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Weekly Epidemiological Bulletin Disease Early Warning and Response System in

Volume 03, Issue 52, Epi week 52, 23 Dec - 29 Dec 2012

D E W S H i g h l i g h t s Fig 1: DEWS Reporting in Sindh Province, Epi week 01 to 52, 2012

● During week 52, 2012; 904 health facilities from 23 districts provided 1200 Highest reports collected

surveillance data for Sindh. No of reports collected

957

1000

944

930

927 921

● The total number of consultations reported during the week in Sindh was 915

904 904

898 898

891

890

889

865

841 836

267,005 compared to 415,375 the previous reporting week. Other acute 833

820

814

809

806

804

803

diarrhea (OAD), upper respiratory tract infections (URTI), suspected malaria

800 754

738

734

729

718

716

(S.Mal) and Scabies (Scb) were the leading causes of morbidity this week.

676

661

647

635 619

600

541

● A total of 21 alerts with 7 outbreaks were reported in week 52, 2012; 497

488

481

470

459

453

452

448

437

435

Altogether 18 alerts of Measles, 2 NNT and 1 Pertussis alerts were received 427

420

394 376

and responded. 400 363

261

● In total 80 people were affected, where 80% of cases were aged <5 years. 195 200

● Five Deaths were reported due to Measles in district Sukkur this week.

0

(Table 7)

Wk 03 Wk 07 Wk 11 Wk 17 Wk 21 Wk 25 Wk 29 Wk 33 Wk 37 Wk 41 Wk 45 Wk 51 Wk Wk 01 Wk 05 Wk 09 Wk 13 Wk 15 Wk 19 Wk 23 Wk 27 Wk 31 Wk 35 Wk 39 Wk 43 Wk 47 Wk 49 Wk

Leading Priority Disease - Sindh Province Leading Priority Diseases by District

● URTI (26.2%), OAD (6.9%), suspected malaria (7.4%), Scabies (4.4%) and ● URTI constituted the largest proportional morbidity this week. Pneumonia (1.5%) remain the leading causes of morbidity representing a District (36.6%) had the highest level during the week. total of 46.4%.

● Suspected malaria was highest in district Kashmore (15.7%). ● Bloody diarrhea, acute viral hepatitis, acute watery diarrhea and typhoid fever represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.4% of this morbidity. ● Scabies was proportionally highest in district Kashmore (13.8%).

● All diarrheal disease comprised 7.5% and Pneumonia 1.5% of total ● Other acute diarrhea was proportionally largest in district morbidity in Sindh Province this week. S.Benazirabad (17.3%)

● Pneumonia was highest in district Tharparkar (4.3%). ● All diarrheal disease comprised 3.7% and Pneumonia 0.8% of total morbidity in the <5 years age group. ● All diarrheal disease was highest in (17.6%).

Trends for Leading Priority Diseases in Sindh Province - Epi weeks 1, 2011 to 52, 2012

35% OAD BD MAL ARI

30%

25%

20%

15%

10%

5%

0%

This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, . For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 1 For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected]

URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0%

12.0

20.0% 10.0

15.0% 8.0

6.0 10.0%

4.0

5.0% 2.0

0.0% 0.0

WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK

WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK

District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698

MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005

Dadu

Badin

Thatta

Larkana

Sanghar TMKhan

Khairpur N-Feroze Umerkot

Jamshoro

Shikarpur

T. T. Allahyar

Tharparkar

Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28

Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500

Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500

Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500

Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500

Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500

Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000

Larkana 1 24 10 6000 0 1830 2500

Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500

Dadu 1 500

DG Health Services Sindh 200 0 0

Director Malaria Control Program 0 0 5400 9600 4960 60000

Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000

2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711

35 33

30

25

20 16 15

10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths

Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease

Current Week Outbreaks

Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass. UC Bachal Shah Miyani 6 0 2 0 O 8 1 Measles

Current Week Alerts

Suspected 2012-52 24-Dec-12 Shikarpur Jakha Muhalla, UC 6 1 0 2 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Shikarpur Village Shadi Khan Sundrani UC Karan Talluka Shikarpur 2 1 0 0 A 3 0 Measles Suspected Naushahro 2012-52 24-Dec-12 tharu shah road naushahro feroze 0 0 0 3 A 3 0 Measles Feroze Suspected Naushahro 2012-52 24-Dec-12 Muhala Karim shah ward 8 near bhiria college Taluka kandiaro 0 0 1 0 A 1 0 Measles Feroze

2012-52 24-Dec-12 Pertussis Jamshoro Sindhi Sachal colony, taluka 0 0 1 0 A 1 0

Suspected 2012-52 24-Dec-12 Dadu Lashari Muhalla, city Dadu 1 1 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Dadu Village Pandhi Siyal, UC Mondiar, city Dadu 1 0 1 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Ghumano Bheel, UC Gharibabad, UC and taluka Umerkot 0 0 1 3 A 4 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Khariya Bah, UC Kaplore, taluka Umerkot 2 0 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Musa Shar, UC Shadi Pali, taluka Pithoro 2 0 0 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Sukhio Bheel, UC Gharibabad, taluka Umerkot 1 0 0 0 A 1 0 Measles Shaheed 2012-52 25-Dec-12 NNT Tamoor Mari near Ghulam Muhammad Jamali uc Abul Hassan 1 0 0 0 A 1 0 Benazir Abad Shaheed 2012-52 25-Dec-12 NNT Village Murad Ali Mir Jat uc obhari sawri taluka daur 1 0 0 0 A 1 0 Benazir Abad Suspected 2012-52 25-Dec-12 Hyderabad Village M. Ramzan Brohi, Kachi Abadi, taluka Hyderabad, city Phuleli 1 0 2 0 A 3 0 Measles Trends for Upper Respiratory Tract Infections and Sus.Malaria by Years (2011 & 2012)

URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0%

12.0

20.0% 10.0

15.0% 8.0

6.0 10.0%

4.0

5.0% 2.0

0.0% 0.0

WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK

WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK

Trends for diarrheal diseases in Sindh Province Year 2010, 2011 & 2012 20.0%

18.0%

16.0%

14.0%

12.0%

10.0%

8.0%

6.0%

4.0%

2.0%

0.0%

Wk 01 Wk 02 Wk 03 Wk 04 Wk 05 Wk 06 Wk 07 Wk 08 Wk 09 Wk 10 Wk 11 Wk 12 Wk 13 Wk 14 Wk 15 Wk 16 Wk 17 Wk 18 Wk 19 Wk 20 Wk 21 Wk 22 Wk 23 Wk 24 Wk 25 Wk 26 Wk 27 Wk 28 Wk 29 Wk 30 Wk 31 Wk 32 Wk 33 Wk 34 Wk 35 Wk 36 Wk 37 Wk 38 Wk 39 Wk 40 Wk 41 Wk 42 Wk 43 Wk 44 Wk 45 Wk 46 Wk 47 Wk 48 Wk 49 Wk 50 Wk 51 Wk 52 Wk

Year 2010 Year 2011 Year 2012

Table 1: Proportional Morbidity of Leading Diseases in Sindh Province (Epi week 52, 2012) District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698 MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005 Table 2: Age and Sex distribution of total consultation of leading diseases in Sindh (Epi week 52, 2012) <1yr 1-4yrs 5-14yrs 15-49yrs 50+ Age No of Consultations % Of Total Consultations 30% Male 3.5% 8.9% 10.8% 15.4% 6.2% Male < 1 year 9279 3.5% Male Female Female 3.3% 8.1% 12.0% 23.9% 7.8% Male 1-4 year 23895 8.9% 25% Male 5-14 years 28872 10.8% 20% Male 15-49 years 41203 15.4%

Male 50 + 16575 6.2% 15% Female < 1 year 8874 3.3% Female 1-4 year 21656 8.1% 10% Female 5-14 years 32010 12.0% 5% Female 15-49 years 63846 23.9% Female 50 + 20795 7.8% 0% Total Consultations 267005 100% <1yr 1-4yrs 5-14yrs 15-49yrs 50+

This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, Pakistan. For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 2

For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected]

Dadu

Badin

Thatta

Larkana

Sanghar TMKhan

Khairpur N-Feroze Umerkot

Jamshoro

Shikarpur

T. T. Allahyar

Tharparkar

Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28

Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500

Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500

Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500

Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500

Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500

Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000

Larkana 1 24 10 6000 0 1830 2500

Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500

Dadu 1 500

DG Health Services Sindh 200 0 0

Director Malaria Control Program 0 0 5400 9600 4960 60000

Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000

2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711

35 33

30

25

20 16 15

10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths

Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease

Current Week Outbreaks

Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass. UC Bachal Shah Miyani 6 0 2 0 O 8 1 Measles

Current Week Alerts

Suspected 2012-52 24-Dec-12 Shikarpur Jakha Muhalla, UC 6 1 0 2 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Shikarpur Village Shadi Khan Sundrani UC Karan Talluka Shikarpur 2 1 0 0 A 3 0 Measles Suspected Naushahro 2012-52 24-Dec-12 tharu shah road naushahro feroze 0 0 0 3 A 3 0 Measles Feroze Suspected Naushahro 2012-52 24-Dec-12 Muhala Karim shah ward 8 near bhiria college Taluka kandiaro 0 0 1 0 A 1 0 Measles Feroze

2012-52 24-Dec-12 Pertussis Jamshoro Sindhi Sachal colony, taluka Kotri 0 0 1 0 A 1 0

Suspected 2012-52 24-Dec-12 Dadu Lashari Muhalla, city Dadu 1 1 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Dadu Village Pandhi Siyal, UC Mondiar, city Dadu 1 0 1 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Ghumano Bheel, UC Gharibabad, UC and taluka Umerkot 0 0 1 3 A 4 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Khariya Bah, UC Kaplore, taluka Umerkot 2 0 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Musa Shar, UC Shadi Pali, taluka Pithoro 2 0 0 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Sukhio Bheel, UC Gharibabad, taluka Umerkot 1 0 0 0 A 1 0 Measles Shaheed 2012-52 25-Dec-12 NNT Tamoor Mari near Ghulam Muhammad Jamali uc Abul Hassan 1 0 0 0 A 1 0 Benazir Abad Shaheed 2012-52 25-Dec-12 NNT Village Murad Ali Mir Jat uc obhari sawri taluka daur 1 0 0 0 A 1 0 Benazir Abad Suspected 2012-52 25-Dec-12 Hyderabad Village M. Ramzan Brohi, Kachi Abadi, taluka Hyderabad, city Phuleli 1 0 2 0 A 3 0 Measles URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0%

12.0

20.0% 10.0

15.0% 8.0

6.0 10.0%

4.0

5.0% 2.0

0.0% 0.0

WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK

WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK

District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698 MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005

MALARIA SITUATION - SINDH

Table 3: Malaria Morbidity by Districts in Sindh Province, Epi week 52, 2012

Dadu

Badin

Thatta

Larkana

Sanghar TMKhan

Khairpur N-Feroze Umerkot

Jamshoro

Shikarpur

T. T. Allahyar

Tharparkar

Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28

120.0 Slide Positivity Rate Falciparum Ratio

100.0

80.0

60.0

40.0

20.0

0.0

Dadu

Badin

Thatta

Ghotki

Feroze

Sukkur

Karachi

-

Kambar

Larkana

Sanghar

TMKhan

Khairpur

MATIARI

Umerkot

N

Shikarpur

Jamshoro

Kashmore

Jacobabad

Hyderabad

Tharparkar

Mirpurkhas

T. ALLAH YART. S. Benazirabad S.

District Khairpur 1600 100%

90% 1400 80% 1200

70%

1000 60%

800 50%

40% FR % & SPR %SPR & % FR

Total Slide Slide Total Tested 600 30% 400 20% 200 10%

0 0% WK 38 WK 39 WK 40 WK 41 WK 42 WK 43 WK 44 WK 45 WK 46 WK 47 WK 48 WK 49 WK 50 WK 51 WK 52 Total Slides Tested Slide Positivity Rate Falciparum Ratio

District Mirpurkhas 800 100% 800 100%

90% 90% 700 700 80% 80%

600 600

70% 70%

500 500 60% 60%

400 50% 400 50%

40% 40%

300 %SPR & FR %

300 % SPR & FR % Total Slide Slide TotalTested 30% Slide Tested Total 30% 200 200 20% 20% 100 100 10% 10%

0 0% 0 0% WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK WK 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 Total Slides Tested Slide Positivity Rate Falciparum Ratio Total Slides Tested Slide Positivity Rate Falciparum Ratio

This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, Pakistan. For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 3 For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected]

Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500

Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500

Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500

Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500

Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500

Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000

Larkana 1 24 10 6000 0 1830 2500

Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500

Dadu 1 500

DG Health Services Sindh 200 0 0

Director Malaria Control Program 0 0 5400 9600 4960 60000

Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000

2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711

35 33

30

25

20 16 15

10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths

Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease

Current Week Outbreaks

Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass. UC Bachal Shah Miyani 6 0 2 0 O 8 1 Measles

Current Week Alerts

Suspected 2012-52 24-Dec-12 Shikarpur Jakha Muhalla, UC 6 1 0 2 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Shikarpur Village Shadi Khan Sundrani UC Karan Talluka Shikarpur 2 1 0 0 A 3 0 Measles Suspected Naushahro 2012-52 24-Dec-12 tharu shah road naushahro feroze 0 0 0 3 A 3 0 Measles Feroze Suspected Naushahro 2012-52 24-Dec-12 Muhala Karim shah ward 8 near bhiria college Taluka kandiaro 0 0 1 0 A 1 0 Measles Feroze

2012-52 24-Dec-12 Pertussis Jamshoro Sindhi Sachal colony, taluka Kotri 0 0 1 0 A 1 0

Suspected 2012-52 24-Dec-12 Dadu Lashari Muhalla, city Dadu 1 1 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Dadu Village Pandhi Siyal, UC Mondiar, city Dadu 1 0 1 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Ghumano Bheel, UC Gharibabad, UC and taluka Umerkot 0 0 1 3 A 4 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Khariya Bah, UC Kaplore, taluka Umerkot 2 0 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Musa Shar, UC Shadi Pali, taluka Pithoro 2 0 0 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Sukhio Bheel, UC Gharibabad, taluka Umerkot 1 0 0 0 A 1 0 Measles Shaheed 2012-52 25-Dec-12 NNT Tamoor Mari near Ghulam Muhammad Jamali uc Abul Hassan 1 0 0 0 A 1 0 Benazir Abad Shaheed 2012-52 25-Dec-12 NNT Village Murad Ali Mir Jat uc obhari sawri taluka daur 1 0 0 0 A 1 0 Benazir Abad Suspected 2012-52 25-Dec-12 Hyderabad Village M. Ramzan Brohi, Kachi Abadi, taluka Hyderabad, city Phuleli 1 0 2 0 A 3 0 Measles URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0%

12.0

20.0% 10.0

15.0% 8.0

6.0 10.0%

4.0

5.0% 2.0

0.0% 0.0

WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK

WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK

District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698

MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005

Dadu

Badin

Thatta

Larkana

Sanghar TMKhan

Khairpur N-Feroze Umerkot

Jamshoro

Shikarpur

T. T. Allahyar

Tharparkar

Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28

FLOOD 2012 Weekly proportionate morbidity of leading diseases in flood affected districts (FAD) of Sindh Province, Epi week 52, 2012 • OAD proportionate morbidity in FAD (6.0%) was lower than that in other districts of Sindh Province (6.9%) this week. Ghotki, Kashmore, Sukkur and Jacobabad districts had higher than the average morbidity for 30.0% FAD. • Scabies comprised a higher proportionate morbidity in FAD (5.5%) 25.0% compared to other districts of Sindh Province (4.4%). Ghotki, Kashmore and Jacobabad districts reported higher than average morbidity for FAD. 20.0%

• Suspected malaria comprised a lower proportionate morbidity in FAD 15.0% (7.2%) compared to other districts of Sindh Province (7.4%). Kashmore and Jacobabad districts reported higher than average morbidity for FAD. 10.0% • URTI in flood affected districts (25.3%) was lower than that in other districts of Sindh Province (26.2%). Ghotki, Shikarpur, Sukkur and 5.0% Jacobabad districts had higher than average morbidity for the FAD. 0.0% • Pneumonia in FAD (1.7%) was higher than that in other districts of URTI Scabies Malaria Pneumonia OAD Sindh Province (1.5%). Ghotki, Shikarpur and Jacobabad districts had Flood Affected Districts (FAD) Sindh higher than the average morbidity for FAD. Table 4: Proportional morbidity in flood affected districts compared to other districts of Sindh Province, Epi week 52, 2012

Sindh Ghotki Kambar Kashmore Shikarpur Sukkur Jacobabad FAD Province

URTI 1,895 27.5% 1,260 11.6% 381 19.5% 3,030 27.1% 4,588 32.7% 2,762 27.2% 13,916 25.3% 69,973 26.2%

Scabies 427 6.2% 445 4.1% 270 13.8% 303 2.7% 423 3.0% 1,149 11.3% 3,017 5.5% 11,670 4.4%

Malaria 478 6.9% 603 5.6% 307 15.7% 715 6.4% 699 5.0% 1,152 11.3% 3,954 7.2% 19,790 7.4%

Pneumonia 122 1.8% 96 0.9% 13 0.7% 330 3.0% 62 0.4% 338 3.3% 961 1.7% 4,058 1.5%

OAD 475 6.9% 430 4.0% 273 14.0% 606 5.4% 880 6.3% 662 6.5% 3,326 6.0% 18,462 6.9% Table 5: District wise Distribution of Essential Medicine during flood 2012, Epi week 52, 2012 Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500

Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500

Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500

Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500

Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500

Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000

Larkana 1 24 10 6000 0 1830 2500

Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500

Dadu 1 500

DG Health Services Sindh 200 0 0

Director Malaria Control Program 0 0 5400 9600 4960 60000

Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000 Dengue Situation as Reported by Dengue Cell in Sindh Province for 2012 90 Total: 723 Cases 81 80

70 63 60 52 50 41 37 38 38 37 40 35 35 31 30 21 21 20 15 13 13 14 11 9 9 9 7 7 7 10 5 5 5 5 5 5 3 4 3 3 3 3 4 3 3 1 1 1 1 2 1 2 2 2 2 1 2 2

0

Wk 01 Wk 02 Wk 03 Wk 04 Wk 05 Wk 06 Wk 07 Wk 08 Wk 20 Wk 21 Wk 22 Wk 23 Wk 24 Wk 25 Wk 26 Wk 27 Wk 28 Wk 29 Wk 30 Wk 31 Wk 32 Wk 33 Wk 34 Wk 35 Wk 36 Wk 37 Wk 49 Wk 50 Wk 51 Wk 52 Wk Wk 09 Wk 10 Wk 11 Wk 12 Wk 13 Wk 14 Wk 15 Wk 16 Wk 17 Wk 18 Wk 19 Wk 38 Wk 39 Wk 40 Wk 41 Wk 42 Wk 43 Wk 44 Wk 45 Wk 46 Wk 47 Wk 48 Wk

This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, Pakistan. For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 4 For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected]

2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711

35 33

30

25

20 16 15

10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths

Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease

Current Week Outbreaks

Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass. UC Bachal Shah Miyani 6 0 2 0 O 8 1 Measles

Current Week Alerts

Suspected 2012-52 24-Dec-12 Shikarpur Jakha Muhalla, UC 6 1 0 2 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Shikarpur Village Shadi Khan Sundrani UC Karan Talluka Shikarpur 2 1 0 0 A 3 0 Measles Suspected Naushahro 2012-52 24-Dec-12 tharu shah road naushahro feroze 0 0 0 3 A 3 0 Measles Feroze Suspected Naushahro 2012-52 24-Dec-12 Muhala Karim shah ward 8 near bhiria college Taluka kandiaro 0 0 1 0 A 1 0 Measles Feroze

2012-52 24-Dec-12 Pertussis Jamshoro Sindhi Sachal colony, taluka Kotri 0 0 1 0 A 1 0

Suspected 2012-52 24-Dec-12 Dadu Lashari Muhalla, city Dadu 1 1 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Dadu Village Pandhi Siyal, UC Mondiar, city Dadu 1 0 1 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Ghumano Bheel, UC Gharibabad, UC and taluka Umerkot 0 0 1 3 A 4 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Khariya Bah, UC Kaplore, taluka Umerkot 2 0 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Musa Shar, UC Shadi Pali, taluka Pithoro 2 0 0 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Sukhio Bheel, UC Gharibabad, taluka Umerkot 1 0 0 0 A 1 0 Measles Shaheed 2012-52 25-Dec-12 NNT Tamoor Mari near Ghulam Muhammad Jamali uc Abul Hassan 1 0 0 0 A 1 0 Benazir Abad Shaheed 2012-52 25-Dec-12 NNT Village Murad Ali Mir Jat uc obhari sawri taluka daur 1 0 0 0 A 1 0 Benazir Abad Suspected 2012-52 25-Dec-12 Hyderabad Village M. Ramzan Brohi, Kachi Abadi, taluka Hyderabad, city Phuleli 1 0 2 0 A 3 0 Measles URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0%

12.0

20.0% 10.0

15.0% 8.0

6.0 10.0%

4.0

5.0% 2.0

0.0% 0.0

WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK

WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK

District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698

MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005

Dadu

Badin

Thatta

Larkana

Sanghar TMKhan

Khairpur N-Feroze Umerkot

Jamshoro

Shikarpur

T. T. Allahyar

Tharparkar

Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28

Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500

Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500

Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500

Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500

Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500

Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000

Larkana 1 24 10 6000 0 1830 2500

Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500

Dadu 1 500

DG Health Services Sindh 200 0 0

Director Malaria Control Program 0 0 5400 9600 4960 60000

Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000

DEWS reporting by districts in Sindh Province, Epi week , 2012 70 64

60 58 57 50 50 48 47 50 45 39 39 40 37 37 36 34 34 33 33 32 30 30 28 28 23 22 20

10

0

`WHO Environmental Health, Week 51, 2012 12 Total Samples • Total 33 water samples collected from different sources including Safe 10 hand pumps, water supplies and household water pots and analyzed Contaminated for critical parameters, 13 found fit for drinking and the remaining 8 20 were found faecally contaminated. 6 • Supported National NGOs (ISWA at district Sukkur, IRC and Takhleeq Foundation in district Shikarpur , RDF and SSIA in district 4 Kandhkot and HHRD in Shikarpur) by providing EH supplies; 221838 2 Pur Sachet, 65000 Aqua tabs, 3390 Soaps , 1048 Jerry canes and

1200 Hygiene Kits for community awareness sessions. 0 Jacoababad Sukkur Gotki TM Khan Jamshoro

*WHO analyzes water samples for only critical parameters. i.e. PH, Turbidity and Bacterial contamination (fecal coliform presence only). Highlights of Alerts and Outbreaks, Epi week 52, 2012

Measles Alerts NNT Alerts Suspected Constituted the mostly reported alerts (18/21) in Sindh. 150 20 Measles 15 District Dadu, Sukkur and Umerkot notified the highest 100 10 number compared to other districts. 50 5

0 0

NNT

04 13 22 31 40 49 01 04 13 22 25 31 34 43 52 01 07 10 16 19 25 28 34 37 43 46 52 07 10 16 19 28 37 40 46 49

Reported the second highest Alerts (2/21) in this week.

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2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 District S. Benazirabad notified the highest number 2012 Pertussis Alerts compared to other districts. 20 20 AWD Alerts 15 15 Pertussis Reported the Third highest Alerts (1/21) in this week. 10 10 District Jamshoro notified the highest number compare to 5 5

0

0

other districts.

01 04 07 10 13 49 52 16 19 22 25 28 31 34 37 40 43 46

01 05 17 21 33 45 49 09 13 25 29 37 41

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2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012

2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 2012 Table 6: Total number of alerts and outbreaks reported and investigated with appropriate response 2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711 This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, Pakistan. For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 5 For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected]

35 33

30

25

20 16 15

10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths

Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease

Current Week Outbreaks

Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass. UC Bachal Shah Miyani 6 0 2 0 O 8 1 Measles

Current Week Alerts

Suspected 2012-52 24-Dec-12 Shikarpur Jakha Muhalla, UC 6 1 0 2 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Shikarpur Village Shadi Khan Sundrani UC Karan Talluka Shikarpur 2 1 0 0 A 3 0 Measles Suspected Naushahro 2012-52 24-Dec-12 tharu shah road naushahro feroze 0 0 0 3 A 3 0 Measles Feroze Suspected Naushahro 2012-52 24-Dec-12 Muhala Karim shah ward 8 near bhiria college Taluka kandiaro 0 0 1 0 A 1 0 Measles Feroze

2012-52 24-Dec-12 Pertussis Jamshoro Sindhi Sachal colony, taluka Kotri 0 0 1 0 A 1 0

Suspected 2012-52 24-Dec-12 Dadu Lashari Muhalla, city Dadu 1 1 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Dadu Village Pandhi Siyal, UC Mondiar, city Dadu 1 0 1 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Ghumano Bheel, UC Gharibabad, UC and taluka Umerkot 0 0 1 3 A 4 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Khariya Bah, UC Kaplore, taluka Umerkot 2 0 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Musa Shar, UC Shadi Pali, taluka Pithoro 2 0 0 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Sukhio Bheel, UC Gharibabad, taluka Umerkot 1 0 0 0 A 1 0 Measles Shaheed 2012-52 25-Dec-12 NNT Tamoor Mari near Ghulam Muhammad Jamali uc Abul Hassan 1 0 0 0 A 1 0 Benazir Abad Shaheed 2012-52 25-Dec-12 NNT Village Murad Ali Mir Jat uc obhari sawri taluka daur 1 0 0 0 A 1 0 Benazir Abad Suspected 2012-52 25-Dec-12 Hyderabad Village M. Ramzan Brohi, Kachi Abadi, taluka Hyderabad, city Phuleli 1 0 2 0 A 3 0 Measles URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0%

12.0

20.0% 10.0

15.0% 8.0

6.0 10.0%

4.0

5.0% 2.0

0.0% 0.0

WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK

WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK

District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698

MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005

Dadu

Badin

Thatta

Larkana

Sanghar TMKhan

Khairpur N-Feroze Umerkot

Jamshoro

Shikarpur

T. T. Allahyar

Tharparkar

Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28

Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500

Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500

Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500

Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500

Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500

Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000

Larkana 1 24 10 6000 0 1830 2500

Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500

Dadu 1 500

DG Health Services Sindh 200 0 0

Director Malaria Control Program 0 0 5400 9600 4960 60000

Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000

2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711

Jacobabad Kashmore (00) (00)

Qambar Ghotki Shikarpur (00) Shahdadkot (02) (00)

Sukkur (04) S. Measles (18) Larkana (00) NNT (2)

Khairpur Pertussis (1) (00)

N-Feroz (02) Dadu (04) Shaheed Benazirabad (02)

Sanghar Matiari (00) (00)

Jamshoro (02)

TA Yar (00) (00) Karachi Hyderabad Umerkot (01) Mirpur (04) khas (00) TM Khan (00)

Tharparkar Badin (00) Thatta (00) (00)

This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, Pakistan. For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 6 For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected]

35 33

30

25

20 16 15

10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths

Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease

Current Week Outbreaks

Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass. UC Bachal Shah Miyani 6 0 2 0 O 8 1 Measles

Current Week Alerts

Suspected 2012-52 24-Dec-12 Shikarpur Jakha Muhalla, UC 6 1 0 2 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Shikarpur Village Shadi Khan Sundrani UC Karan Talluka Shikarpur 2 1 0 0 A 3 0 Measles Suspected Naushahro 2012-52 24-Dec-12 tharu shah road naushahro feroze 0 0 0 3 A 3 0 Measles Feroze Suspected Naushahro 2012-52 24-Dec-12 Muhala Karim shah ward 8 near bhiria college Taluka kandiaro 0 0 1 0 A 1 0 Measles Feroze

2012-52 24-Dec-12 Pertussis Jamshoro Sindhi Sachal colony, taluka Kotri 0 0 1 0 A 1 0

Suspected 2012-52 24-Dec-12 Dadu Lashari Muhalla, city Dadu 1 1 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Dadu Village Pandhi Siyal, UC Mondiar, city Dadu 1 0 1 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Ghumano Bheel, UC Gharibabad, UC and taluka Umerkot 0 0 1 3 A 4 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Khariya Bah, UC Kaplore, taluka Umerkot 2 0 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Musa Shar, UC Shadi Pali, taluka Pithoro 2 0 0 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Sukhio Bheel, UC Gharibabad, taluka Umerkot 1 0 0 0 A 1 0 Measles Shaheed 2012-52 25-Dec-12 NNT Tamoor Mari near Ghulam Muhammad Jamali uc Abul Hassan 1 0 0 0 A 1 0 Benazir Abad Shaheed 2012-52 25-Dec-12 NNT Village Murad Ali Mir Jat uc obhari sawri taluka daur 1 0 0 0 A 1 0 Benazir Abad Suspected 2012-52 25-Dec-12 Hyderabad Village M. Ramzan Brohi, Kachi Abadi, taluka Hyderabad, city Phuleli 1 0 2 0 A 3 0 Measles URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0%

12.0

20.0% 10.0

15.0% 8.0

6.0 10.0%

4.0

5.0% 2.0

0.0% 0.0

WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK

WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK

District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698

MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005

Dadu

Badin

Thatta

Larkana

Sanghar TMKhan

Khairpur N-Feroze Umerkot

Jamshoro

Shikarpur

T. T. Allahyar

Tharparkar

Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28

Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500

Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500

Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500

Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500

Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500

Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000

Larkana 1 24 10 6000 0 1830 2500

Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500

Dadu 1 500

DG Health Services Sindh 200 0 0

Director Malaria Control Program 0 0 5400 9600 4960 60000

Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000

2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711

Suspected Measles cases/alerts/outbreaks/deaths Distributed by district during week 52, 2012

35 33

30

25

20 16 15

10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths

Alerts Distribution by weeks, 2011-2012 160

140

120

100

80

60

40

20

0

WK 3 WK 5 WK 7 WK 9 WK WK 1 WK 2 WK 4 WK 6 WK 8 WK

WK 11 WK 13 WK 15 WK 20 WK 22 WK 24 WK 26 WK 28 WK 30 WK 32 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 52 WK WK 10 WK 12 WK 14 WK 16 WK 17 WK 18 WK 19 WK 21 WK 23 WK 25 WK 27 WK 29 WK 31 WK 33 WK 34 WK 36 WK 38 WK 40 WK 42 WK 44 WK 46 WK 48 WK 49 WK 50 WK 51 WK

Year 2011 Year 2012

Distribution of Alerts by Districts, Epi week 52, 2012

Total 21 alerts were reported and responded during this week, out of them majority of alerts 04 (19.0%) were reported from Dadu, Sukkur and

Umerkot followed by 02 (9.5%) from Jamshoro, Nausheroferoz, Shaheed Benazirabad and Shikarpur, 1 (4.8%) from Hyderabad. 4.5 4 4 4 4

3.5

3

2.5 2 2 2 2 2

1.5 1 1

0.5

0 Dadu Sukkur Umer Kot Jamshoro N-Feroze S. Benazir Abad Shikarpur Hyderabad

This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, Pakistan. For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 7 For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected]

Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease

Current Week Outbreaks

Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass. UC Bachal Shah Miyani 6 0 2 0 O 8 1 Measles

Current Week Alerts

Suspected 2012-52 24-Dec-12 Shikarpur Jakha Muhalla, UC 6 1 0 2 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Shikarpur Village Shadi Khan Sundrani UC Karan Talluka Shikarpur 2 1 0 0 A 3 0 Measles Suspected Naushahro 2012-52 24-Dec-12 tharu shah road naushahro feroze 0 0 0 3 A 3 0 Measles Feroze Suspected Naushahro 2012-52 24-Dec-12 Muhala Karim shah ward 8 near bhiria college Taluka kandiaro 0 0 1 0 A 1 0 Measles Feroze

2012-52 24-Dec-12 Pertussis Jamshoro Sindhi Sachal colony, taluka Kotri 0 0 1 0 A 1 0

Suspected 2012-52 24-Dec-12 Dadu Lashari Muhalla, city Dadu 1 1 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Dadu Village Pandhi Siyal, UC Mondiar, city Dadu 1 0 1 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Ghumano Bheel, UC Gharibabad, UC and taluka Umerkot 0 0 1 3 A 4 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Khariya Bah, UC Kaplore, taluka Umerkot 2 0 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Musa Shar, UC Shadi Pali, taluka Pithoro 2 0 0 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Sukhio Bheel, UC Gharibabad, taluka Umerkot 1 0 0 0 A 1 0 Measles Shaheed 2012-52 25-Dec-12 NNT Tamoor Mari near Ghulam Muhammad Jamali uc Abul Hassan 1 0 0 0 A 1 0 Benazir Abad Shaheed 2012-52 25-Dec-12 NNT Village Murad Ali Mir Jat uc obhari sawri taluka daur 1 0 0 0 A 1 0 Benazir Abad Suspected 2012-52 25-Dec-12 Hyderabad Village M. Ramzan Brohi, Kachi Abadi, taluka Hyderabad, city Phuleli 1 0 2 0 A 3 0 Measles URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0%

12.0

20.0% 10.0

15.0% 8.0

6.0 10.0%

4.0

5.0% 2.0

0.0% 0.0

WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK

WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK

District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698

MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005

Dadu

Badin

Thatta

Larkana

Sanghar TMKhan

Khairpur N-Feroze Umerkot

Jamshoro

Shikarpur

T. T. Allahyar

Tharparkar

Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28

Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500

Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500

Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500

Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500

Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500

Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000

Larkana 1 24 10 6000 0 1830 2500

Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500

Dadu 1 500

DG Health Services Sindh 200 0 0

Director Malaria Control Program 0 0 5400 9600 4960 60000

Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000

2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711

35 33

30

25

20 16 15

10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths

Table 7: Alerts and outbreaks in Sindh Province, Epi week 52, 2012

Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease

Current Week Outbreaks

Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass. UC Bachal Shah Miyani 6 0 2 0 O 8 1 Measles

Current Week Alerts

Suspected 2012-52 24-Dec-12 Shikarpur Jakha Muhalla, UC 6 1 0 2 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Shikarpur Village Shadi Khan Sundrani UC Karan Talluka Shikarpur 2 1 0 0 A 3 0 Measles Suspected Naushahro 2012-52 24-Dec-12 tharu shah road naushahro feroze 0 0 0 3 A 3 0 Measles Feroze Suspected Naushahro 2012-52 24-Dec-12 Muhala Karim shah ward 8 near bhiria college Taluka kandiaro 0 0 1 0 A 1 0 Measles Feroze

2012-52 24-Dec-12 Pertussis Jamshoro Sindhi Sachal colony, taluka Kotri 0 0 1 0 A 1 0

Suspected 2012-52 24-Dec-12 Dadu Lashari Muhalla, city Dadu 1 1 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Dadu Village Pandhi Siyal, UC Mondiar, city Dadu 1 0 1 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Ghumano Bheel, UC Gharibabad, UC and taluka Umerkot 0 0 1 3 A 4 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Khariya Bah, UC Kaplore, taluka Umerkot 2 0 1 0 A 3 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Musa Shar, UC Shadi Pali, taluka Pithoro 2 0 0 0 A 2 0 Measles Suspected 2012-52 24-Dec-12 Umer Kot Village Sukhio Bheel, UC Gharibabad, taluka Umerkot 1 0 0 0 A 1 0 Measles Shaheed 2012-52 25-Dec-12 NNT Tamoor Mari near Ghulam Muhammad Jamali uc Abul Hassan 1 0 0 0 A 1 0 Benazir Abad Shaheed 2012-52 25-Dec-12 NNT Village Murad Ali Mir Jat uc obhari sawri taluka daur 1 0 0 0 A 1 0 Benazir Abad Suspected 2012-52 25-Dec-12 Hyderabad Village M. Ramzan Brohi, Kachi Abadi, taluka Hyderabad, city Phuleli 1 0 2 0 A 3 0 Measles

The objective of this weekly epidemiological bulletin is to provide a snap shot on selected health events reported from the DEWS surveillance system in Sindh Province. While every attempt is made to present the weekly trends of epidemic prone diseases, the information presented in the bulletin needs to be interpreted in the context that precise information on the reference populations is not always available. The bulletin also includes information collected by the DEWS teams established during 2010 flloods. The primary focus of DEWS is early detection of epidemic prone desease, to faciletate a rapid public health response. We would like to thank the Diector general Health Sindh, Director Public Health (in charge of EIC), EDOH-Sindh, PPHI and all national and international partners who contribute to DEWS This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, Pakistan. For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 8 For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected]