VOLUME 4 WEEK 43 27TH OCTOBER, 2019 Nandom District hits epidemic threshold for Meningitis Ghana kicks off Adaptation of 3rd Edition IDSR Technical Guidelines Summary of Weekly Epidemiological Data, Week 43, 2019 The Ghana Weekly Epidemiological Report is a publication of the Ghana Health Service and the Ministry of Health, Ghana © Ghana Health Service 2019 ISSN - 2579-0439 Ghana Weekly Epidemiological Report Vol. 4 Week 43 27 October 2019 i Summary of Weekly Epidemiological Data, Week 43, 2019 Acknowledgement This publication has been made possible with technical and financial support from the Bloomberg Data for Health Initiative (www.bloomberg.org), the CDC Foundation and the World Health Organisation Ghana Weekly Epidemiological Report Vol. 4 Week 43 27 October 2019 ii Summary of Weekly Epidemiological Data, Week 43, 2019 Summary of Weekly Epidemiological Data for Week 43, 2019 Highlights: Nandom District hits epidemic threshold for Meningitis SUMMARY OF PRIORITY Influenza-like illness 429 DISEASES AND EVENTS - WEEK Acute watery diarrhoea in persons … 230 43, 2019 Measles 46 Yellow fever (suspected) 14 The total all-cause notifiable disease Diarrhoea with blood 18 morbidity for the week (as per IDSR AFP (suspected polio) 12 Weekly Summary Reporting Form) Meningitis was 767 with two maternal deaths and 13 Adverse events following… 2 one meningitis related death. Disease/Health Event Influenza -like Illnesses contributed Human rabies 0 56% of the notifiable diseases’ Neonatal tetanus 0 caseload during Week 43 [See Figure 0 100 200 300 400 500 1 and Annex 1] Number of Cases Figure 1: Reported cases/notifiable disease conditions, Ghana, Week 43, 2019 REGIONAL PERFORMANCE BASED ON REPORTING Upper West region with the perfect score of 100% was the best Timeliness and Completeness of reporting for all performing regions in the week under review whilst Central region notifiable conditions for the Week were 98.3% recorded the lowest mean score of 90.4%. All regions achieved the and 99.3% respectively. All regions scored expected targets (66.2%) for percentage of districts reporting at least a above 90% for both indicators. suspected case of either Measles or Yellow Fever [Table 1]. Table 1: Ranking of Regional Performance based on selected Surveillance reporting indicators, Ghana, Week 43, 2019 Region Timeli- Complete- Measles YF Average ness (%) ness (%) Cum. Annualized AFP % % Score % Position Week Week AFP Non-Polio Score District District 43 43 Cases AFP Rate (%) reporting reporting (A+B+C+ A B Week 43 C D E D+E)/5 Upper East 100 100 36 4.4 100 100 100 100 1st Brong-Ahafo 99.5 100 54 2.1 100 100 100 99.9 2nd Upper West 99.5 99.8 40 7.9 100 . 100 100 99.9 2nd Western 99.2 100 48 3.2 100 100 100 99.8 4th Volta 98.9 100 50 3.5 100 100 100 99.8 4th Ashanti 99.0 99.8 70 2.1 100 100 96.7 99.1 6th Northern 96.9 97.9 92 4.5 100 100 100 99.0 7th Greater Accra 96.8 97.8 65 1.9 93 100 100.0 97.5 8th Eastern 99.8 100 34 1.7 86 100 92.3 95.6 9th Central 90.7 96.1 48 3.3 100 90.0 75.0 90.4 10th Ghana 98.3 99.3 537 2.8 100 99.0 96.4 98.6 Ghana Weekly Epidemiological Report Vol. 4 Week 43 27 October 2019 1 Summary of Weekly Epidemiological Data, Week 43, 2019 INFLUENZA-LIKE ILLNESS (IDSR Weekly MEASLES Report) During the Week, 46 cases of suspected Measles were recorded across the country [Table 3]. Samples were taken and sent to the A total of 429 cases with no deaths were reported through IDSR weekly reporting [Table 2]. Laboratory National Public Health and Reference Laboratory [NPHRL] for samples were sent from sentinel sites to Noguchi testing and awaiting results. Memorial Institute for Medical Research (NMIMR) for testing and awaiting results. Table 3: Suspected Measles cases by Region and District, Ghana, Week 43, 2019 Table 2: Reported Influenza-Like Illness cases by Region District Cases Deaths Region and District, Ghana, Week 43, 2019 Ashanti Afigya-Kwabre 1 0 Kwabre 1 0 Region District Cases Deaths Kumasi 1 0 Central Cape Coast 90 0 Asante Akim North 2 0 Greater Accra Accra 78 0 Sekyere South 1 0 Adentan 10 0 Brong Ahafo Banda 1 0 Ga Central 9 0 Nkoranza North 1 0 Ga West 74 0 Sunyani 4 0 La-Dade-Kotopon 11 0 Central Ajumako-Enyan-Essiam 3 0 Ledzokuku Krowor 44 0 Eastern Kwahu East 2 0 Shai Osudoku 108 0 Kwahu West 1 0 Volta Ketu South 5 0 Fanteakwa 1 0 Total 429 0 Akwapim North 1 0 Akwapim South 1 0 CHOLERA Asuogyaman 2 0 No cholera case was reported during the Week. Ayensuano 1 0 Greater-Accra Ledzokuku-Krowor 2 0 NEONATAL TETANUS Upper West Jirapa 2 0 No case of Neonatal Tetanus was reported during the Sissala East 1 0 Week. Wa 1 0 Sissala West 1 0 Nadowli-Kaleo 1 0 Volta Akatsi South 2 0 MENINGITIS Kpando 1 0 During the week, 13 suspected cases of meningitis Ketu South 2 0 were recorded with one death across the country. Tain 1 0 Nandom district with 7 cases crossed the epidemic South Tongu 2 0 North Dayi 1 0 threshold (A.R. =13.1) while Lawra on the other hand was in alert phase recording 2 cases [Table 4]. Western Tarkwa-Nsuaem 1 0 Lumbar Punctures were done for all cases with none Nzema East 1 0 Upper East Talensi 2 0 confirmed positive for meningitis. Total 46 0 Table 4: Meningitis cases and deaths by Region, Ghana, Week 43, 2019 Cerebrospinal Cerebrospinal CFR District in District in Region Cases Fluid (CSF) Lab Deaths Fluid (CSF) (%) Alert Epidemic Test Positive Ashanti 0 0 0 0 - 0 0 Brong-Ahafo 0 0 0 0 - 0 0 Central 1 1 0 0 0 0 0 Eastern 0 0 0 0 - 0 0 Greater Accra 0 0 0 0 - 0 0 Northern 0 0 0 0 - 0 0 Upper East 2 2 0 0 0 0 0 Upper West† 9 9 0 1 11.1 1 1 Volta 1 1 0 0 0 0 0 Western 0 0 0 0 - 0 0 Total (Ghana) 13 13 0 1 7.7 1 1 † Attack Rate per 100,000 population [District; Nandom; 7 cases (AR= 13.1) Lawra; 2 cases (AR=3.0)] Confirmed Pathogens from Meningitis Laboratory Districts in Meningitis Alert or Epidemic Results, Week 43, 2019 Nandom district with seven cases and none confirmed hit the Lumbar Puncture was done for all 13 cases recorded in epidemic threshold in Week 43 having been in alert phase in the week with none testing positive [Table 4] including Weeks 38, 40, 41 and 42 [Figure 2]. Lawra crossed the alert cases from Nandom and Lawra districts which were in threshold in the Week under review and previously in Week 36 epidemic and alert phase respectively [Table 5]. [Figure 3]. Table 5: Meningitis cases confirmed, Ghana, Week 43, 2019 Districts Cases CSF CSF positive Deaths Causative Organism Nandom 7 7 0 1 Nil Lawra 2 2 0 0 Nil Ghana Weekly Epidemiological Report Vol. 4 Week 43 27 October 2019 2 Summary of Weekly Epidemiological Data, Week 43, 2019 Table 6: Suspected Yellow Fever cases by Region, Ghana, Nandom Alert Epidemic 10 Week 43, 2019 Region District Cases Deaths 5 Ashanti Asante Akim North 1 0 Cases Sekyere South 1 0 0 Brong Ahafo Banda 1 0 36 37 38 39 40 41 42 43 Asunafo South 1 0 Epidemiological Week Nkoranza South 1 0 Tano South 1 0 Figure 2: Meningitis threshold monitoring chart for Eastern Kwahu West 1 0 Nandom, Week 36 - 43, 2019 Upper East Binduri 1 0 Pusiga 2 0 Lawra Alert 10 Bolgatanga 1 0 Upper West Sissala West 1 0 5 Volta North Dayi 2 0 Cases Total 14 0 0 36 37 38 39 40 41 42 43 Epidemiological Week ACUTE FLACCID PARALYSIS (SUSPECTED POLIOMYELITIS) Twelve cases of Acute Flaccid Paralysis (AFP) were reported in Figure 3: Meningitis threshold monitoring chart for Week 43 [Table 7]. The stool specimens were tested at the Polio Nandom, Week 36 - 43, 2019 Laboratory at NMIMR and were negative for wild poliovirus. HUMAN RABIES Table 7: Suspected Polio cases by Region and District, Ghana, No case of Human Rabies was recorded in Week 43. Week 43, 2019 Region District Cases Death MATERNAL DEATHS Ashanti Asante-Akim Central 1 0 During Week 43, one maternal death each was recorded in . Atwima Mponua 1 0 the Cape Coast Metropolis and New Juaben Municipality. Brong Ahafo Dormaa West 1 0 Sunyani 1 0 Tano North 1 0 YELLOW FEVER Greater-Accra La-Dade-Kotopon 1 0 Fourteen cases of suspected Yellow Fever were reported Northern Central Gonja 1 0 across the country [Table 6]. Samples were sent to the Kumbungu 1 0 National Public Health and Reference Laboratory for testing Upper East Bongo 1 0 and awaiting results Upper West Jirapa 1 0 Lambussie-Karni 1 0 Lawra 1 0 Total 12 0 . Summary on Acute Flaccid Paralysis (AFP) Indicators, Week 1 – 43, 2019 All regions achieved the annualized Non-Polio AFP rate of 2.0 per 100,000 population less than 15 years except Eastern (1.7) and Greater Accra (1.9) as at the end of Week 43 [Table 7]. All regions achieved timeliness and adequacy of stool received by the laboratory except Greater Accra (78.5%) which failed to achieve for the expected target.