 Wk 28 Wk 30 Wk 31 Wk 33 Wk 34 Wk 36 Wk 39 Wk 42 Wk 14 Wk 15 Wk 17 Wk 18 Wk 20 Wk 23 Wk 26 Wk 29 Wk 32 Wk 35 Wk 37 Wk 38 Wk 40 Wk 41 Leading causes of morbidity and mortality in Epi-week 42 2015 Proportional morbidity of leading priority diseases, Epi weeks 1 to 42, 2015 b. Other leading priority diseases 25.0% ● URTI (13.9%), suspected malaria (2.7%), OAD (10.3%) and Pneumonia (4.7%) remain the 20.0% leading causes of morbidity representing a total of 31.6%. 15.0% 10.0% 5.0% ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% 0.0% Wk 1 Wk 2 Wk 3 Wk 6 Wk 7 Wk 4 Wk 5 Wk 8 Wk 9 Wk Wk 10 Wk 11 Wk 14 Wk 15 Wk 16 Wk 19 Wk 20 Wk 23 Wk 24 Wk 28 Wk 29 Wk 32 Wk 33 Wk 36 Wk 37 Wk 41 Wk 42 Wk Wk 13 Wk 17 Wk 18 Wk 21 Wk 22 Wk 25 Wk 26 Wk 27 Wk 30 Wk 31 Wk 34 Wk 35 Wk 38 Wk 39 Wk 40 of total morbidity in reporting period. Bloody diarrhea represented 0.4% of this morbidity. Wk 12 DD URTI S.MAL Pneumonia Pneu 4.7% ● All diarrheal disease comprised 10.6% and Pneumonia 4.7% of total morbidity in Pilot URTI 14.0% OAD 10.3% Governorates this week. BD 0.4% Sch 0.1% Others 67.0% S.Mal 2.7% ● All diarrheal disease comprised 5.54% and Pneumonia 2.64% of total morbidity in the <5 Rb 0.2% years age group. Cases (n=16,379) AVH 0.3% URTI=Upper respiratory infections; Pneu=Pneumonia; OAD=Other acute diarrhea; BD=Bloody diarrhea; AWD=Acute Watery Diarrhea; Sch=Schistosomiasis; Mal=Malaria; Rb=Rabies; AVH=Acute viral hepatitis; Meng=Meningitis; DF=Dengue fever; VHF=Viral hemorrhagic fever; Meas=Measles; CL=Cutaneous Leishmaniasis; Pert=Pertussis; Diph=Diphtheria; NNT=Neonatal Tetanus This weekly Epidemiological bulletin is published jointly by the Ministry of Public Health & Polupation and World Health Organization (WHO), WHO/EHA office, Sana'a, Yemen. For Correspondence: Mobile:+967 713228999;MOPH;[email protected]: +967 772924388 WHO/EHA Office; Email: [email protected] 1 Weekly Bulletin:Electronic Disease Early Warning & Response System, Yemen - Epidemiological Week Number 42 ( 12 - 18 Oct 2015 ) Weekly trends of Diarrheal Diseases, Upper Respiratory infections, Suspected Malaria and Pneumonia ( Epi week 1 to 42, 2015) Diarrheal Diseases URTI Sus.Malaria Pneumonia 6.0% 25.0% 16.0% 8.0% 14.0% 7.0% 5.0% 20.0% 12.0% 6.0% 4.0% 10.0% 5.0% 15.0% 8.0% 4.0% 3.0% 10.0% 6.0% 3.0% 2.0% 4.0% 2.0% 5.0% 1.0% 2.0% 1.0% 0.0% 0.0% 0.0% 0.0% Wk 1 Wk 3 Wk 5 Wk 9 Wk Wk 7 Wk 1 Wk 3 Wk 5 Wk 7 Wk 9 Wk Wk 1 Wk 5 Wk 7 Wk 9 Wk Wk 3 Wk Wk 11 Wk 13 Wk 17 Wk 19 Wk 21 Wk 25 Wk 27 Wk 29 Wk 33 Wk 35 Wk 37 Wk 41 Wk Wk 15 Wk 23 Wk 31 Wk 39 Wk 1 Wk 3 Wk 5 Wk 7 Wk 9 Wk Wk 11 Wk 13 Wk 15 Wk 41 Wk Wk17 Wk19 Wk21 Wk23 Wk25 Wk27 Wk29 Wk31 Wk33 Wk35 Wk37 Wk39 Wk 13 Wk 15 Wk 17 Wk 21 Wk 23 Wk 25 Wk 29 Wk 31 Wk 33 Wk 37 Wk 39 Wk 41 Wk Wk11 Wk19 Wk27 Wk35 Wk 11 Wk 13 Wk 15 Wk 17 Wk 19 Wk 21 Wk 35 Wk 37 Wk 39 Wk 41 Wk Wk23 Wk25 Wk27 Wk29 Wk31 Wk33 Age and Sex distribution of total consultations of leading diseases (Epi week 42, 2015) Cumulative number of major health events reported in Epi-weeks 1 to 42, 2015 (1st Jan 2015 to 18th Oct 2015) 16000 Diseases No of Cases Percentage 14000 Upper Respiratory Infections 287652 12.1% 12000 10000 Diarrheal Diseases 226157 9.5% 8000 Suspected Malaria 80552 3.4% 6000 Number of Consultations of Number 4000 Pneumonia 107666 4.5% 2000 0 Total (All consultations) 2376278 100% <1yr 1-4yr 5-14yr 15-44yr >45yr Male 4579 5936 7057 11041 6282 Female 4157 5681 7001 14158 6377 Leading Diseases by Governorate, Epi week 42 Distribution of consultations of leading diseases by Governorates, Epi week 42 Hadramout Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodidah Hajjah Amana Sa'da Amran Sana'a Gov. Shabwah Al-Mahrah Dhamar Total wady Upper Respiratory Infections 616 1465 622 93 833 646 553 350 1368 679 402 379 408 604 203 845 10066 Pneumonia 137 166 264 73 194 458 382 89 298 126 418 63 74 212 28 402 3384 Other Acute Diarrhea 306 742 418 103 319 859 693 462 1142 607 479 219 258 208 102 512 7429 Bloody Diarrhea 7 1 4 0 0 100 1 2 2 20 29 10 28 3 0 46 253 Acute Watery Diarrhea 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Schistosomiasis 0 0 3 0 4 3 0 3 14 6 17 3 1 0 0 6 60 Malaria 1 16 9 0 0 182 915 606 7 42 88 19 27 0 0 54 1966 Meningitis 0 3 0 0 0 8 2 2 3 0 6 0 0 0 0 14 38 Dengue Fever 4 16 21 0 7 0 4 0 0 0 0 0 50 0 56 0 158 Viral Hemorrhagic Fever 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 Rabies 0 0 1 0 0 3 1 5 61 0 4 0 0 1 0 38 114 Measles 0 2 2 0 1 2 0 8 2 3 1 1 6 0 0 0 28 Acute Viral Hepatitis (A & E) 8 16 1 0 4 41 0 2 41 1 20 10 7 2 0 49 202 Neonatal Tetanus 0 0 0 0 0 0 2 0 0 0 0 0 0 0 0 0 2 Acute Flaccid Paralysis 0 4 0 0 0 1 2 0 2 0 1 2 0 0 0 0 12 Cutaneous Leishmaniasis 0 0 0 0 0 2 0 0 1 3 4 0 0 4 0 1 15 Diphtheria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Pertussis 1 0 2 0 0 2 1 0 1 2 1 0 4 0 0 0 14 Other Un 2 28 8 0 0 12 217 3 6 28 0 0 0 1 8 4 317 Other Consultations 2164 3779 1968 171 2616 5016 4766 1467 9831 2405 2185 1442 1499 2125 815 5967 48216 Total Consultations 3246 6239 3323 440 3980 7335 7539 2999 12779 3922 3655 2148 2361 3160 1212 7931 72269 A Number of alerts & outbreaks reported and investigated with appropriate response g Number of Alerts Received and Responded (Epi weeks 39 and 42, 2015) e 2015 Current week 42, 2015 System Gen.
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