MINISTRY OF HEALTH Northern, Upper East and Western regions record 100% for both Timeliness and Completeness of reporting for all notifiable conditions VOLUME 4 Eastern region falls below the annualized Non-Polio AFP rate of WEEK 2.0 per 100,000 population less than 15 years 32 th 11 August, 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 32 11 August 2019 i 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 32 11 August 2019 ii Summary of Weekly Epidemiological Data, Week 32, 2019 Summary of Weekly Epidemiological Data for Week 32, 2019 Highlights: Northern, Upper East and Western regions record 100% for both Timeliness and Completeness of reporting for all notifiable conditions Eastern region falls below the annualized Non-Polio AFP rate of 2.0 per 100,000 population less than 15 years SUMMARY OF PRIORITY Acute watery diarrhoea in persons aged … DISEASES AND EVENTS - Influenza-like illness WEEK 32, 2019 The total all-cause notifiable disease Measles morbidity for the week (as per IDSR Diarrhoea with blood Weekly Summary Reporting Form) was 886 with one maternal death and Yellow fever (suspected) two deaths from Human Rabies. AFP (suspected polio) Acute watery diarrhoea in persons Meningitis aged 5 years and above was the Event Disease/Health highest proportion of cases reported, Adverse events following immunization contributing to approximately 52% of the notifiable diseases’ caseload Human rabies during Week 32 [See Figure 1 and 0 200 400 600 Annex 1 Number of Cases Figure 1: Reported cases/notifiable disease conditions, Ghana, Week 32, 2019 REGIONAL PERFORMANCE BASED ON REPORTING T he best performing region in the week under review was Western Timeliness and Completeness of reporting for all region with a mean score of 100% whilst Central region recorded notifiable conditions for the Week were 97.6% the lowest mean score of 84.6%. All regions achieved the expected and 98.9% respectively. Three regions namely; tar gets (49.2%) for percentage of districts reporting at least a Northern, Upper East and Western recorded 100% suspected case of Measles or Yellow Fever [Table 1]. for both indicators. Table 1: Ranking of Regional Performance based on selected Surveillance. reporting indicators, Ghana, Week 32, 2019 Region Timeli- Complete- Measles YF Average ness (%) ness (%) Cum. Annualized AFP % % Score % Position Week Week AFP Non-Polio Score District District 32 32 Cases AFP Rate (%) reporting reporting (A+B+C+ A B Week 32 C D E D+E)/5 Western 100 100 39 2.9 100 100.0 100.0 100.0 1st Greater Accra 99.7 100 50 2.1 100 100.0 100.0 99.9 2nd Volta 99.5 99.8 34 2.7 100 100.0 100.0 99.9 2nd Northern 100 100 57 4.0 100 100.0 96.2 99.2 4th Upper East 100 100 24 4.7 100 100.0 92.3 98.5 5th Brong-Ahafo 94.6 100 44 3.8 100 100.0 96.3 98.2 6th Ashanti 95.6 96.8 52 2.0 100 100.0 96.7 97.8 7th Eastern 99.9 100 25 1.8 92 100.0 92.3 96.8 8th Upper West 82.2 92.4 34 8.4 100 100.0 100.0 94.9 9th Central 96.3 96.5 26 2.3 100 75.0 55.0 84.6 10th Ghana 97.6 98.9 385 2.8 100 97.7 93.1 97.4 Ghana Weekly Epidemiological Report Vol. 4 Week 32 11 August 2019 1 Summary of Weekly Epidemiological Data, Week 32, 2019 INFLUENZA-LIKE ILLNESS (IDSR Weekly Report) MEASLES A total of 316 cases with no deaths were reported through During the Week, 37 cases of suspected Measles were IDSR weekly reporting [Table 2]. Laboratory samples were recorded across the country [Table 3]. Samples were sent from sentinel sites to Noguchi Memorial Institute for taken and sent to the National Public Health and Medical Research (NMIMR) for testing. Reference Laboratory [NPHRL] for testing. Table 2: Reported Influenza-Like Illness cases by Region Table 3: Suspected Measles cases by Region and and District, Ghana, Week 32, 2019 District, Ghana, Week 32, 2019 Region Districts Cases Deaths Region Districts Cases Deaths Central Asikuma-Odoben-Brakwa 13 0 Ashanti Atwima-Kwanwoma 1 0 Greater Accra Accra 17 0 Kwabre 2 0 Adentan 8 0 Brong-Ahafo Asutifi South 1 0 Ga Central 17 0 Atebubu Amanten 2 0 Ga East 13 0 Dormaa West 1 0 Ga West 41 0 Jaman South 1 0 La-Dade-Kotopon 7 0 Sunyani 1 0 Shai Osudoku 57 0 Central Ajumako-Enyan-Essiam 1 0 Tema 133 0 Eastern New Juaben 1 0 Upper East Bolgatanga 5 0 Suhum 2 0 Volta Ketu South 5 0 Upper West Akim 1 0 Total 316 0 West Akim 1 0 Greater-Accra Ashaiman 1 0 NEONATAL TETANUS Ga East 1 0 No case of Neonatal Tetanus was reported during the Ga West 1 0 Week Upper East Bawku West 1 0 Pusiga 1 0 Upper West Sissala East 6 0 CHOLERA Volta Ho West 2 0 No cholera case was reported during the Week. Ketu South 2 0 Krachi West 1 0 Krachi Nchumuru 2 0 ACUTE WATERY DIARRHOEA IN PERSONS Western Sekondi Takoradi 1 0 AGED ≥5 YEARS Shama 1 0 Wassa East 1 0 The number of cases reported in the Week dropped significantly below the monitoring threshold [Figure 2]. Wassa Amenfi East 1 0 Districts are encouraged to continue monitoring their Total 37 0 trends for any increase in the number of case for immediate response, Threshold = Mean + 2SD* of nine weeks prior Week being monitored without Case Threshold 2500 immediate 2 preceding weeks 2000 . 1500 1000 Number of Cases of Number 500 0 Wk21 Wk22 Wk23 Wk24 Wk25 Wk26 Wk27 Wk28 Wk29 Wk30 Wk31 Wk32 Epidemiological Week Figure 2: Monitoring of Acute watery diarrhoea in persons aged ≥5 years, Ghana Weeks 21-32, 2019 *Standard Deviation MATERNAL DEATHS Table 4: Human Rabies cases and deaths by Region, No case of maternal death was reported during the Week Ghana, Week 32, 2019 Region District Cases Deaths HUMAN RABIES Eastern Atiwa 1 1 Two deaths from Human Rabies were recorded from health Upper East Bawku West 1 1 facilities in the Atiwa and Bawku West districts in Week 32 Total 2 2 [Table 4]. Ghana Weekly Epidemiological Report Vol. 4 Week 32 11 August 2019 2 Summary of Weekly Epidemiological Data, Week 32, 2019 MENINGITIS A total of 6 cases of meningitis were recorded with no deaths during the week. Lawra recorded 3 cases and crossed the alert threshold. Lumbar Punctures were done for all cases with none confirmed positive for meningitis [Table 5]. Table 5: Meningitis cases and deaths by Region, Ghana, Week 32, 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 0 0 0 0 - 0 0 Eastern 2 2 0 0 - 0 0 Greater Accra 1 1 0 0 - 0 0 Northern 0 0 0 0 - 0 0 Upper East 0 0 0 0 - 0 0 Upper West† 3 3 0 0 - 1 0 Volta 0 0 0 0 - 0 0 Western 0 0 0 0 0 0 Total (Ghana) 6 6 0 0 - 1 0 YELLOW FEVER ACUTE FLACCID PARALYSIS (SUSPECTED Twenty-five cases of suspected Yellow Fever were reported across POLIOMYELITIS) the country [Table 7]. Samples were sent to the National Public Seven cases of Acute Flaccid Paralysis (AFP) were Health and Reference Laboratory for testing with results pending. reported in Week 32 [Table 6]. The stool specimens were tested at the Polio Laboratory at NMIMR and were Table 7: Suspected Yellow Fever cases by Region, Ghana, Week negative for wild poliovirus. 32, 2019 Region District Cases Deaths Table 6: Suspected Polio cases by Region and District, Ashanti Kwabre 1 0 Ghana, Week 32, 2019 Brong-Ahafo Dormaa West 1 0 Region Districts Cases Deaths Jaman South 1 0 Brong-Ahafo Jaman South 1 0 Pru 4 0 Pru 1 0 Techiman South 1 0 Greater-Accra Ga Central 1 0 Central Ajumako-Enyan Essiam 1 0 Ningo Prampram 1 0 Eastern Birim South 1 0 Upper East Pusiga 3 0 Suhum 1 0 Total 7 0 West Akim 2 0 Yilo Krobo 1 0 Greater Accra Accra 1 0 Summary on Acute Flaccid Paralysis (AFP) Ashaiman 1 0 Indicators, Week 1 – 32, 2019 Northern Central Gonja 1 0 All regions achieved the annualized Non-Polio AFP Tamale 2 0 rate of 2.0 per 100,000 population less than 15 years Upper East Pusiga 1 0 except Ashanti region (1.9) and Eastern region (1.8) as Upper West Sissala East 1 0 at the end of Week [Table 8]. All regions achieved Wa 1 0 timeliness and adequacy of stool received by the Wa East 1 0 laboratory except Greater Accra (77.1%) which failed Volta Krachi West 1 0 South Tongu 1 0 to achieve for the expected target. Total 25 0 Table 8: Summary on Acute Flaccid Paralysis Surveillance, Ghana, Week 1 – 32, 2019 Expected Population Non- Annualized % % Reported Region Under 15 Polio Compatible Discarded Non-Polio Timely Adequate AFP years AFP for AFP Rate Stools Stools the year Ashanti 2,559,248 77 52 1 48 2.0 90.4 88.5 Brong-Ahafo 1,199,191 35 44 0 41 3.8 86.4 86.4 Central 1,216,036 35 26 0 25 2.3 96.2 96.2 Eastern 1,345,144 39 25 0 22 1.8 96.0 92.0 Greater Accra 2,148,065 67 50 0 43 2.1 78.0 78.0 Northern 1,348,239 41 57 0 50 4.0 89.5 89.5 Upper East 498,068 16 24 0 23 4.7 95.8 95.8 Upper West 353,090 12 34 0 31 8.4 94.1 91.2 Volta 1,116,490 36 34 0 30 2.7 88.2 88.2 Western 1,204,310 35 39 0 31 2.9 84.6 84.6 Ghana 12,987,880 393 385 1 344 2.8 88.8 88.1 Ghana Weekly Epidemiological Report Vol.