Weekly Epidemio Weekly Epidemiological Bulletin - Ethiopian Public ...

EPIDEMIOLOGICAL BULLETIN: Weekly/Volume 2/Number 28/ Page 1-10 /July11-17/2016 Etsehiwot Zemelak1, Abrham Lilay1, Emana Alemu1 Ethiopian Public Health Institute, Telephone 0112765340/0112758631 Tall Free 8335/8665, Fax 0112758634, Email: [email protected],, Website: www.ephi.gov.et, PO. Box 1242, Swaziland Street, Addis Ababa

Weekly Epidemiological Bulletin Completeness and Timeliness rate is 92 2% and 92% - increased by 2% and 1%,, respectively, compared to last week. Acute watery diarrhea (AWD) outbreak is ongoing in six regions: Addis Ababa, Oromia, SNNP, SNNP Amhara and Afar, Ethio-Somali regions. regions A total of 1,206 cases and 9 deaths reported. Since November, 52 woredas and 10 Sub-cities Sub towns affected and a total of 7,565 cases with 37 deaths reported. One suspected Guinea worm case reported from Tirunesh Beijing hospital, investigated and classified as non-compatible. Malaria is increasing since week 19 of 2016 – 3461 cases (9% increment) increment reported compared to last week. A total of 65 dengue fever cases reported from Dire Dawa since July 1, 2016 The national PHEM officers are closely monitoring/Following AWD and other disease outbreaks situations on daily basis. Interventions to tackle AWD outbreak is underway in all affected areas: Surveillance, Case management, health education. Two teams from EPHI/PHEM deployed – one to Jimma and the other to East and West Harerghe and Meiso. Orientation on AWD surveillance and laboratory investigation were given to 24 woreda PHEM officers of North Shoa of Amhara region. I.

Introduction

This Epidemiological Weekly Bulletin serves to provide key information on public health emergency management activities, and nd summarizes surveillance data and performance on epidemic prone diseases and other public health emergencies. The bulletin mainly includes surveillance data of week 28 of 2016 and daily phone communication, line list reports of outbreaks for week 29 of 2016. It highlights the surveillance completeness and timeliness across the regions, trends of diseases under surveillance, cluster of cases and events, ongoing outbreaks and responses undertaken at all levels in Ethiopia. The numbers of disease specific cases indicated in this issue i of

bulletin are subject to change due to on on-going receiving late surveillance data and retrospective verification and investigation of data from outbreak areas. II.

Surveillance report completeness and timeliness

Completeness: The national completeness ra rate of reports from government health facilities was 992%. Except for Somali and Gambella region all the regions has fulfilled the expected minimum completeness rate for the week. Among the nine regional states and two city administrations eight (73%) of them achieved more than 90% surveillance completeness rate (Figure 1). Wk25

Completeness of reporting (%)

SUMMARY of the Week – Week 28 of 2016: 2016

Wk26

Wk27

Wk28

Min Requirement

100 90 80 70 60 50 40 30 20 10 0

Regions

Figure 1: Regional Surveillance Report Completeness, Week 25-27/2016 Timeliness: In week 28,, the national surveillance timeliness rate was 92% % which is above minimum requirement. From all regional states and city Administrations nine (82%) of them achieved more than 80% surveillance report timeliness (Figure 2).

Weekly Epidemiological Bulletin Wk26

Wk27

Wk28

Wk25

Min Requirement

100.0 90.0 80.0 70.0 60.0 50.0 40.0 30.0 20.0 10.0 0.0

Wk28

Afar

Amhara

2000 1500 1000 500 0 SNNPR

Figure 2: Regional Surveillance Report timeliness, Week 25-27/2016 Diseases and conditions

1) Severe Acute Malnutrition (SAM) National SAM Trend: A total of 4,631 SAM cases were reported in week 28 of 2016 which iss increased by 21 % (802) compared with week 27 of 2016 (Figure 3). 2014

2015

2016

W1 W4 W7 W10 W13 W16 W19 W22 W25 W28 W31 W34 W37 W40 W43 W46 W49 W52

12000 10000 8000 6000 4000 2000 0

Epidemiological week

Figure 3: National SAM cases trend 2014-week2 week28/2016 Regional SAM Trend: In week 28 Oromia region has accounted for 51 % of the national cases followed by SNNPR (162%) and Afar (10 %) of the national cases. relatively the trend is showing increment in the top three higher number of case reported regions (Figure (Fig 4).

Weekly/Volume 2/No. 22

Somali


Regions

Number of cases

Wk27

2500

Oromia

III.

Wk26

3000 Number of cases

Timeliness of reports (%)

Wk25

Figure 4: SAM trend by region by week 25-27/2016 The inpatient rate for SAM cases in week 28 was 13% at national level. When hen further analysis was done at regional level seven regions have an inpatient rate of more than 10%, which is the highest acceptable rate. However the high inpatient rate as detailed in table 1 should be further evaluated. Table 1: New OTP and SC SAM cases and deaths in week 28, 2016 Region

Total SAM

OTP

IInpatient

Death

Inpatient %

Oromia

2321

1998

323

2

14

SNNPR

760

626

134

3

18

Afar

460

431

29

0

6

Amhara

381

350

31

0

8

Somali

371

371

0

0

0

Tigray

169

138

31

1

18

Dire Dawa

60

38

22

0

37

Addis Ababa

40

32

8

0

20

Gambella

27

25

2

0

7

Hareri

24

9

15

0

63

Benishangul

18

11

7

0

39

4631

4029

602

6

87.0

13.0

0.1

Total Percent

Zonal SAM Trend: In week 28 the top 15 zones with the highest number of SAM cases contributed for 63% of all cases at national level. The highest number of SAM cases was reported from East Hararge contributing to 18% % followed by West Hararge contributing 9% of Page 2

Ethiopian Public Health Institute Center for Public Health Emergency Management the national cases. The two zones have been contributing to the highest SAM case for the last several weeks (Table 2). The contributing factors and intervention status should be further evaluated. Table 2: Top 15 zones reported highest number of new SAM cases in week 25-27 of 2016 Zone

Wk25

Wk26

Wk27

Wk28

Zone 01

Dubti

10 687

5 552

13 452

53 850

2) Malaria National Malaria Trend: A total of 42,948 malaria cases were reported in week 28. Cases were increased in this week 9 % (3461).The Malaria case have been increasing starting from week 19 of 2016 and crosses the 2014 and 2015 trends. It is also expected the number of malaria cases could increase in the coming weeks except adequate and appropriate intervention will taken (Figure 5).

Oromia

East Hararge

603

546

401

833

Oromia

West Hararge

585

444

409

406

Oromia

Bale

426

197

172

190

Oromia

West Arsi

295

166

125

141

Oromia

Arsi

218

126

89

139

Oromia

Guji

206

151

115

127

Oromia

Jimma

103

82

65

109

Oromia

Borena

68

80

53

84

SNNP

Gedeo

141

179

103

139

SNNP

Hadiya

118

123

81

113

SNNP

Gamo Gofa

85

117

106

102

SNNP

Sidama

164

180

160

88

Afar

Zone 01

94

106

97

189

Year w3 w6 w9 w12 w15 w18 w21 w24 w27 w30 w33 w36 w39 w42 w45 w48 w51

Region

Afar Total

Afar

Zone 03

137

91

82

98


Afar

Zone 02

80

84

86

91

Amha

Wag Himra

125

96

54

83

Sum Top 15 zones

3448

2768

2198

2932

Sum National

5532

4693

3829

4631

62

59

57

63

Number of cases

Woreda SAM Trend: The top 15 woredas with the highest number of SAM cases in week 28 contributed to 18% of the national SAM cases. All of the top 15 woredas are from Oromia regional state (table 3). Table 3: Top 15 woredas reported highest number of new SAM cases in week 25-27/2016 Region

Zone

Woreda

Oromia Oromia Oromia Oromia Oromia Oromia Oromia Oromia Oromia Oromia

E/Harerga E/Harerga E/Harerga E/Harerga E/Harerga E/Harerga E/Harerga E/Harerga E/Harerga W/Harerga

Oromia Oromia Oromia Oromia

W/Harerga W/Harega W/Arsi W/Arsi

Girawa Fedis Chinakesen Gole Oda Gursum Bedeno Goro Gutu Meta Haromaya Mesela Hawi gudina Gemechis Siraro Shala


2015

2016

80000 70000 60000 50000 40000 30000 20000 10000 0

Figure 5: National Malaria cases trend, 2014-wekk28/2016

Wk 25 98 87 58 16 3 28 44 53 32 36

Wk 26 60 79 30 24 66 19 24 30 63 24

Wk 27 41 36 15 48 43 20 13 22 17 31

Wk 28 96 91 76 70 61 59 58 47 44 46

16 112 43 61

15 62 61 0

54 40 28 44

61 41 42 58

Regional Malaria Trend: From Amhara region 11,772 malaria cases were reported in week 28, accounted for 27% of all cases. Compared with week 27, this week malaria cases increased in A,hara, Tigray, Benshangul, Oromia and Gambella regions (Figure 6). Wk25 Number of cases

Percent top 15 zones

2014

Wk26

Wk27

Wk28

16000 14000 12000 10000 8000 6000 4000 2000 0

Region

Figure 6: Regional Malaria trend, Week 25-28/2016 In week 28, a total of 146,264 cases suspected for malaria are tested either by microscopy or RDT. Of which 41,152

Detect, Prepare, Response and Recover

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Weekly Epidemiological Bulletin (95.8%) are ended positive for malaria parasites. The positivity rate is increasing from week to week. PF contributes 28,352 (66 %) while 12827 (29.9%) were PV and the rest 1,796 (4.2%) are clinically diagnosed malaria cases. There are only 385(0.9%) inpatient cases with one death reported in the week. When looking at regional level, Somali has reported treating 62% of the cases clinically in week 28. Throughout 2016 weekly report high proportion of clinical malaria case treatment has been observed from Somali region. Compared with other regions and nationally the Somali pattern is quite different. The reason behind treating high number of patients should be further investigated and the regional health bureau is expected to decrease clinical malaria treatment since there is no shortage of resources (Table 4). Table 4: Regional Malaria cases by type and region, Week 28, 2016 Malaria

PF

PV

Cli.

Inp

Amh SNNP Oro Tig B.G Gam Afa Harari A.A Somali D.D Grand Total %

41514 34555 27437 21431 12230 3795 3260 583 555 505 399

11772 6305 5594 8148 6097 2511 1384 294 127 699 17

3904 2363 1887 3075 810 241 237 165 75 69 1

146264

42948 95.8

7863 3803 3530 4874 4592 2036 1147 216 52 196 16 2832 5 66.0

5 139 177 199 695 234 0 87 0 434 0 179 6 4.2

12827 29.9

Number of cases

4000 3000 2000 1000

Figure 7.1: Zones in which malaria cases are increased compared with previous week, Amhara region,Week 2528/2016

24 74 15 74 82 116 0 0 0 0 0 385 0.9

1 0.0

28

Wk25

Wk26

Wk27

Wk28

1800 1600 1400 1200 1000 800 600 400 200 0 North Western Tigray

Western Tigray

Eastern Tigray

South Tigray

South East

Zone

Figure 7.2: Zones in which malaria cases are increased compared with previous week, Tigray region,Week 2528/2016 Wk25

Wk26

Wk27

Wk28

3500 3000 2500 2000 1500 1000 500 0 Metekel

Assosa

Kamashi Maokomo Agnuwak Special

Benishangul-Gumuz Region/Zone


North Wollo

Zone

MP R 28 18 20 37 44 60 42 65 23 52 4

Zonal Malaria Trend: Up on disaggregating the data to the zonal level, the total malaria cases have been increased in 39 zones. Among them malaria is increasing in North Gonder, metekel,Assosa, ,Agnwak,North West Tigray Gamogofa, East Shoa and Western Tigray zones (Figure 7.1).

Wk28

North West East North Oromiya Wag Gondar Gojjam Gojjam Shewa Himra

Deat h 0 0 0 0 0 1 0 0 0 0 0

Note: Tested-Suspected malaria fever cases examined by microscopy or RDT, PF-Plasmodium falciparum, PV-Plasmodium vivax,Cli-Clinical Malaria, Inp-Inpatient malaria cases, MPR, Malaria positivity rate

Wk27

0

Number of cases

Tested

Wk26

5000

Number of cases

Region

Wk25

Gambella

Figure 7.3: Zones in which malaria cases are increased compared with previous week, Benishngul and Gambella region,Week 25-28/2016 Page 4

Ethiopian Public Health Institute Center for Public Health Emergency Management

Wk25 Wk26

Wk27

Wk28 Number of cases

Number of cases

Wk25 1600 1400 1200 1000 800 600 400 200 0

Wk26

Wk27

Wk28

2000 1800 1600 1400 1200 1000 800 600 400 200 0 Ahiferom

Mereb Leha

Tanqua Abergele

Tsegede

Central Tigray

Qafta Humera

Humera Town

Western Tigray

Asegede Tsimbila

Tahitay Adiyabo

North Western Tigray

Zone/Woreda

Zone

Agnuwak

Assosa

Metekel

Benishangul-G

Fentale

Boset

Blo Jiganifado

Guba

Wk28

Dibate

Wk27

Bambasi

Assosa Rural

Wk26

Oda Bildagul

Wk28

Sherkole

Wk27

Abobo

Wk26

Gambella

Kamashi East Shewa Gambella

Oromia

North Gondar

Bati Town

Zikwala

Debere Elias

Baso Liben

Gendawuha

West Armacho

Tegede

Shoarobit

Tach Armacho

Qaura

Region/Zone/Woreda

Dembia

800 700 600 500 400 300 200 100 0

Metema

Number of cases

Wk25

700 600 500 400 300 200 100 0

Gambella Town

Woreda Malaria Trend: Up on disaggregating the data to the woreda level, malaria cases have been increased in 39 woredas (Figure 7.5,7.6,7.7).

Wk25

Numer of cases

Figure 7.4: Zones in which malaria cases are increased compared with previous week, Oromia region,Week 2528/2016

Figure 7.6: Woredas in which malaria cases are increased compared with previous week Tigray region, Week 2528/2016

East GojjamWag Himra Oromiya

Zone/Woreda

Figure 7.5: woredas in which malaria cases are increased compared with previous weekAmhara region,Week 2528/2016


Figure 7.7: Woredas in which malaria cases are increased compared with previous week Gambella, Benishangul and Oromia region,Week 25-28/2016

3) Rabies: Nationally, a total of 59 rabies exposure cases with one death are reported in week 28 of 2016. Among them 68% were reported from Aksum town, Gonder town and Abi Adi town. One death were reported from South Kombolcha town of South Wello zone, Amhara region (Table 5).


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Weekly Epidemiological Bulletin 2014

Table 5: Regional rabies Exposure cases, Week 28, 2016 Death

2016

2500

0 0 0 0 0 0 0 1 0 0 0

2000 1500 1000 500 w52

w49

w46

w43

w40

w37

w34

w31

w28

w25

w22

w19

w16

0 w13

% 36 12 5 8 10 20 5 0 2 2 100

w7

21 7 3 5 6 12 3 0 1 1 59

w10

E-Cases

w4

Woreda

Akisum T Abiyi Adi T Lailay Mayichewu Adi Girat T South & North Mekele Gonder T Tefera Hailu Hospital Kombolcha T Munesa Mizan Aman Hosp

w1

Zone C/Tigray C/Tigray C/Tigray E/Tigray Mekelle Spec Gonder T Wag Himira S/ Wello Arsi Bench Maji

Number of cases

Region Tig Tig Tig Tig Tig Amh Amh Amh Oro SNNP Total

2015


4)

Meningitis In week 28 of 2016, a total of 15 suspected meningitis cases are reported to the national level through weekly routine surveillance. Majority60% of the cases reported from Hospitals. Up on disaggregating the hospital cases to woreda level, the cases were reported from different woredas (table 6). The Meningitis threshold was not crossed in all reported woredas .

Figure 9: National suspected Measles Trend ,2014week28/2016 Table 7: Suspected Measles cases, week 28, 2016

Table 6: Suspected Meningitis Cases in week 28, 2016 Region

Zone

Woreda

Total MM 2

Op

Ip

Death

Oro

Bale

Goba Town

Oro Oro

Borena Guji

0

2

0

Bule Hora Hosp Negele Hosp

1 1

0 0

1 1

0 0

Oro

Shambu T.

1

0

1

0

Oro

Horo Gudru Wellega Jimma Spe T.

Jimma Spe T.

1

1

0

0

Oro

W.Harerga

Chiro Hosp.

1

1

0

0

Oro

W.Harerga

Gelemso Hosp.

1

1

0

0

SNNP

Hawassa T

5

0

5

0

SNNP

Kembata Tembaro Agnuwak

Hawassa Refer Hosp Durame T

1

0

1

0

1

0

1

0

15

3

12

0

Gambella

Gambella Hosp

Total

5) Measles National measles trend: The national trend of reported measles cases is below the reports received in 2015 and 2014 of the same time. The number of cases reported has steadly declined since week 12 (Figure 9).


Region

28

Percent

Death

Oromia Amhara Addis Ababa SNNPR Somali Benishangul-Gumuz Afar Dire Dawa Gambella Harari Tigray Grand Total

23 14 8 2 2 1 0 0 0 0 0 50

46 28 16 4 4 2 0 0 0 0 0 100

0 0 0 0 0 0 0 0 0 0 0 0

Woreda Measles trend: Up on disaggregating suspected measles cases to woreda level.The weekly surveillance report showed outbreak in two hospitals; Oromia region St.luke and Addis Ababa city, Yekatit 12 hospital which reported above five case in this week.(Table 8). Table 8: Suspected measles cases from Wk 25-28/2016 Region

Zone

Woreda

Wk25

Wk26

Wk27

Amh

Gonder T.

Amh

N/Shewa

Amh

Wk28

Gonder Town

3

4

1

4

0

0

0

3

Wagkimira

Angolelana Tera Zikwala

0

0

0

2

Amh

W/Gojam

North Achefer

1

1

0

2

Amh

Dese T.

Dese Town

1

1

1

1

Amh

W/Gojam

Gonji Kolela

0

0

0

1

Amh

W/Gojam

South Achefer

0

0

0

1

A.A

Arada

Yekatit 12 Hosp

0

1

5

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Ethiopian Public Health Institute Center for Public Health Emergency Management A.A

Addis Ketema

0

1

A.A

Addis Ketema Chirkos

Zeweditu Hosp.

0

1

0

1

A.A

Gulele

Gulele

0

2

1

1

Oro

E/Shewa

0

0

0

1

Oro

Illu Aba Bora Jimma

Olanciti Hospital Bedele T.

1

1

1

1

Limu Seka

10

10

2

3

0

1

1

1

2

1

2

Oro Oro

1

Jimma Spe T.

Oro

Jimma Spe T. Qelem Wellega S/W/Shewa

Ameya

11

4

7

4

Oro

S/W/Shewa

St.Luke Hosp

27

25

17

11

54 194 28

53 109 49

33 51 65

45 50 90

Oro

Dale Sedi

Sub total Total case per week Percent

6) Anthrax In week 287, a total of 5 suspected Anthrax cases with zero death reported from Amhara and Tigray regions only (Figure 9). Table 9: Suspected Anthrax cases reported in Week 28, 2016 Region

Zone

Woreda

Case

Amh

Waghimira

Abergele

1

0

Amh

Waghimira

Zikwala

1

0

Tig

C.Tigray

Abiyi Adi Town

1

0

Tig

E.Tigray

Saesi Tsadamba

2

0

5

0

Total

Death

Maternal Death Since maternal death is integrated in PHEM surveillance system a number of deaths were reported to national level both through weekly report and MDRF. This week a total of 10 maternal deaths were reported to national level through rutine surveillance from Oromia and Dire Dawaegions. The other regions reported zero maternal death in the week (Table 10). Table 10: Maternal Deaths report by Woreda, Week 28, 2016 Zone Dil Chora Arsi E.Harerga Jimma W/Harega Awi S/Gondor W/Gojam W/Gojam

Grand Total

Woreda Dilchora Hosp Robe Goro Gutu Agaro Chiro Hosp Jawi Lay Gayint Gonji Kolela Sekela

Suspected AWD Cases: The AWD outbreak is still ongoing in Oromia and Somali,SNNP,Afar regions and Addis Ababa city administration. So far, 52 woredas and 10 sub cities were reported suspected AWD cases in five regions and one city administration (Oromia, Somali, SNNP and Afar regions and Addis Ababa). Nationally as of 24, 2016, about 2681 suspected AWD cases were reported (table 11)(figure 10,11,12,13,14,15 and 16). Since June 25/2016 Addis Ababa regional health bureau also identfied the first AWD cases a total of 4590 cases were reported. As of week 28 a total of 1855 AWD Cases were reported. All of the 10 subcities were reported case. Majority of the cases were reported from Nefasilk 760 (17%) followed by Kolfe 743(16%) and Addis Ketema529(12%). All the cases are isolated and treated in CTC. Table 11: AWD cases by Woreda, Week 28, 2016

7)

Region Dire Dawa Oromia Oromia Amhara Amhara Amhara Amhara Amhara Amhara

reported at least one maternal death within the last 28 weeks. Oromia region reported the highest deaths (159 Deaths) comparing with other regions. All woredas are started reporting maternal deaths (at least zero report). Majority of the woredas kept reporting zero maternal death which needs furher evaluation.

Deaths 2 1 1 1 1 1 1 1 1 10

Region

Zone

Woreda

Onset of First case

Onset of last case

T.Case

7/22/2016 7/6/2016 7/17/2016 7/9/2016

Zero case for the last # days 2 18 7 15

Oro Oro Oro Oro

Borena Borena Bale Bale

6/12/2016 6/19/2016 5/31/2016 11/28/2015

Oro Oro Oro

Finfinne Finfinne Finfinne

Oro Oro Oro Oro

Finfinne Finfinne Finfinne Finfinne

Oro Oro Oro Guji Oro Oro Oro Oro Oro Afar Somali SNNP

Finfinne Bishoftu T Guji Guji Guji Guji Shashemene T W/Harega W/Harega Zone03 Shinille Gamo Gofa

SNNP SNNP

Sidama Sidama

Abeya Muyale Delo Mana Mada Welabu Burayu T. Gelan Town Laga Tafo T. Sebeta Sululta R. Sululta T Sandafa Bake Walmara Bishoftu T Adola Rede Girja Negele T. Wadera Shashemene T Doba Tullo Amibara Meiso Arbaminch T. Dara Lock Abaya

6/25/2016 7/4/2016 7/2/2016

7/10/2016 7/4/2016 7/20/2016

14 20 4

19 2 10

6/17/2016 7/1/2016 6/17/2016 7/19/2016

7/12/2016 7/6/2016 7/18/2016 7/19/2016

12 18 6 5

81 4 28 1

7/19/2016 7/15/2016 4/22/2016 6/4/2016 3/28/2016 11/22/2015 3/30/2016

7/19/2016 7/21/2016 7/22/2016 7/19/2016 7/18/2016 7/19/2016 7/12/2016

5 3 2 5 6 5 12

1 7 15 20 121 44 12

7/14/2016 7/18/2016 7/15/2016 7/19/2016 6/13/2016

7/19/2016 7/20/2016 7/17/2016 7/22/2016 7/10/2016

5 4 7 2 14

154 2 28 9 86

7/5/2016 7/8/2016

7/22/2016 7/13/2016

2 11

58 14

136 324 92 91

In 2016, Week 1-28, a total of 362 maternal deaths were notified through weekly surveillance system. All regions Weekly/Volume 2/No. 22


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7/22/2016

7/21/2016

7/20/2016

7/19/2016

7/18/2016

7/17/2016

7/16/2016

7/15/2016

7/14/2016

7/13/2016

7/12/2016

0

7/11/2016

2

7/9/2016

4

7/10/2016

6

7/8/2016

8

7/7/2016

10

16 14 12 10 8 6 4 2 0

7/5/2016

Number of cases

Number of cases

12

7/6/2016

Weekly Epidemiological Bulletin

Date of onset Date of onset

Figure 13: AWD Outbreak trend by date of onset, Sidama zone, SNNP, 2016, N=88

50

12

40

10

Number of cases

7/22/2016

7/20/2016

7/18/2016

7/16/2016

7/14/2016

7/12/2016

Date of onset

Figure 14: AWD Outbreak trend by date of onset, Gamogofa zone, SNNP, 2016, N=85

9 8 7 6 5 4 3 2 1 0

Date of onset

Figure 12: AWD Outbreak trend by date of onset, West Arsi, Oromia, 2016, N=54

Number of cases

Number of cases

Figure 11: AWD Outbreak trend by date of onset, West Harerga, 2016, N=163

7/10/2016

Date of onset

7/8/2016

0

7/17/2016

7/6/2016

6/17/2016

7/4/2016

5/17/2016

7/2/2016

4/17/2016

6/30/2016

3/17/2016

2

6/28/2016

0

4

6/26/2016

10

6

6/24/2016

20

8

6/22/2016

30

6/20/2016

Number of cases

Figure 10: AWD Outbreak trend by date of onset, Finfine special zone (Oromia) 2016, N=114

18 16 14 12 10 8 6 4 2 0 7/15/2016

7/16/2016

7/17/2016

7/18/2016

7/19/2016

Date of onset

Figure 15: AWD Outbreak trend by date of onset, zone 03,Amibara woreda, Afar, 2016, N=28


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Ethiopian Public Health Institute Center for Public Health Emergency Management 5

7

11

9

5

8

8

3

5

200

4

1

2

150

6

1

2

7

1

2

Total

65

100

Confirmed

Suspected

Number of cases

250

100 50 0 6/7/2016 6/14/2016 6/21/2016 6/28/2016 7/5/2016 7/12/2016 7/19/2016

Date of Onset

Figure 16: AWD Outbreak trend by date of onset, Addis Ababa, 2016, N=4590

8) Guinea Worm (GW) Since week 20 a total of 3 cases were reported from Goge and Abobo woredas of Agnwa zone. In week 28, one suspected case reported from Tirunesh Beijing hospital and found to be non-compatible. Tall free phone is working 24/7 to collect rumors from the community. 9)

Dengue fever

Number of cases

Dengue fever outbreak is reported from Dire Dawa region since 7/1/2016. As of 7/24/2016 a total of 65 cases with no death were reported (figure). All cases were reported from 9kebeles. Most cases were reported from two kebeles; kebele 2 and 3(Table12). 10 8 6 4 2 0

Response

Addis Ababa AWD Outbreak: a. Addis Ababa Regional health bureau together with EPHI and Partners established 26 CTC and equipped with required medical and infection prevention supplies. b. Command post was established by Addis Ababa city Municipality and evaluation of daily AWD prevention and response activity was started. c. First cohort FETP Urban track residents (22) have been investigating each AWD suspected cases and support the response activities. d. Active case searching and Contact Tracing, Health Education and Social mobilization are continued in all the 10 Addis Ababa sub cities involving Urban HEWs. Oromia AWD Outbreak:

Investigation, active case searching, social moblization and community awerness is continioued in all affected woredas Somali and Afar AWD Outbreak:


Table 12: Dengue fever cases by Keble Week28, 2016 Kebele

IV.

# of cases

Percent

2

28

43

3

10

15

1

9

14


a. Teams sent to the region from EPHI to conduct investigation and response to the outbreak. b. Patient isolation and treatment in designated CTC (Case Treatment Center), Contact trasing, infection prevention, health education and social moblization activities, distributing of water treatment chemicals at household level, treatment of water at the source and detail case investigation is undertaking in all AWD affected woredas. c. Patient isolation and treatment in designated CTC (Case Treatment Center), Contact trasing, infection prevention, health education and social moblization activities, distributing of water treatment chemicals at household level, treatment of water at the source and detail case


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Weekly Epidemiological Bulletin investigation is undertaking in all AWD affected woredas. d. Patient isolation and treatment in designated CTC (Case Treatment Center), Contact trasing, infection prevention, health education and social moblization activities, distributing of water treatment chemicals at household level, treatment of water at the source and detail case investigation is undertaking in all AWD affected woredas.

10) 

 

Acknowledgment All regional health bureaus – for sharing us their respective regional weekly surveillance data. Data managemers of EPHI – Compiling all regional surveillance data. All national PHEM officer – for their close follow-up and sharing updates.


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