Weekly Epidemiological Bulletin Disease Early Warning and Response System in Sindh Volume 03, Issue 52, Epi week 52, 23 Dec - 29 Dec 2012 D E W S H i g h l i g h t s Fig 1: DEWS Reporting in Sindh Province, Epi week 01 to 52, 2012 ● During week 52, 2012; 904 health facilities from 23 districts provided 1200 Highest reports collected surveillance data for Sindh. No of reports collected 957 1000 944 930 927 921 ● The total number of consultations reported during the week in Sindh was 915 904 904 898 898 891 890 889 865 841 836 267,005 compared to 415,375 the previous reporting week. Other acute 833 820 814 809 806 804 803 diarrhea (OAD), upper respiratory tract infections (URTI), suspected malaria 800 754 738 734 729 718 716 (S.Mal) and Scabies (Scb) were the leading causes of morbidity this week. 676 661 647 635 619 600 541 ● A total of 21 alerts with 7 outbreaks were reported in week 52, 2012; 497 488 481 470 459 453 452 448 437 435 Altogether 18 alerts of Measles, 2 NNT and 1 Pertussis alerts were received 427 420 394 376 and responded. 400 363 261 ● In total 80 people were affected, where 80% of cases were aged <5 years. 195 200 ● Five Deaths were reported due to Measles in district Sukkur this week. 0 (Table 7) Wk 03 Wk 07 Wk 11 Wk 17 Wk 21 Wk 25 Wk 29 Wk 33 Wk 37 Wk 41 Wk 45 Wk 51 Wk Wk 01 Wk 05 Wk 09 Wk 13 Wk 15 Wk 19 Wk 23 Wk 27 Wk 31 Wk 35 Wk 39 Wk 43 Wk 47 Wk 49 Wk Leading Priority Disease - Sindh Province Leading Priority Diseases by District ● URTI (26.2%), OAD (6.9%), suspected malaria (7.4%), Scabies (4.4%) and ● URTI constituted the largest proportional morbidity this week. Pneumonia (1.5%) remain the leading causes of morbidity representing a District Tharparkar (36.6%) had the highest level during the week. total of 46.4%. ● Suspected malaria was highest in district Kashmore (15.7%). ● Bloody diarrhea, acute viral hepatitis, acute watery diarrhea and typhoid fever represented less than 1% of total morbidity in reporting period. Bloody diarrhea represented 0.4% of this morbidity. ● Scabies was proportionally highest in district Kashmore (13.8%). ● All diarrheal disease comprised 7.5% and Pneumonia 1.5% of total ● Other acute diarrhea was proportionally largest in district morbidity in Sindh Province this week. S.Benazirabad (17.3%) ● Pneumonia was highest in district Tharparkar (4.3%). ● All diarrheal disease comprised 3.7% and Pneumonia 0.8% of total morbidity in the <5 years age group. ● All diarrheal disease was highest in Karachi (17.6%). Trends for Leading Priority Diseases in Sindh Province - Epi weeks 1, 2011 to 52, 2012 35% OAD BD MAL ARI 30% 25% 20% 15% 10% 5% 0% This weekly Epidemiological bulletin is published by the World Health Organization (WHO), WHO/EHA office, Sindh Province, Pakistan. For Correspondence 01: Dr. Soomar Khoso, Mobile: 0300-5010496, Email: [email protected] 1 For Correspondence 02: Mohd Imran Khan, Mobile: 0333-2632358, Email: [email protected] URTIs Suspected Malaria 30.0% 16.0 Year 2011 Year 2012 Year 2011 Year 2012 14.0 25.0% 12.0 20.0% 10.0 15.0% 8.0 6.0 10.0% 4.0 5.0% 2.0 0.0% 0.0 WK 01 WK 11 WK 21 WK 31 WK 43 WK WK 03 WK 05 WK 07 WK 09 WK 13 WK 15 WK 17 WK 19 WK 23 WK 25 WK 27 WK 29 WK 33 WK 35 WK 37 WK 39 WK 41 WK 45 WK 47 WK 49 WK 51 WK WK 13 WK 23 WK 33 WK 49 WK WK 01 WK 03 WK 05 WK 07 WK 09 WK 11 WK 15 WK 17 WK 19 WK 21 WK 25 WK 27 WK 29 WK 31 WK 35 WK 37 WK 39 WK 41 WK 43 WK 45 WK 47 WK 51 WK District ARI DD's Mal Scb T.Cons District ARI DD's Mal Scb T. Cons Badin 3861 (29.8%) 924 (7.1%) 1318 (10.2%) 534 (4.1%) 12945 Mirpurkhas 6157 (30.2%) 1458 (7.2%) 879 (4.3%) 528 (2.6%) 20373 Karachi 1335 (35.3%) 586 (15.5%) 101 (2.7%) 370 (9.8%) 3781 N-Feroze 2616 (29.4%) 770 (8.7%) 1367 (15.4%) 528 (5.9%) 8889 Dadu 3224 (18.9%) 1316 (7.7%) 1017 (6%) 766 (4.5%) 17059 Sanghar 2886 (27.3%) 672 (6.4%) 934 (8.8%) 482 (4.6%) 10580 Ghotki 2017 (29.2%) 526 (7.6%) 478 (6.9%) 427 (6.2%) 6903 S.Benazirabad 1722 (26.2%) 1155 (17.5%) 1003 (15.2%) 277 (4.2%) 6582 Hyderabad 9006 (29.5%) 1971 (6.5%) 1239 (4.1%) 646 (2.1%) 30551 Shikarpur 3360 (30.1%) 700 (6.3%) 715 (6.4%) 303 (2.7%) 11180 Jacobabad 3100 (30.5%) 1102 (10.8%) 1152 (11.3%) 1149 (11.3%) 10164 Sukkur 4650 (33.1%) 893 (6.4%) 699 (5%) 423 (3%) 14043 Jamshoro 3558 (26.4%) 986 (7.3%) 641 (4.8%) 295 (2.2%) 13486 T.Allahyar 2207 (22%) 521 (5.2%) 340 (3.4%) 128 (1.3%) 10046 Kambar 1356 (12.5%) 440 (4.1%) 603 (5.6%) 445 (4.1%) 10846 Tharparkar 3228 (40.9%) 461 (5.8%) 557 (7.1%) 166 (2.1%) 7889 Kashmore 394 (20.2%) 276 (14.1%) 307 (15.7%) 270 (13.8%) 1955 Thatta 2583 (29.8%) 802 (9.3%) 793 (9.2%) 717 (8.3%) 8661 Khairpur 4510 (24.8%) 1435 (7.9%) 2728 (15%) 1070 (5.9%) 18177 TMKhan 2603 (24.3%) 517 (4.8%) 622 (5.8%) 571 (5.3%) 10698 Larkana 3637 (27.7%) 1008 (7.7%) 973 (7.4%) 1019 (7.8%) 13121 Umerkot 3636 (37.5%) 740 (7.6%) 751 (7.7%) 190 (2%) 9698 MATIARI 2385 (24.9%) 690 (7.2%) 573 (6%) 366 (3.8%) 9590 Sindh 74031 (27.7%) 19949 (7.5%) 19790 (7.4%) 11670 (4.4%) 267005 Dadu Badin Thatta Larkana Sanghar TMKhan Khairpur N-Feroze Umerkot Jamshoro Shikarpur T. T. Allahyar Tharparkar Mirpurkhas S. Benazirabad Pf 5 3 0 33 2 13 7 1 1 18 2 3 4 0 19 Pv 0 10 6 31 0 3 10 5 25 15 5 4 3 3 39 Mixed 3 1 1 1 0 4 42 0 0 1 6 0 3 0 10 Total +ve Slides 8 14 7 65 2 20 59 6 26 34 13 7 10 3 68 SPR 12.3 4.2 16.3 21.6 16.7 10.0 34.7 3.4 23.6 12.3 15.7 3.1 7.8 3.4 14.3 FR 62.5 21.4 0.0 50.8 100.0 65.0 11.9 16.7 3.8 52.9 15.4 42.9 40.0 0.0 27.9 Total Slides Tested 65 336 43 301 12 201 170 176 110 276 83 226 128 88 477 Number of Malaria Reports 50 50 39 58 37 64 33 34 28 33 45 48 47 36 28 Assorted Population Estimated ACTs Jerry Filter Pure Wagtech Aqua Coartem Primaquine DISTRICTS EHK DDK Medicin TIG ASV Coverage by Treatments RDTS Treatm Cane s sachet Kit Tab Treatments Tablets es EHK Covered from ents Jacobabad 7 4 11149 1609 24 40 280587 2 123834 42000 DDks2000 2820 4500 Shikarpur 3 2 114039 3154 20 461307 111333 18000 1000 2760 2500 Kashmore 7 2 72051 1133 30 282986 53833 42000 1000 2820 4500 Kamber/shadadkot 2 2 450 34 20 38400 20000 12000 1000 1830 2500 Ghotki 1 2 6930 90 164 36 2000 6000 1000 1830 3500 Sukkur 1 840 20 40 20 78480 52000 6000 0 2310 3000 Larkana 1 24 10 6000 0 1830 2500 Khairpur 0 2 20788 870 157200 65500 0 1000 2640 3500 Dadu 1 500 DG Health Services Sindh 200 0 0 Director Malaria Control Program 0 0 5400 9600 4960 60000 Total 22 15 224957 8146 184 158 340 1298960 2 428500 132000 7500 24240 36100 4960 60000 2011 2012 (Week 1-50) 2012 (Week 51) 2012 (Week 1-51) Disease A O A O A O A O Suspected Measles 586 66 2204 481 18 7 2222 488 Pertussis 131 59 264 123 1 0 265 123 AWD 721 207 398 73 0 0 398 73 NNT 200 0 303 0 2 0 305 0 Typhoid 1 1 165 6 0 0 165 6 Scabies 3 0 79 7 0 0 79 7 Leishmaniasis 11 1 47 0 0 0 47 0 DHF 148 13 18 0 0 0 18 0 Malaria 54 28 8 3 0 0 8 3 Tetanus 53 0 5 0 0 0 5 0 Other 191 13 172 11 0 0 172 11 Total 2099 388 3663 704 21 7 3684 711 35 33 30 25 20 16 15 10 10 6 5 5 4 4 4 4 4 5 3 2 2 2 1 1 1 0 Dadu Hyderabad Jamshoro N-Feroze Shikarpur Sukkur Umer Kot Alerts Outbreaks Cases Deaths Suspected Week Date Investigated District Location <5 M >5 M <5 F >5 F A/O Cases Deaths Disease Current Week Outbreaks Suspected 2012-52 24-Dec-12 Jamshoro Baloch goath, UC AB Shoro 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Dadu Jamali Muhalla, city Dadu 1 0 4 1 O 6 0 Measles Suspected 2012-52 24-Dec-12 Dadu Gulshan-e-Zeid colony, city Dadu 2 0 3 0 O 5 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Village Hadi Bux Shambani UC Lal Jurio 0 1 2 1 O 4 3 Measles Suspected 2012-52 24-Dec-12 Sukkur Jamali Muhalla Adam Shah colony Uc Adam Shah 3 1 2 0 O 6 1 Measles Suspected 2012-52 24-Dec-12 Sukkur Tando Thatti near Bus terminal UC Long Bhatti 7 2 4 2 O 15 0 Measles Suspected 2012-52 24-Dec-12 Sukkur Rice Canal, Air port road bypass.