COMMUNICABLE DISEASE TOOLKIT WHO/CDS/NTD/DCE/2005.2a PPPRRROOOFFFIIILLLEEE AAA NNN NNN EEE XXX EEE SSS Burundi WHO Communicable Disease Working Group on Emergencies WHO Regional Office for Africa WHO Office, Bujumbura Communicable disease toolkit for Burundi 2005: Communicable disease profile © World Health Organization 2005 All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietary products are distinguished by initial capital letters. All reasonable precautions have been taken by WHO to verify the information contained in this publication. However, the published material is being distributed without warranty of any kind, either express or implied. The responsibility for the interpretation and use of the material lies with the reader. In no event shall the World Health Organization be liable for damages arising from its use. The named authors alone are responsible for the views expressed in this publication. Further information is available at: CDS Information Resource Centre, World Health Organization, 1211 Geneva 27, Switzerland. Fax: (+41) 22 791 4285; e-mail [email protected] or [email protected] 2 World Health Organization Communicable disease toolkit for Burundi 2005: Communicable disease profile Introduction The purpose of this document is to provide public health professionals working in Burundi with up-to-date information on the major communicable disease threats faced by the population. The list of endemic and epidemic-prone diseases has been selected on the basis of the burden of morbidity and mortality. Diseases for which there are global eradication or elimination goals are also included. The document outlines the burden of communicable diseases in Burundi for which data are available, provides data on recent outbreaks in the country and presents disease-specific guidelines on the prevention and control of these diseases. The control of communicable diseases represents a major challenge to those providing health-care services in Burundi. It is hoped that this document will facilitate the coordination of communicable disease control activities among all agencies working in the country. World Health Organization 3 Communicable disease toolkit for Burundi 2005: Communicable disease profile Acknowledgements Edited by Dr Michelle Gayer, Dr Pamela Sabina Mbabazi and Dr Máire Connolly of the Programme on Disease Control in Humanitarian Emergencies, WHO/CDS. This profile is a collaboration between the Communicable Disease Working Group on Emergencies (CD- WGE) at WHO/HQ, the Division of Communicable Disease Prevention and Control (DCD) at WHO/AFRO and the Office of the WHO Representative for Burundi. The CD-WGE provides technical and operational support on communicable disease issues to WHO regional and country offices, ministries of health, other United Nations agencies, and nongovernmental and international organizations. The working group includes the departments of Epidemic and Pandemic Alert and Response (EPR), Neglected Tropical Diseases (NTD), Roll Back Malaria (RBM), Stop TB (STB), HIV/AIDS (HIV), Child and Adolescent Health and Development (CAH), Immunizations, Vaccines and Biologicals (IVB), Sustainable Development and Healthy Environments (SDE), and Health and Action in Crises (HAC). The following people were involved in the development and review of this document, and their contribution is gratefully acknowledged: Julian Bilous (FCH/IVB), Maureen Birmingham (FCH/IVB), Sylvie Briand (CDS/CSR), Claire Lise Chaignat (CDS/NTD), Claire Chauvin (FCH/IVB), Denis Coulombier (CDS/EPR), Katelijn Vandemaele (CDS/EPR), Pierre Formenty (CDS/EPR), Charles Delacollette (HTM/RBM), Philippe Duclos (FCH/IVB), Tetford Iris (FCH/IVB), Gacicdobo Marta (FCH/IVB), Abdel Wahed El Abassi (WHO/Burundi), Akla Ayigan (WHO/Burundi), Marie Thérese Zoundi (WHO/Burundi), Stanislas Ntahobari (WHO/Burundi), Alphonse Ciza (WHO/Burundi), Bénédicte Dundaguza (WHO/Burundi), Rose Nduwimana (WHO/Burundi), Pat Drury (CDS/EPR), Dirk Engels (CDS/NTD), Hans Everts (FCH/IVB), Guliano Gargioni (HTM/STB), Pierre Guillet (CDS/NTD), Tom Grein (CDS/EPR), Bradley Hersh (FCH/IVB), Yvan Hutin (HTP/EHT), Randall Hyer (CDS/EPR), Jean Jannin (CDS/NTD), Kande-bure Kamara (CDS/EPR), Thierry Lambrechts (FCH/CAH), François Meslin (CDS/EPR), Lulu Muhe (FCH/CAH), Jose Nkuni (HTM/RBM), Salah Ottmani (HTM/STB), William Perea (CDS/EPR), Shamim Qazi (FCH/CAH), Aafje Rietveld (HTM/RBM), Cathy Roth (CDS/EPR), Mike Ryan (CDS/EPR), Michel Tailhades (HTM/TSH), George Tembo (UNAIDS/CRD), Marta Valenciano (CDS/EPR), Steve Wiersma (FCH/IVB), Sergio Yactayo (CDS/NTD). We would like to thank the Government of Ireland and the Office of US Foreign Disaster Assistance (OFDA) of the United States Agency for International Development for their support in development of this document. 4 World Health Organization Communicable disease toolkit for Burundi 2005: Communicable disease profile CONTENTS INTRODUCTION .......................................................................................................................... 3 1. ACUTE LOWER RESPIRATORY INFECTIONS (ALRI) ........................................................ 6 2. AFRICAN TRYPANOSOMIASIS (SLEEPING SICKNESS) ................................................. 10 3. BACILLARY DYSENTERY (SHIGELLOSIS) ....................................................................... 15 4. CHOLERA ............................................................................................................................. 19 5. DIARRHOEAL DISEASES (OTHERS) ................................................................................. 24 6. DIPHTHERIA ......................................................................................................................... 28 7. HIV/AIDS................................................................................................................................ 32 8. LYMPHATIC FILARIASIS..................................................................................................... 43 9. MALARIA............................................................................................................................... 47 10. MEASLES............................................................................................................................. 56 11. MENINGOCOCCAL DISEASE ............................................................................................ 61 12. ONCHOCERCIASIS (RIVER BLINDNESS)......................................................................... 68 13. PERTUSSIS (WHOOPING COUGH) ................................................................................... 73 14. PLAGUE ............................................................................................................................... 77 15. POLIOMYELITIS .................................................................................................................. 81 16. RABIES................................................................................................................................. 87 17. SCHISTOSOMIASIS (BILHARZIASIS) ............................................................................... 91 18. SOIL-TRANSMITTED HELMINTHIASES............................................................................ 95 19. TUBERCULOSIS.................................................................................................................. 99 20. TYPHOID FEVER ............................................................................................................... 112 21. TYPHUS.............................................................................................................................. 115 22. YELLOW FEVER................................................................................................................ 118 APPENDIX 1: FLOWCHARTS FOR THE DIAGNOSIS OF COMMUNICABLE DISEASES . 121 APPENDIX 2: STEPS FOR MANAGEMENT OF AN OUTBREAK......................................... 126 APPENDIX 3: SAFE WATER AND SANITATION .................................................................. 127 APPENDIX 4: INJECTION SAFETY........................................................................................ 128 APPENDIX 5: KEY CONTACTS FOR BURUNDI ................................................................... 129 APPENDIX 6: LIST OF WHO GUIDELINES ON COMMUNICABLE DISEASES................... 132 APPENDIX 7: IMMUNIZATION SCHEDULE FOR BURUNDI ................................................ 135 APPENDIX 8: MAP OF BURUNDI........................................................................................... 136 APPENDIX 9: POPULATION DATA, 2005.............................................................................. 137 APPENDIX 10: BASIC HEALTH INDICATORS FOR BURUNDI, 2005 ................................. 138 World Health Organization