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South Sudan IDSR Annex

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South Sudan IDSR Annex South Sudan Integrated Disease Surveillance and Response (IDSR) Annexes W42 2017 (Oct 16-Oct 22) Ministry of Health Republic of South Sudan Printed: 07:52 Sunday, 29 October 2017 UTC Contents Access and Utilisation Acute Watery Diarrhoea (AWD) Slide 2 Map 1 Map of consultations by county (2017) Slide 8 Trend in AWD cases over time Slide 9 AWD maps and alert management Indicator-based surveillance Slide 3 Figure 1 Proportional mortality Bloody diarrhoea Slide 4 Figure 2 Proportional morbidity Slide 10 Trend in bloody diarrhoea cases over time Slide 5 Figure 3 Trend in consultations and key diseases Slide 11 Bloody diarrhoea maps and alert management Disease trends and maps Measles Slide 12 Trend in measles cases over time Malaria Slide 13 Measles maps and alert management Slide 6 Trend in malaria cases over time Slide 7 Malaria maps and alert management Sources of data 1. Weekly IDSR Reporting Form 2. Weekly EWARS Reporting Form 1 W42 2017 (Oct 16-Oct 22) Access and Utilisation | Map of consultations by county Map 1 | Map of total consultations by county (W42 2017) Hub W42 2017 Aweil 20,367 804,082 Renk Bentiu 29,188 901,169 Manyo Bor 12,559 353,946 Melut Juba 13,966 436,139 Fashoda Maban Abyei Pariang Malakal Kwajok 19,627 826,318 Abiemnhom Panyikang Baliet Aweil North Aweil East RubkonGa uit Longechuk Twic Mayom FangakCanal Pigi Malakal 9,193 700,125 Aweil West Luakpiny Nasir Aweil South Maiwut Raja GogriaGl oWgerisatl East Koch Nyirol Ulang Aweil Centre Rumbek 22,231 666,345 Tonj North Ayod MayenLdeiter Torit 4,693 328,355 Tonj East Akobo Duk Uror Jur River Rumbek NPorathnyijiar Wau Wau 12,998 547,791 Pochalla Tonj SoCutuhReiubmetbek Centre Twic East Rumbek EaYstirol East Yambio 7,156 430,683 Nagero Yirol West Bor Pibor Wulu Awerial South Sudan 151,978 5,994,953 Tambura Mvolo Terekeka Ezo Nzara Mundri East Mundri West Lopa LaKfoanpoeta North Yambio Ibba Maridi Kapoeta East Juba Kapoeta South Torit Budi Yei Lainya Ikotos Kajo Keji Magwi Morobo Number of consultations 0 1 1,000 2,500 5,000 2 W42 2017 (Oct 16-Oct 22) Proportional morbidity Figure 2 | Proportional morbidity (2017) Syndrome W42 2017 # cases % morbidity # cases % morbidity Malaria 71,268 68.2% 2,054,389 59.9% ARI 10,342 9.9% 364,728 10.6% AWD 8,880 8.5% 486,962 14.2% Bloody 1,152 1.1% 77,231 2.3% diarrhoea AJS 1 0.0% 1,604 0.0% Measles 4 0.0% 1,081 0.0% Other 12,792 12.2% 444,039 12.9% Total cases 104,439 100% 3,430,034 100% Malaria Acute Jaundice Syndrome (AJS) Acute Respiratory Infection Measles (ARI) Other Acute Watery Diarrhoea Bloody diarrhoea 4 W42 2017 (Oct 16-Oct 22) Trend in consultations and key diseases Trend in consultations and key diseases IDSR trends in absolute counts Figure 3 | Trend in total consultations and key diseases (W42) Figure 3 | Trend in total consultations and key diseases (W39) 300000 275000 250000 250000 225000 200000 200000 175000 r e 150000 r b e b m 150000 u m N u N 125000 100000 100000 75000 50000 25000 0 6 7 7 7 7 7 7 7 6 7 6 7 6 7 6 6 7 7 6 7 7 7 7 7 7 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 8 3 5 5 8 9 9 1 2 2 4 6 9 9 8 4 8 3 2 6 2 5 1 9 5 4 1 3 1 0 3 0 3 5 2 4 2 3 0 4 4 1 1 5 2 2 0 3 3 3 W W W W W W W W W W W W W W W W W W W W W W W W W T Tootatal lc coonnssuultlatatitoionnss A Acuctuet eW Wataetreyr yD iDairarhrroheoaea Malaria Acute Jaundice Syndrome (AJS) Malaria Acute Jaundice Syndrome (AJS) Acute Respiratory Infection (ARI) Measles Acute Respiratory Infection (ARI) Measles 5 W3492 22001177 ((SOecpt 1265-Oct 0212) Trend in consultations and key diseases IDSR Proportionate morbidity trends Figure 3 | Trend in total consultations and key diseases (W39) Fig. 1|IDSR Proportionate morbidity trends, week 1-42, 2017 275000 70% 160 250000 140 22500060% Consultations Malaria ARI AWD ABD 120 Thousands 20000050% 175000 100 40% 150000 80 r e b m u 30% N 125000 60 20% 1000Proportionate morbidity 00 40 7500010% 20 Number of consultations 50000 0% 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 25000 Epidemiological week of reporting 2017 0 6 7 6 6 7 7 6 7 7 7 7 7 7 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 2 2 2 2 2 2 2 2 2 2 2 2 2 9 9 8 4 8 3 2 6 2 5 1 9 5 3 0 4 4 1 1 5 2 2 0 3 3 3 W W W W W W W W W W W W W Malaria is the top cause of morbidity countrywide that accounted for Total consultations Acute Watery Diarrhoea 52% of Malaria Acute Jaundice Syndrome (AJS) the consultations in week Acute Respiratory Infec42 tion (Awith a cumulative 40% in 2017. RI) Measles The malaria proportionate morbidity increased from an average of 30% prior to the malaria transmission season to nearly 50% currently. 5 W39 2017 (Sep 25-Oct 01) Trend in consultations and key diseases IDP Proportionate morbidity trends Figure 3 | Trend in total consultations and key diseases (W39) Fig. 2|IDP Proportionate morbidity trends, week 1-42, 2017 275000 250000 45% 50 225000 40% 45 Consultations Malaria ARI AWD ABD Measles 200000 40 35% Thousands 175000 35 30% 30 150000 r e b 25% m u 25 N 125000 20% 20 100000 15% 15 Proportionate morbidity 75000 10% 10 Number of consultations 50000 5% 5 25000 0% 0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 0 6 7 6 6 7 7 6 7 7 7 7 7 7 1 1 1 1 1 1 1 1 1 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 Epidemiological week of reporting 2017 0 2 2 2 2 2 2 2 2 2 2 2 2 2 9 9 8 4 8 3 2 6 2 5 1 9 5 3 0 4 4 1 1 5 2 2 0 3 3 3 W W W W W W W W W W W W W Total consultations Acute Watery Diarrhoea In the IDPs, malaria surpassed ARI as the top cause of morbidity in week 25 and Malaria Acute Jaundice Syndrome (AJS) now accounts for 30% of the total consultations. ARI and AWD currently account Acute Respiratory Infection (ARI) Measles for 22% and 6% of the total consultations. 5 W39 2017 (Sep 25-Oct 01) Proportional mortality Figure 1 | Proportional mortality (2017) Syndrome W42 2017 # deaths % mortality # deaths % mortality Malaria 6 75.0% 346 33.9% ARI 1 12.5% 41 4.0% AWD 1 12.5% 253 24.8% Bloody 0 0.0% 70 6.9% diarrhoea AJS 0 0.0% 1 0.1% Measles 0 0.0% 17 1.7% Other 0 0.0% 292 28.6% Total deaths 8 100% 1,020 100% Malaria Acute Jaundice Syndrome (AJS) Acute Respiratory Infection Measles (ARI) Other Acute Watery Diarrhoea Bloody diarrhoea 3 W42 2017 (Oct 16-Oct 22) Acute Watery Diarrhoea | Trends over time Figure 5a | Trend in AWD cases over time (South Sudan) 20000 17500 15000 12500 10000 7500 5000 2500 0 Jan Mar May Jul Sep Nov Graph legend Key AWD indicators (2017) Figure 5b | % morbidity Figure 5c | Age breakdown 2017 − · − · − · − − 2016 − − − − − − − 2015 486,962 253 58 · · · · · · · · · · 2014 Cases Deaths Alerts 8 W42 2017 (Oct 16-Oct 22) Acute Watery Diarrhoea | Maps and Alert Management Map 4 | Map of AWD cases by county (2017) Map 5 | Map of AWD alerts by county (2017) a. 2014 b. 2015 c. 2016 d. 2017 Map legend Risk Assessment Number of AWD cases 0 1 5,000 10,000 20,000 Number of AWD alerts 58 19 0 0 0 0 0 1 10 Alerts Verified Low Risk Moderate Risk High Risk Very High Risk Alert threshold Twice the average number of cases over the past 3 weeks. Source: IDSR 9 W42 2017 (Oct 16-Oct 22) Acute Bloody Diarrhoea | Trends over time Figure 6a | Trend in bloody diarrhoea cases over time (South Sudan) 3500 3000 2500 2000 1500 1000 500 0 Jan Mar May Jul Sep Nov Graph legend Key bloody diarrhoea indicators (2017) Figure 6b | % morbidity Figure 6c | Age breakdown 2017 − · − · − · − − 2016 − − − − − − − 2015 77,231 70 106 · · · · · · · · · · 2014 Cases Deaths Alerts 10 W42 2017 (Oct 16-Oct 22) Acute Bloody Diarrhoea | Maps and Alert Management M(2a0p1 76) | Map of bloody diarrhoea cases by county Map 7 | Map of bloody diarrhoea alerts by county (2017) a.
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