Emergency and Humanitarian Action (EHA), Uganda Weekly Activity Report I. General Situation a. Political, Social and Security; • Acholi Sub-region is calm despite rumors of a new rebel group that has been Week 25, formed to fight the government of Uganda • Lango and Karamoja sub-region is calm. Disarmament of armed Karamojong by 15th – 21st June government of Uganda is still continuing though at a slow pace. b. Main Events of Interest/Concern for Health; 2009 • Uganda still continues to be on high alert following the declaration of Influenza A HINI pandemic. So far six suspected cases have been registered in Uganda. All cases were confirmed negative. Following the report of one confirmed case in neighboring Kenya the surveillance at entry points to Uganda has been intensified. • All districts in Acholi, Lango and Karamoja sub-regions are registering increase in number of cases of malaria registered on weekly basis. Districts showing marked increase are Gulu, and Lira. WHO continues to support Gulu and Lira district to respond to upsurge of malaria cases. II. Analysis and Health Consequences (Health Problems and Needs of Affected Population) Malaria: Lango; The weekly incidence of malaria reported in epi week 25 in Lira district continues to be high and comparable to that of 2008. Note that there was an epidemic outbreak of malaria in Lira district last year around the same period. See figure I for details. Highlights • There is a general increase in the number of cases of malaria reported in all districts in Acholi, Lango and Karamoja Acholi, The number of cases of malaria registered in Gulu district from epi-week 19 to date sub-region. Marked increase is higher than the malaria normal channel for the district as seen from the figure II below. was noted in Lira and Gulu Figure II district where there is an impending epidemic. Gulu District 'Malaria Normal Channel' vs malaria trends in 2009 8000 6000 4000 caseloads 2000 malaria Weekly 0 1 3 5 7 9 111315171921232527293133353739414345474951 Epidemiological weeks 4th 2nd 2009 Karamoja, The number of cases of malaria reported in karamoja region has increased from 5,606 in epi-week 18 to 9,984 in epi-week 25 representing a 78% increase in number. The trend in 2009 is comparable to that of 2008. Acknowledgement Dysentery: Production of this weekly activity Acholi sub-region; The number of cases of dysentery registered in all districts in Acholi report has been made possible by sub-region in 2009 is slightly less than that of 2008. The trends for the two years are contribution from the followings similar. See figure III for below for details. Lango sub-region; Dysentery incidence in Lango sub-region in 2009 remain low as compared to 2008. See figure IV below. Karamoja; The incidence of dysentery in Karamoja sub-region in epi-week 25 of 2009 is comparable to that of 2008. Hepatitis E; A total of 32 new cases of Hepatitis E were registered in Kitgum district in Epi week 25 of 2009 up from 23 cases registered in epi-week 24 representing a 39% increase in number of cases. The cumulative number of cases registered to date in Kitgum distrcit is 10,172. There was no death registered in the week. District New cases New deaths Cumulative cases Cumulative deaths Kitgum 32 0 10,172 160 (1.57%) Gulu & Amuru 0 0 40 (9 positive) 0 (0) Pader 3 0 177 8 (4.6%) Lango 0 0 3 0 Total 35 0 10,392 168(1.62%) AFP; • Three suspected case reported one from Gulu another from Moroto and the third from Pader district. HAT and Meningitis; • No new case reported in the week HINI; • One suspected case followed up in the week Measles; • Two suspected cases reported one from Gulu and another from Lira district III. Actions (WHO response, Sida grant) Epidemic Response Disease surveillance; WHO continues to support surveillance activity in all district of Acholi, Lango and Karamoja sub-region. Malaria; WHO and partners are supporting the district of Lira and Gulu to respond to the upsurge in the number of cases of malaria in the district. • Weekly meeting of the EPR committee in Gulu district. • Community mobilization and sensitization on malaria in Gulu and Lira distrct • MoH with support from WHO is to visit Gulu and Lira district to strengthen response to malaria upsurge by training of health workers on RDT and to deliver supply of RDTs to Lira district • WHO is advocating with partners especially NUMAT and Malaria consortium to heighten response to the impending epidemic Diarrheal disease; Community mobilization on latrine construction and improve hygiene is ongoing in all district. Measles; Samples from the suspects have been sent to UVRI for confirmation. HINI; • Draft preparedness and response plan have been developed • Active surveillance continues. Investigated the 6th suspected case of HINI lab result was negative for HINI. • Handed over 40,400 doses of Tamiflue and 25 sets of personal protection kits to MoH AFP; • Spacemen from the suspected case from Moroto district has been sent to UVRI for confirmation. Hepatitis E; • Ongoing activities; 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. Not that the intensity and coverage of the above activity is poor due to lack of fund HAT; WHO continues to support Dokolo district to respond to HAT. Mini UDHS in Acholi and Karamoja sub-region; • Data collection ongoing in all districts in Acholi and Karamoja sub-region Other activities conducted by WHO; • Ongoing rehabilitation works in Lorengechora, Lolachat and Panyagara in Karamoja sub-region IV Response from others partners; • NUMAT continues to fund the Malaria, TB and HIV/AIDS activities in Lira districts including training of CMDs on the new antimalarial treatment protocol. • CUAMM continues to support Oyam in implementing comprehensive maternal and child health services (staff development, EmoC, ambulance systems for referrals, immunizations, radio talk shows, support supervision); • Partners doing various health activities are ASB, Mercy corps, Food for the hungry, IRC, IMC, COW-Foundation, UNICEF, UNFPA, CESVI, Concern, MTI, AVSI, AIS, TPO Uganda, MSU, CPAR, ICRC, GOAL, ACET and UNICEF. IV. Comments and Conclusions All districts in Acholi, Lango and Karamoja sub-region are experiencing and increase in number of cases of malaria. WHO is continuing to support response to the increase in number of cases reported on weekly basis. V. Plan for Coming Week • Support MOH to respond to Influenza A H1N1 pandemic • Support hepatitis E epidemic response in Kitgum and Pader district • Support MoH and the districts of Lira and Gulu to respond to upsurge in the number of cases of malaria being reported. • Provide technical and financial support to the DHOs in strengthening HMIS/IDSR • Provide technical and financial support to MoH and UBoS in conducting mini- Demographic and Health Survey For further information, please contact: Dr. Joaquim Saweka, WHO Representative Uganda: Tel. +256 41 335500, Mobile +256 752 728 257, Email: [email protected] .