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 16, • Acholi and Lango sub-regions; the region is relatively calm however, the incidences of petty theft of household properties have increased. 13th to 19th April 2009 • Karamoja sub-region: Incidences of cattle raids reported and disarmament of armed Karamojong by government of Uganda forces is still continuing though at a slow pace. b. Main Events of Interest/Concern for Health; • The court injunction on conducting IRS in has been lifted. II. Analysis and Health Consequences (Health Problems and Needs of Affected Population) Malaria: Lango; The number of cases of clinical malaria registered in Lango sub-region declined from 15,552 in epi-week 11 to 8,761 in epi-week 16 representing a 43% decline. The biggest decline was registered in Lira and district. See figure I for details.

Highlights

• Court injunction on conducting IRS in Lira district Lango sub-region has been lifted

Acholi, The weekly incidence of clinical malaria recorded in , Kitgum and Pader districts in epi-week 14, 15 and 16 of 2009 was slightly lower than that of 2008. Mean while the number of cases of clinical malaria registered in in the same epi-week was slightly higher in 2009 as compared to 2008. See figure II below for Amuru district.

Dysentery: Lango and Acholi sub-region; The number of cases of dysentery recorded and the trend in 2009

are similar to that of 2008 for both regions. See figure III below for Lango sub-region for details. Acknowledgement

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

Hepatitis E: , the epicenter of the epidemic registered 43 new cases in epi-week 16 down from 44 cases registered in epi-week 15. The cumulative number of cases registered in all districts is 10,105 with 163 deaths (CFR 1.61%). See table I below for details.

Table I District New cases New deaths Cumulative cases Cumulative deaths

Kitgum 43 0 9,912 156 (1.6%)

Gulu & Amuru 1 0 21(9 positive) 0 (0)

Pader 4 0 169 7 (4.1%)

Lango 0 0 3 0

Total 48 0 10,105 163(1.61%)

The sub counties that registered most cases in Kitgum district in Epi week 16 of 2009 are; Lokung [8]; Mucwini [7 ];Palabek Gem [5}; Kitgum Matidi [5];Omiya Anyima[4].

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

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

Epidemic Response

Disease surveillance; WHO continues to support disease surveillance activity in all district of Acholi, Lango and Karamoja sub-region through provision of data collection tools and airtime to facilitate data collection and reporting, provision of technical assistance for data analysis, reporting and dissemination and investigations of suspected disease outbreaks. Malaria; Following the lifting of court injunction on IRS in Lira district, WHO will now intensify efforts to advocate for IRS in Lango sub-region AFP; Stool sample from the suspected case of AFP has been taken to UVRI for confirmation. Diarrheal disease; WHO continues to support community mobilization activities for improve hygiene and latrine construction. Measles; Samples sent to UVRI for confirmation.

Hepatitis E; • WHO is continuing to advocate with all stake holders (MoH, donor partners and NGO) for increased funding for Hepatitis E control activities in Kitgum and Pader district. • 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 district to respond to HAT. Mini UDHS in Acholi and Karamoja sub-region; • Pre-testing of data collection tools completed. • Data collection tools finalized based on feedback of pretest • Training of data collectors to begin on 27th April 2009 • Actual field survey will begin on 11th May 2009

IV Response from others partners; • NUMAT is conducting refresher training of laboratory personnel and provision of laboratory equipments and reagents in Acholi and Lango regions. • AVSI is in the final process of procuring anti epileptic drugs to replenish the stock that was supplied by WHO to the Sub Counties of Atanga, Laguti & Awere where high numbers of cases of epileptic were registered • ASB, CESVI, Concern, MTI, AVSI and AIS 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 Court injunction on conducting IRS in Lango sub-region has been lifted. It is time for all partners to support MoH to ensure that IRS is conducted in areas where there is high incidences of malaria 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 • Begin advocating for IRS in Lango sub-region For further information, please contact:

Dr. Joaquim Saweka, WHO Representative Uganda: Tel. +256 41 335500, Mobile +256 752 728 257, Email: [email protected]