Weekly Epidemiological Bulletin Electronic Disease Early Warning and Response System Ministary of public Health Papulation Primary Health Care Sector DG for Disease Contraol Surveillance Volume 03, Issue 26, Epi week 26, 22 - 28 Jun 2015 H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 26, 2015 96%97 % 100% 93% 94% 100,000 94% 94%92 %93 % 93%92 % 94% ● During week no. 26, 2015; 70% (402/280) health facilities from 16 governorates provided 90% 92% 82%82 % 90,000 78% 80% 72% 70% 70% 80,000 valid surveillance data. 66% 66% 67% 70% 64% 64%62 % 64%64 % 70,000 60% 60,000 50% 50,000 ● The total number of consultations reported during the week in 16 governorates was 44491 40% 40,000 30% 30,000 P e r c e n t a ge a e t c n r Pe 20% 20,000 compared to 45849 the previous reporting week. Acute respiratory tract infections (ARI), s n i a o l t t s u n Co 10% 10,000 acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of morbidity this 0% - week. Wk 5 Wk 8 Wk Wk 1 Wk 2 Wk 3 Wk 4 Wk 6 Wk 7 Wk 9 Wk Wk 11 Wk 14 Wk 22 Wk 25 Wk Wk 10 Wk 12 Wk 13 Wk 15 Wk 16 Wk 17 Wk 18 Wk 19 Wk 20 Wk 21 Wk 23 Wk 24 Wk 26 Wk Reporting Rate Consultations ● A total of 96 alerts were generated by eDEWS system in week 26, 2015; Of these 94 alerts were verified as true for further investigations with appropriate response. Distribution of Reporting Rates by Governorates (Epi-week 26, 2015) ● Altogether 18 alerts for Dengue Fever, 14 Bloody diarrhea, 12 each for Measles and 100% Pertussis, 11 Cut.Leishmaniasis, 9 AVH, 6 Meningitis, 3 each for Schistosomiasis and Viral 80% % % % % 60% % % % % hemorrhagic fever, 2 Other acute diarrhea, 1 each for Acute Flaccid Paralysis, Malaria, 39 % 92 % % 88 92 % 92 100 100 % 32 40% % 96 27 80 96 Acute Watery Diarrhea and Neonatal Tetanus were received and responded. 92 76 % 20% % 8 0 N o. H F R e p o r t t s r o p e R F H o. N 0% ● 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 Reporting Rate Target expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov., HadramoutAl- wady and Dhamar) in April Ongoing on site trainings to improve weekly Note: The cause of reporting rates decline in Aden. Lahj, Abyan, Taiz and Sa'da are the armed conflict, as reporting and immediate notification are underway in all governorates. well as the reasons to the others ( Sana'a city, Ibb, and Mukhalla); lack of electricity, fuels, and access to the net . Leading Priority Diseases - 16 Governorates (Epi-week 26, 2015) 210 districts from 16 Governorates reported to eDEWS in week 26, 2015 ● URTI (10.8%), suspected malaria (3%), OAD (10.7%) and Pneumonia (4.8%) remain the leading causes of morbidity representing a total of 29.3%. ● Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.7% of this morbidity. ● All diarrheal disease comprised 11.4% and Pneumonia 4.8% of total morbidity in Pilot Governorates this week. ● All diarrheal disease comprised 5.99% and Pneumonia 2.77% of total morbidity in the <5 years age group. Trends for Leading Priority Diseases in 16 Governorates - Epi weeks 1 to 26, 2015 Proportional Morbidity for Leading Priority Diseases - Epi week 26, 2015 16.0% 14.0% Pneu 4.8% 12.0% URTI 10.8% 10.0% OAD 10.8% 8.0% 6.0% BD 0.7% Others 68.6% 4.0% Sch 0.1% 2.0% S.Mal 3.0% 0.0% Rb 0.1% Wk 1 Wk 2 Wk 3 Wk Wk 4 Wk 5 Wk 6 Wk 7 Wk 8 Wk 9 Wk Wk 16 Wk 17 Wk 18 Wk 19 Wk Wk 11 Wk 12 Wk 13 Wk 14 Wk 15 Wk 20 Wk 21 Wk 22 Wk 23 Wk 24 Wk 25 Wk 26 Wk Wk 10 Wk AVH 0.2% *Acute Diarrhea=OAD;DD Bloody Diarrhea=BD;URTI S.Malaria=Mal;S.MAL Acute Respiratory Infections=ARIPneumonia Cases (n=16,379) 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 26 ( 22 - 28 Jun 2015 ) Weekly trends of Diarrheal Diseases, Upper Respiratory infections, Suspected Malaria and Pneumonia ( Epi week 1 to 26, 2015) Diarrheal Diseases URTI Sus.Malaria Pneumonia 12.0% 16.0% 8.0% 6.0% 14.0% 7.0% 10.0% 5.0% 12.0% 6.0% 8.0% 4.0% 10.0% 5.0% 6.0% 8.0% 4.0% 3.0% 6.0% 3.0% 4.0% 2.0% 4.0% 2.0% 2.0% 1.0% 2.0% 1.0% 0.0% 0.0% 0.0% 0.0% Wk 1 Wk 2 Wk 4 Wk 5 Wk 8 Wk 9 Wk Wk 3 Wk 6 Wk 7 Wk Wk 1 Wk 4 Wk 7 Wk Wk 2 Wk 3 Wk 5 Wk 6 Wk 8 Wk 9 Wk Wk 11 Wk 12 Wk 15 Wk 16 Wk 19 Wk 22 Wk 23 Wk 26 Wk Wk 10 Wk 13 Wk 14 Wk 17 Wk 18 Wk 20 Wk 21 Wk 24 Wk 25 Wk Wk 1 Wk 2 Wk 4 Wk 5 Wk 8 Wk 9 Wk Wk 3 Wk 6 Wk 7 Wk Wk 2 Wk 5 Wk 7 Wk 9 Wk Wk 1 Wk 3 Wk 4 Wk 6 Wk 8 Wk Wk 10 Wk 11 Wk 13 Wk 14 Wk 17 Wk 20 Wk 23 Wk 24 Wk 26 Wk Wk 12 Wk 15 Wk 16 Wk 18 Wk 19 Wk 21 Wk 22 Wk 25 Wk Wk 12 Wk 15 Wk 16 Wk 19 Wk 20 Wk 22 Wk 23 Wk 26 Wk Wk 10Wk 11Wk 13Wk 14Wk 17Wk 18Wk 21Wk 24Wk 25Wk Wk 11 Wk 12 Wk 14 Wk 16 Wk 18 Wk 21 Wk 23 Wk 25 Wk Wk 10 Wk 13 Wk 15 Wk 17 Wk 19 Wk 20 Wk 22 Wk 24 Wk 26 Wk Cumulative number of major health events reported in Epi-weeks 1 to 26, 2015 (1st Jan 2015 to 28th Jun Age and Sex distribution of total consultations of leading diseases (Epi week 26, 2015) 2015) 9000 Diseases No of Cases Percentage 8000 Upper Respiratory Infections 185874 12.4% 7000 6000 Diarrheal Diseases 125862 8.4% 5000 4000 Suspected Malaria 57266 3.8% 3000 Number of Consultations Number 2000 Pneumonia 65738 4.4% 1000 0 Total (All consultations) 1503998 100% <1yr 1-4yr 5-14yr 15-44yr >45yr Male 2851 3720 4201 6520 3805 Female 2996 3673 4221 8475 4029 Leading Diseases by Governorate, Epi week 26 Distribution of consultations of leading diseases by Governorates, Epi week 26 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 70 200 395 48 665 326 321 221 859 0 226 234 191 346 223 465 4790 Pneumonia 24 17 247 48 82 171 237 130 255 0 265 51 50 150 64 343 2134 Other Acute Diarrhea 88 50 140 63 226 535 360 361 1058 0 434 282 161 237 127 660 4782 Bloody Diarrhea 2 0 0 0 0 64 2 0 0 0 26 14 7 5 11 161 292 Acute Watery Diarrhea 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 Schistosomiasis 0 0 0 0 1 0 0 6 18 0 15 2 1 3 0 17 63 Malaria 6 13 11 0 0 72 667 347 10 0 36 24 23 2 1 109 1321 Meningitis 0 7 0 0 0 0 1 4 9 0 0 0 0 0 0 27 48 Dengue Fever 6 42 3 0 77 0 85 5 4 0 0 0 26 0 1 0 249 Viral Hemorrhagic Fever 0 6 0 0 1 0 0 0 0 0 0 0 0 0 0 0 7 Rabies 0 0 0 0 0 0 0 2 42 0 0 1 3 0 0 0 48 Measles 0 1 0 0 1 0 0 2 2 0 4 2 0 1 0 1 14 Acute Viral Hepatitis (A & E) 5 1 0 1 3 5 2 1 16 0 5 5 4 0 2 41 91 Neonatal Tetanus 0 0 0 0 0 0 4 0 0 0 0 0 0 0 0 0 4 Acute Flaccid Paralysis 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 Cutaneous Leishmaniasis 0 0 0 0 0 0 0 2 1 0 4 0 1 0 0 10 18 Diphtheria 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Pertussis 0 1 0 0 0 2 2 0 2 0 4 10 0 3 2 0 26 Other Un 2 0 0 0 0 0 240 0 11 0 4 4 2 10 1 0 274 Other Consultations 548 237 1244 151 1651 2249 4490 1406 10037 0 2126 955 787 1416 652 2434 30383 Total Consultations 751 575 2040 311 2707 3424 6411 2458 12324 0 3151 1584 1233 2170 1084 4268 44491 A Number of alerts & outbreaks reported and investigated with appropriate response g Number of Alerts Received and Responded (Epi weeks 23 and 26, 2014) e 2015 Current week 26, 2015 System Gen.