Weekly Epidemiological Bulletin Ministary of public Health Papulation Electronic Disease Early Warning and Response System Primary Health Care Sector DG for Disease Contraol Surveillance Volume 03, Issue 50, Epi week 50, 7 - 13 Dec 2015 H i g h l i g h t s eDEWS Reporting Rates vs Consultations in All Governorates, Epi weeks 1 to 50, 2015 96%97 % 100% 93% 94% 92%94 %94 %95 % 120,000 94% 93% 88%90 % 89% 94%92 % 9392%% 94%92 % 85% 85%86 % 90% 82%82 % 81% 80%82 % 81% • During week no. 50, 2015;95% (402/382) health facilities from 16 governorates provided 78% 79% 79% 100,000 80% 72% 74% 70% 68%70 %69 %68 % 70%70 % 64%66 %64 % 66% 64%64 % valid surveillance data. 70% 62% 62% 80,000 60% 54% 51% 50% 60,000 40% 30% 40,000 P e r c e n t a ge a t e n c r e P • The total number of consultations reported during the week in 16 governorates was C o n s u l a t i t o n s 20% 20,000 95607 compared to 91402 the previous reporting week. Acute respiratory tract infections 10% 0% - (ARI), acute diarrhea (OAD) and suspected malaria (S.Mal) were the leading cause of Wk 1 Wk 5 Wk 7 Wk 9 Wk Wk 3 Wk 13 Wk 15 Wk 21 Wk 23 Wk 27 Wk 29 Wk 31 Wk 35 Wk 37 Wk 39 Wk 43 Wk 45 Wk 47 Wk Wk 17 Wk 19 Wk 25 Wk 33 Wk 41 Wk 49 morbidity this week. Wk 11 Reporting Rate Consultations Distribution of Reporting Rates by Governorates (Epi-week 50, 2015) 100% • A total of 173 alerts were generated by eDEWS system in week 50, 2015; Of these 168 80% % 60% % % % % % % % % % % alerts were verified as true for further investigations with appropriate response. % % % % % 92 40% 96 100 96 100 92 100 84 92 100 72 100 100 96 100 20% 100 N o. H F R et N o. p o r H F R s 0% • Altogether 32 alerts for Measles, 31 Dengue Fever, 29 Acute viral hepatitis, 21 Bloody diarrhea, 16 Cut.Leishmaniasis, 14 Pertussis, 11 Acute Flaccid Paralysis, 7 Meningitis, 3 Reporting Rate Target Schistosomiasis, 2 Viral hemorrhagic fever, 1 each for Neonatal Tetanus and Diphtheria were received and responded in system generated. Note: The cause of reporting rates decline in Taiz are the armed conflict. • 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 expansion phase has 6 Governorates (Amran, Shabwah, Al-Mahrah, Sana'a Gov., HadramoutAl- wady and Dhamar) in April 2015 Ongoing on site trainings to improve weekly reporting and immediate notification are underway in all governorates. Leading causes of morbidity and mortality in Epi-week 50, 2015 Suspected dengue outbreak in Abyan, Shabwah, Al-Hodaidah and Al-Mahra Gov., Epi a). Suspected dengue outbreak weeks 14 to 50, 2015 250 Suspected Dengue fever cases • 432 suspected dengue cases were reported in 10 governorates, out of these 157 cases Shabwah 200 reported from Abyan, 82 cases from Al-Hodaidah, 56 cases from Shabwah and 14 cases Al-Mahra from A-Mahra, 4 cases with hemorrhagic manifestations were reported in Abyan and 150 Aden governorate through the eDEWS sentinel sites. 100 NO. of cases 50 0 Wk 16 Wk 19 Wk 22 Wk 25 Wk 28 Wk 31 Wk 34 Wk 37 Wk 40 Wk 43 Wk 46 Wk 49 Wk 15 Wk 17 Wk 18 Wk 20 Wk 21 Wk 23 Wk 24 Wk 26 Wk 27 Wk 29 Wk 30 Wk 32 Wk 33 Wk 35 Wk 36 Wk 38 Wk 39 Wk 41 Wk 42 Wk 44 Wk 45 Wk 47 Wk 48 Wk 50 • Abyan, Shabwah, Al-Mahra and Al-Hodidah governorates having increase number of Wk 14 reporting DF cases. 600 Suspected Dengue fever cases Abyan 500 Al-Hodidah 400 • Surveillance is being intensified to ensure that the ongoing Dengue and Acute viral 300 NO. of cases hepatitis outbreak is effectively monitored and other priority communicable disease 200 are reported through alternative sources including private health facilities, mobile 100 clinics, NGO partners on the ground, health workers in the community, and the general 0 public WK 2 WK 6 WK 3 WK 4 WK 5 WK 7 WK 8 WK 9 WK 1 WK 10 WK 14 WK 15 WK 18 WK 19 WK 22 WK 23 WK 26 WK 27 WK 31 WK 35 WK 39 WK 43 WK 47 WK WK 11WK 12WK 13WK 16WK 17WK 20WK 21WK 24WK 25WK 28WK 29WK 30WK 32WK 33WK 34WK 36WK 37WK 38WK 40WK 41WK 42WK 44WK 45WK 46WK 48WK 49WK 50WK Leading causes of morbidity and mortality in Epi-week 50, 2015 Proportional morbidity of leading priority diseases, Epi weeks 1 to 50, 2015 b. Other leading priority diseases 25.0% • URTI (16.4%), suspected malaria (3.3%), OAD (8.4%) and Pneumonia (5.5%) remain the 20.0% leading causes of morbidity representing a total of 33.6%. 15.0% 10.0% 5.0% • Acute viral hepatitis, acute watery diarrhea and Schistosomiasis represented less than 1% 0.0% Wk 1 Wk 2 Wk 3 Wk 4 Wk Wk 5 Wk 6 Wk 7 Wk 8 Wk 9 Wk 22 Wk 23 Wk 24 Wk 25 Wk 26 Wk 27 Wk 28 Wk 29 Wk 30 Wk 31 Wk 32 Wk 33 Wk 34 Wk 35 Wk 36 Wk 37 Wk 38 Wk 39 Wk 40 Wk 41 Wk 42 Wk 43 Wk 44 Wk 45 Wk 46 Wk 47 Wk 48 Wk 49 Wk 50 Wk Wk 11 Wk 12 Wk 13 Wk 14 Wk 15 Wk 16 Wk 17 Wk 18 Wk 19 Wk 20 Wk 21 of total morbidity in reporting period. Bloody diarrhea represented 0.2% of this morbidity. Wk 10 DD URTI S.MAL Pneumonia Pneu 5.5% • All diarrheal disease comprised 8.7% and Pneumonia 5.5% of total morbidity in Pilot URTI 16.5% OAD 8.5% Governorates this week. BD 0.3% Sch 0.1% S.Mal 3.3% • All diarrheal disease comprised 4.51% and Pneumonia 3.03% of total morbidity in the <5 Others 64.8% Rb 0.1% years age group. Cases (n=16,379) AVH 0.2% 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 50 ( 7 - 13 Dec 2015 ) Weekly trends of Diarrheal Diseases, Upper Respiratory infections, Suspected Malaria and Pneumonia ( Epi week 1 to 50, 2015) Diarrheal Diseases URTI Sus.Malaria Pneumonia 6.0% 25.0% 18.0% 8.0% 16.0% 7.0% 5.0% 20.0% 14.0% 6.0% 12.0% 4.0% 15.0% 5.0% 10.0% 4.0% 3.0% 8.0% 10.0% 3.0% 6.0% 2.0% 4.0% 2.0% 5.0% 1.0% 2.0% 1.0% 0.0% 0.0% 0.0% 0.0% Wk Wk 1 Wk 3 Wk 5 Wk 7 Wk 9 Wk 3 Wk 9 Wk Wk 1 Wk 5 Wk 7 Wk Wk Wk 3 Wk 5 Wk 7 Wk 9 Wk 1 Wk Wk 1 Wk 3 Wk 7 Wk 9 Wk 5 Wk 11 Wk 13 Wk 15 Wk 17 Wk 19 Wk 21 Wk 23 Wk 25 Wk 27 Wk 29 Wk 31 Wk 33 Wk 35 Wk 39 Wk 43 Wk 47 Wk 37 Wk 41 Wk 45 Wk 49 Wk 17 Wk 23 Wk 31 Wk 37 Wk 45 Wk Wk 11 Wk 13 Wk 15 Wk 19 Wk 21 Wk 25 Wk 27 Wk 29 Wk 33 Wk 35 Wk 39 Wk 41 Wk 43 Wk 47 Wk 49 Wk Wk Wk 11 Wk 13 Wk 15 Wk 17 Wk 21 Wk 23 Wk 25 Wk 29 Wk 31 Wk 33 Wk 35 Wk 39 Wk 41 Wk 43 Wk 47 Wk 49 Wk 19 Wk 27 Wk 37 Wk 45 Wk 11 Wk 13 Wk 15 Wk 17 Wk 19 Wk 21 Wk 23 Wk 27 Wk 29 Wk 33 Wk 35 Wk 39 Wk 41 Wk 43 Wk 45 Wk 47 Wk 49 Wk 25 Wk 31 Wk 37 Age and Sex distribution of total consultations of leading diseases (Epi week 50, 2015) Cumulative number of major health events reported in Epi-weeks 1 to 50, 2015 (1st Jan 2015 to 13th Dec 2015) 20000 Diseases No of Cases Percentage 18000 16000 Upper Respiratory Infections 388568 12.8% 14000 12000 Diarrheal Diseases 289664 9.5% 10000 8000 Suspected Malaria 102042 3.4% Number of Consultations of Number 6000 4000 Pneumonia 142188 4.7% 2000 0 Total (All consultations) 3041811 100% <1yr 1-4yr 5-14yr 15-44yr >45yr Male 5574 7662 9526 15398 7570 Female 5601 8234 9204 18393 8445 Leading Diseases by Governorate, Epi week 50 Distribution of consultations of leading diseases by Governorates, Epi week 50 Sana'a Hadramout Suspected Disease Lahj Aden Abyan Taiz Hadramout Ibb Hodidah Hajjah Amana Sa'da Amran Shabwah Al-Mahrah Dhamar Total Gov.