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Somalia Health updates 2012/2013

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  • #16
    Re: Somalia Health updates 2012

    Somalia Emergency Weekly Health Update
    Reporting dates 2 - 8 June 2012
    (reflecting Epidemiological week 22)
    ...

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    Twitter: @RonanKelly13
    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

    Comment


    • #17
      Re: Somalia Health updates 2012

      Somalia Emergency Weekly Health Update

      Reporting dates 9 - 15 June 2012
      (reflecting Epidemiological week 23)

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      Twitter: @RonanKelly13
      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

      Comment


      • #18
        Re: Somalia Health updates 2012

        Somalia Emergency Weekly Health Update

        Reporting dates 16 - 29 June 2012
        (reflecting Epidemiological week 24 and 25)

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        Somaliland did not report for weeks 24 and 25.

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        Twitter: @RonanKelly13
        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

        Comment


        • #19
          Re: Somalia Health updates 2012

          Somalia Emergency Weekly Health Update
          Reporting dates 14 - 20 July 2012
          (reflecting Epidemiological week 28)

          SITUATION OVERVIEW:
          During week 28, the leading causes of morbidity across the zones were suspected measles for Central Somalia (1.5%), confirmed malaria for Southern Somalia (2.7%), suspected shigellosis for Somaliland (0.3%) and suspected cholera for Puntland (0.4%). General caseload has remained relatively stable across all the 4 with Central reporting a total of 8488 consultations from 25 sentinel sites; Southern 5981 from 36 sites; North West zone (Puntland) 5124 from 45 sites; and North East zone (Somaliland) 3953 from 54 sites. These compare to last week except for Central which only 41% of sentinel sites reported on time.

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          Most of the confirmed malaria cases in Southern Somalia were reported from Lower Jubba and Bay regions, which accounted for 49% and 32% of all reported cases respectively in Southern Somalia. Afmadow and Kismayo districts accounted for 33% and 29% of cases reported from Lower Jubba. Mapping of the availability of rapid diagnostic tests and supplies for malaria treatment is ongoing.
          Confirmed cholera cases were reported by partners in Lower Jubba; 6 of 10 cases tested positive for cholera using rapid diagnostic test. The situation was responded to immediately and controlled through case management. It has not been possible to implement water chlorination in the area pending clearance by local health authorities. Active case detection and referral is ongoing. The increased number of cases was localized and although under control, the risk for an outbreak remains. Adequate supplies have been made available for partners to access. Kismayo General Hospital reported only 3 cases under the age of 5 years of suspected cholera compared to 15 in
          week 27. WHO, UNICEF and partners remain on high alert for any unusual number of cases.

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          The observed reduction in the overall health facility caseload is because over 50% of the health facilities did not report on time. This may be attributed to the participation of some of the health workers and the CSR team in various
          training activities during the week. However the proportional morbidity for suspected measles cases increased almost threefold despite the fewer reporting facilities. The increase was observed in Mogadishu/Banadir region
          where there was a 40% increase in the number of reported cases compared to week 27 despite fewer reporting sites. Mogadishu is still receiving internally displaced people from areas that have not received any vaccination over
          the past two years such as from Lower and Middle Shabelle, Lower and Middle Jubba and Bay regions. Although vaccination activities have been done in Mogadishu, the continued population influx and overcrowding in informal
          settlements provides amble conditions for the continued existence of cases and the risk of outbreaks.

          SOMALILAND
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          Suspected cholera cases were reported during week 28 from Lascanod district, Sool region. Details of these cases
          are still pending but the situation is reportedly stable. The Ministry of Health, WHO and partners in Somaliland have
          adequate capacity to launch response activities if needed.
          The number of suspected shigellosis is reducing. The health workers’ adherence to the recommended case
          definitions remains a challenge. Cases were reported from Baki (3), Borama (4) districts in Awdal region; and Sheikh
          district (2) in Togdheer region. Trainings on case definitions will be conducted after Ramadan.

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          Bari and Nugaal regions accounted for 30% and 29% of all suspected cholera cases in Puntland. There has been a
          steady reduction in the number of reported cases. Preventive activities are ongoing with partners undertaking
          chlorination and health education activities. Adequate case management supplies are on ground.
          ...
          Twitter: @RonanKelly13
          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

          Comment


          • #20
            Re: Somalia Health updates 2012

            Somalia Emergency Weekly Health Update
            Reporting dates 21 - 27 July 2012
            (reflecting Epidemiological week 29)
            ...
            SITUATION OVERVIEW:
            During week 29, the leading causes of morbidity across the zones were confirmed malaria for Southern Somalia
            (1.8%) and Central Somalia (1.9%), suspected shigellosis for Somaliland (1.0%) and suspected measles for
            Puntland (0.6%). An unknown illness was reported from Qol village (Nugaal region) in northeastern Somalia with
            patients presenting with diarrhea and vomiting. A Ministry of Health (MoH) team verified 47 people affected of which
            8 were hospitalized at Dhahar Hospital where they were treated with intravenous fluids and antibiotics. All patients
            recovered. The source and cause of illness was suggested to be contaminated milk. There are no more cases.

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            The leading cause of morbidity in Southern Somalia was also confirmed malaria; Lower Jubba region accounted for
            51% of all reported cases and Kismayo accounted 44% of these. Partners have reported lack of rapid diagnostic
            tests, an issue that is being sorted.
            The number of reported suspected cholera cases continues to decline and there were no alerts for suspected
            cholera during the week. Of the cases reported from Southern Somalia, 89% were reported from Lower Jubba.
            Knowing that the area is facing violence and fighting with the opposing forces, health partners are on high alert for
            cases in the zone.
            Suspected measles and whooping cough are a concern given the denied access for interventions that provide
            vaccination. The proportion of children aged less than five years with suspected pertussis is increasing making the
            risk of whooping cough-related death greater. Of 20 districts in Southern Somalia, 14 reported at least 1 case of
            suspected measles (median 2.5 cases).
            Suspected shigellosis cases continue to be reported from health facilities but verification indicated non-adherence
            to the recommended case definitions at most. Classification is largely based on history of blood in stool rather than
            visible blood in stool.
            Comprehensive trainings for health staff have just been completed in both Central and Southern Somalia and it is
            expected that application of case definitions will improve for all conditions.
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            The leading cause of morbidity for Central Somalia continues to be confirmed malaria. Over the past weeks
            awareness of use and subsequent access to rapid diagnostic tests has been the focus of the health cluster and
            partners. This is expected to regulate the number of reported cases as increase in adherence to the recommended
            case definition is expected. Banadir region accounted for 76% of the reported cases of which Wadajir district alone
            accounted for 59% while Madina district accounted for 18% of the total cases. These districts are densely populated,
            mainly inhabited by internally displaced persons (IDPs) living in makeshift shelters that may not have been part of
            those targeted for indoor residual spraying (IRS). These shelters are not suitable for IRS as they are too small to
            ensure adequate distribution of the residue.
            Despite a 4% reduction in the overall caseload, suspected cholera was the second leading cause of morbidity and
            proportional morbidity compared to the previous week. Banadir region alone accounted for 98% (157) of the reported
            cases followed by Wadajir and Huruwaa districts. The two districts are home to thousands of IDPs with limited
            access to safe drinking water and poor sanitation. The cholera awareness activities are ongoing but all interventions
            to ensure acceptable access to adequate water quantity and quality are still weak.
            Measles remains a problem across Central Somalia, which is characterized by non-functioning routine vaccination
            programs, population displacement and general low vaccination coverage. Banadir region accounted for 84% (109)
            of all reported cases in Central Somalia, with Huruwaa district alone reporting 62% (80) of all reported cases for
            Banadir region. Children are especially affected with 90% of the cases this week being less than 5 years old; the
            population who need to be targeted for vaccination.

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            There were 36 reported suspected shigellosis cases reported in Somaliland, which is triple the proportional morbidity
            and cases reported in week 28 after declines since week 26. The cases were reported from 9 of the 21 reporting
            districts and 5 of these 9 districts did not report any cases in week 28. Five districts reported 23 cases in week 27;
            hence the trend is showing a geographical spread of suspected shigellosis cases. Investigations are ongoing and the
            MoH, WHO and partners in Somaliland have adequate response capacity if need arises. After weeks of no reported
            cases of suspected pertussis, one case was reported for week 29.

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            One suspected shigellosis case was reported in week 29, indicating a sustained decline in reported cases for three
            consecutive weeks. Prevention activities, mainly water chlorination and health education are ongoing. There was a
            surge in reported suspected measles cases, with 16 cases (55.2%) reported in Galkacyo district and 9 cases
            (31.0%) reported in Eyl district. There have been no suspected measles cases reported in Galkacyo in the previous
            two weeks. Feedback on investigation is still awaited. The majority of cases are in children aged less than 5 years as
            seen in weeks 26 and 27.

            ...
            Twitter: @RonanKelly13
            The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

            Comment


            • #21
              Re: Somalia Health updates 2012

              Somalia Emergency Weekly Health Update
              Reporting dates 28 July – 3 August 2012
              (reflecting Epidemiological week 30)

              ...
              SITUATION OVERVIEW:
              The number of suspected cholera cases is expected to remain relatively stable with the rains having reduced across
              Somalia. Health facility visits are observed to have remained stable in most regions.This particular trend is expected
              to be sustained over the next coming weeks.
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              Continued decline in reported suspected cholera cases have been observed in South Zone where the number of
              reported cases and the proportional morbidity have declined possibly due to an end of the rainy season along with
              prevention activities. While the number of reported suspected shigellosis cases is higher, the trend is similar to
              that of suspected cholera cases. However the trend in suspected whooping cough cases raises concerns while
              suspected measles cases remain stable. Immunization coverage in the South Zone is low due to reduced access
              and insecurity. Sixty percent of all confirmed malaria cases were reported from three districts namely Afgooye,
              Baidoa and Kismayo. The reasons for the increase in reported confirmed malaria cases and proportional morbidity
              are being investigated. In comparison to the month of June, in July the number of reported cases for suspected
              cholera decreased by 84%, suspected measles by 6% and confirmed malaria by 45% (see chart below).
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              There was a 6.8% increase observed in reported suspected cholera cases in Central Zone, but a decrease seen
              among children under the age of five. Adherence to surveillance case definition still remains a challenge. About
              98.8% of the cases were reported from Banadir region which is densely populated with the internally displaced
              persons (IDPs) moving into Mogadishu. Suspected shigellosis cases were reported from 11 of the 36 districts in
              the Central Zone. High numbers of suspected measles cases continue to be reported. Huruwaa district in Banadir
              region reported 67.8% of suspected shigellosis cases and suspected measles cases in week 30. Confirmed
              malaria cases among children under the age of five increased in week 30 after steady decline since week 26.
              Wadajir District accounted for 60% of the confirmed malaria cases reported in the zone. Central Zone continues to
              report neonatal cases mainly from Wadajir district where the three cases were reported. This district has reported
              at least one case since week 16, which may point to the low immunization coverage, poor cord care practices or
              poor application of the case definition. In comparison to the month of June, in July the number of reported cases for
              suspected cholera decreased by 38% and confirmed malaria by 15%. Suspected measles cases increased by 38%
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              Somaliland reported cases of suspected shigellosis and suspected measles. Sixty-four percent of the suspected
              shigellosis cases were reported from Borama Hospital in Borama District (seven cases after at least 6 weeks without
              a reported case). Follow up of these cases is been undertaken. No suspected cholera cases have been reported for
              two consecutive weeks, attributable to the success of the prevention campaign including hygiene promotion and
              water chlorination that was undertaken by the Ministry of Health and health cluster partners.

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              Reported cases of suspected cholera and suspected shigellosis have reduced. In week 30, only five suspected
              cholera cases were reported from districts of Galdogob and Galkacyo. This reduction in cases is possibly attributed
              to ongoing capacity building of health workers in communicable disease surveillance and response.
              ...
              Twitter: @RonanKelly13
              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

              Comment


              • #22
                Re: Somalia Health updates 2012

                Somalia Emergency Weekly Health Update
                Reporting dates 4-10 August 2012
                (reflecting Epidemiological week 31)

                BULLETIN HIGHLIGHTS Reporting
                • In week 31, Bakool region in Central Somalia, reported a significant increase in reported suspected
                measles cases as compared to previous week. Eighteen of the 23 cases were reported from a single
                facility. Investigations are ongoing to establish if it is an outbreak.

                SITUATION OVERVIEW:
                Suspected cholera cases are seen to be declining except in the region of Banadir where there is concentration of
                internally displaced persons (IDP) resulting to overcrowding, as well as poor water and sanitation conditions. People
                are moving to the Mogadishu area due to security and economic issues. However, no new outbreaks have been
                reported. Trends in suspected whooping cough cases have stabilized at high levels in both the Southern and
                Central Zones with caseloads higher in the Southern regions. This is possibly due to lack of access to routine
                immunization services especially due to insecurity particularly in the South.
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                Reported suspected cholera, suspected measles and suspected shigellosis cases increased in week 31, following a
                decrease in the previous week. Eleven suspected cholera cases were reported from Lower Jubba region, with 7 of
                these cases being reported from Kismayo district where cases had generally declined in recent weeks. In Gedo
                region, two suspected cholera cases were also reported for the first time in nine weeks. In Bakool region,
                suspected measles cases almost doubled between weeks 30 and 31, from 12 to 23 cases respectively. Eighteen
                of the 23 cases were reported from a single facility and investigations are ongoing to establish if it is an outbreak. In
                the other regions the trend remained relatively stable. Suspected whooping cough continues at an unacceptably
                high case count and proportional morbidity for three weeks in a row. Majority of the cases (96.6%) were reported
                from Bakool and Bay regions. No deaths have been reported this year from the zone.

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                After receiving retrospective updates for weeks 29 and 30 to complete the number of reports, there appear to be an
                increase in the reported suspected cholera cases although the proportional morbidity has remained between 1%
                and 1.2% in the last four weeks. No cases have been reported in Galgadud region since week 27 while in Middle
                Shabelle region, cases were last reported in week 17. The reported cases are concentrated in the Banadir region
                which accounted for 96.6% of reported cases in week 31. Within Banadir region, cases were reported in 4 districts
                namely Abdiaziz, Hodan, Waberi and Wadajir. Wadajir district accounted for 91.9% of the reported cases in the
                region, while two cases were reported in Abdiaziz district that had not reported any suspected cholera since the
                beginning of the year. The CSR zonal and regional teams are investigating the cases reported in the district.
                Huriwaa district continues to report most the suspected measles cases accounting for 54.8% of reported cases
                from Central Zone, attributable to the low immunization coverage in the district. People from other regions where
                vaccination has been banned continue to move to Mogadishu. This is also seen with the continued cases of
                suspected whooping cough in all regions with the highest caseload reported from Lower Shabelle region. Neonatal
                tetanus cases continue to be reported in Banadir region. This trend of both diseases is an indication of the low
                immunity levels among the populations due to limited routine immunization services available to pregnant women
                and children. WHO Somalia and partners are supporting immunization outreach activities all the districts of
                Mogadishu.
                Confirmed malaria cases and the proportional morbidity have stabilized although still at high levels. There is
                adequate availability of rapid diagnostic test (RDT) kits and Artemisinin-based Combination Therapy (ACTs) after
                shortages in some facilities was addressed. Recommended is the need for continued monitoring and strengthening
                of the supply management systems to avoid any future stock-outs. In Banadir region, confirmed malaria cases have
                consistently increased since week 29. During week 31, 11 out of the 61 health facilities reported at least one case
                of confirmed malaria. 88.3% of cases were reported from five of those facilities. Since week 24, all reported
                suspected shigellosis cases have been reported from one facility with no clear trend.

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                No suspected cholera cases have been reported since week 29. The trends in suspected measles and shigellosis
                cases including the proportional morbidity have remained stable. Togdheer Region reported 4 suspected measles
                cases from two facilities which had not reported a single case since weeks 18 and 26. This region had no reports of
                any suspected measles cases for two consecutive weeks. Suspected shigellosis cases continue to be reported in
                all regions except Togdheer and Sanaag regions. However, the trend is stable. No confirmed malaria cases have
                been reported since week 26. One neonatal tetanus case has been reported in Maroodijeh region, the first such
                case to be reported in Somaliland since the beginning of the 2012.

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                Two suspected cholera cases were reported from Mudug and Sanaag regions, which has shown a declining trend
                since week 26. The regions of Bari, Mudug and Sool reported a total of seven suspected measles cases. Since
                week 24 when one case was reported in Bari region, no suspected measles case had been reported since. In
                Mudug region, suspected measles cases have declined, while a case was reported in Sool region after four weeks
                of no cases reported.
                ...
                Twitter: @RonanKelly13
                The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                Comment


                • #23
                  Re: Somalia Health updates 2012

                  Somalia Emergency Weekly Health Update
                  Reporting dates 18-24 August 2012
                  (reflecting Epidemiological week 33)

                  BULLETIN HIGHLIGHTS
                  • Banadir and Lower Shabelle regions reported a total of 25 suspected shigellosis cases, with 84% (21
                  out of the 25 reported cases) located in Banadir region alone. Since week 23, all suspected shigellosis
                  cases reported in Banadir region are located in one health facility; however this is being investigated as
                  concerns were expressed about the adherence to the recommended case definition.

                  ...
                  SITUATION OVERVIEW:
                  Suspected measles, confirmed malaria, suspected shigellosis and suspected cholera cases continue to be reported
                  across Somalia. Adherence to the recommended case definitions for health events under surveillance remains a
                  challenge, especially for suspected cholera and suspected shigellosis. In collaboration with the Ministries of Health
                  and health partners, targeted trainings for health workers in sentinel sites are ongoing as part of the capacity building
                  activities for the communicable diseases surveillance program. These aim to improve the adherence of the health
                  workers to the recommended case definitions, which is expected to improve disease specific data from health
                  facilities and case management. Current trends indicate a steady reduction in the number of health facility visits,
                  which has been observed in past years during August and stability is expected through October, when the next
                  seasonal changes will begin.

                  SOUTHERN SOMALIA
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                  The trend in suspected cholera, measles, shigellosis and whooping cough in Southern Somalia continues to
                  decline. While the proportional morbidity of suspected whooping cough cases declined from 1% to 0.7% between
                  weeks 30 and 33, for the other conditions it remained stable. Total consultations have consistently declined in the
                  past 3 weeks.

                  Suspected cholera cases continue to be reported in Afmadow, Jamaame and Kismayo districts of Lower Jubba
                  region. Confirmed malaria cases have been reported from all regions in Southern Somalia although most of the
                  cases are located in Lower Jubba and Bay regions. Lower Jubba region accounts for the highest number of reported
                  cases for all health events. The region is currently the epicenter of armed conflict between government and their
                  allies against the opposing forces. In addition, the region became also a transit area for refugees moving from the
                  upper regions fleeing towards the border area with Kenya.

                  CENTRAL SOMALIA
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                  A retrospective update of the data of week 32 has been carried out since the report from Banadir region was
                  missing. Looking at the updated data for Central Somalia, the trend in suspected cholera cases shows an
                  increase from weeks 29 to 32. A decline was observed during week 33, with a total of 162 suspected cholera cases
                  reported in three regions with Banadir region accounted for 95.7% of those cases. Compared to week 32, this means
                  a 36.7% decrease; however it is not clear yet if this will be the start of a steady decline.
                  Banadir and Lower Shabelle regions reported a total of 25 suspected shigellosis cases, with 84% (21 out of the 25
                  reported cases) located in Banadir region alone. Since week 23, all suspected shigellosis cases reported in Banadir
                  region are located in one health facility; however this is being investigated as concerns were expressed about the
                  adherence to the recommended case definition.
                  During week 33, nine out of the twenty health facilities that reported in week 33, reported at least 1 case of
                  confirmed malaria with 73.9% of cases reported in 3 facilities.
                  Suspected measles cases continue to be reported and are mainly concentrated in Banadir region (62% of all
                  reported cases in week 33) and Lower Shabelle region (35% of all reported cases in week 33). Plans are underway
                  to carry out Child Health Days activities in October 2012, providing essential vaccination and treatment to children
                  and women of childbearing age.
                  Cases of suspected tetanus continue to be reported. This is due to the fact that the IDP population, mainly
                  concentrated in Banadir region, comes from areas where limited or no immunization services are available,
                  especially in Lower Shabelle region. A follow up investigation is underway to gather more information regarding
                  these cases.

                  SOMALILAND

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                  Of all reported suspected measles cases during week 33, half of them were located in Burao Hospital. Back in June
                  2012, a measles outbreak was reported in Burao. As response, measles vaccination activities were undertaken.

                  PUNTLAND
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                  ...
                  Twitter: @RonanKelly13
                  The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                  Comment


                  • #24
                    Re: Somalia Health updates 2012

                    Somalia Emergency Weekly Health Update
                    Reporting dates 6-12 October 2012
                    (reflecting Epidemiological week 40)

                    for whatever reason, the PDF is hard to copy - has format problems, but is available to view here; http://reliefweb.int/sites/reliefweb...tober_2012.pdf

                    Bulletin Highlights
                    Following the recent confirmation of three vaccine-derived poliovirus type 2 (cVDPV2) cases in the refugee camps in Dadaab, Kenya and one cVDPVs case in Kismayo, South Central Somalia, an immunization response is currently being planned.
                    ...
                    SOUTHERN SOMALIA
                    Confirmed malaria was the leading cause of morbidity, having increased its caseload by 17% compared to week
                    39. Lower Jubba and Bay regions accounted for 48% and 30% of all reported cases.

                    Cases of suspected shigellosis continue to be reported. A suspected outbreak with 12 cases including 11 children under the age of five is being investigated in Qooqani village, which is located about 65km from Afmadow town.
                    Samples collection kits are available on the ground and WHO and health partners are conducting case based
                    surveillance to collect samples for laboratory confirmation.

                    Trends of reported suspected measles cases have remained stable. No vaccination activities have been conducted
                    in the region in the past two years.

                    CENTRAL SOMALIA
                    Cases of reported suspected cholera remained stable for week 40. However, as part of the pre-season random
                    check for cholera, samples were collected from two sentinel sites and referred to a laboratory for confirmation. This
                    exercise is being conducted due to the confirmed cholera cases in Lower Jubba region. In addition, observed
                    population movements out of and into Mogadishu, which remains densely populated with variable access to safe
                    drinking water, sanitation and water safety interventions, is one of the risk factors for a potential outbreak.

                    Suspected shigellosis and suspected measles cases continue to be reported as well. Follow up investigations are
                    being made to ascertain the status of the reported cases and if they all fulfill to the recommended case definitions so
                    that samples can be collected.

                    Confirmed malaria is the leading cause of morbidity with Banadir region accounting for 83% (186) of the cases.

                    SOMALILAND
                    Trends for events under surveillance remained stable compared to the previous two weeks.

                    PUNTLAND
                    The investigation team has finally carried out case investigation, and confirmed that the reported malaria case on
                    week 38 was false positive. Other more false positive cases from Darasalam and the other MCH were also
                    identified by the investigating team. Trends for events under surveillance remained stable compared to the previous
                    two weeks.
                    ...
                    Twitter: @RonanKelly13
                    The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                    Comment


                    • #25
                      Re: Somalia Health updates 2012

                      Somalia Emergency Weekly Health Update
                      Reporting December 2012 - Epidemiological weeks 49 – 52

                      ...
                      Ten alerts of suspected cholera were reported, eight in Lower Jubba and two in Bay
                      Lower Jubba - Eight alerts were reported by partners in Hido, Jedecaley, Jaaro, Diidadey, Dhobley,
                      Kulbio, Durow and Gora. A total of 241 cases were reported, mainly children under the age of five, with
                      three-related deaths (Case Fatality Rate: 1.2). Of these cases, 200 were treated as out-patients while 39
                      required in-patient treatment. Results of the verification of cases and deaths are still pending.
                      Bay region - Two alerts were verified and 13 cases and four-related deaths (including one adult) were
                      registered. It was concluded that the affected victims developed diarrhea after consuming contaminated
                      camel milk. The situation is back to normal.

                      Malaria: outbreak declared in Bossaso
                      An outbreak of confirmed malaria in Bossaso district (Bari region) was declared by health authorities,
                      following an observed increase in cases attended to at private health facilities. The authorities requested
                      the coordination of response activities and evaluation of impact integrating all data from both private and
                      public health facilities. Outbreak investigation is currently ongoing. In the last week of December, 119
                      malaria cases were confirmed by Rapid-Diagnostic Testing (RDT).

                      ...
                      SOUTHERN SOMALIA
                      In the month of December, from weeks 49 to 52, four
                      cases of suspected cholera were reported from the
                      36 sentinel sites in southern zone. This represents a
                      73.3% decrease compared to the month of
                      November, when 15 cases of suspected cholera were
                      reported, mainly in weeks 45 and 48. Over the past 4
                      months, adherence to the recommended case
                      definition for suspected cholera has improved
                      significantly among partners working in the Southern
                      zone. Trainings on revised reporting tools for 2013
                      are planned, with the objective to cover case
                      definitions and the monitoring and evaluation
                      component of the program, and to ensure at least
                      one visit to each sentinel site per month (where and
                      when access is possible).

                      During the same period, 69 cases of suspected
                      measles
                      were reported, showing a slight decrease
                      compared to the 61 cases reported during the month
                      of November (weeks 45-48).
                      A 23 % increase in the reported confirmed malaria
                      cases was observed. About 682 cases were reported
                      in December compared to 526 cases reported during
                      November.

                      Cases of suspected shigellosis continue to be
                      reported and all verifications indicate non-adherence
                      to the recommended case definition for suspected
                      shigellosis, which is: “visible blood in stool”. This is
                      expected to improve following the weekly feedback
                      as part of the weekly monitoring and evaluation
                      protocol and through the planned trainings of health
                      workers.
                      ...
                      CENTRAL SOMALIA
                      In central zone, a 19.5% increase of suspected cholera
                      cases was observed during the month of December
                      (weeks 49 to 52) with a total of 657 cases reported
                      compared to 529 cases reported in the month of
                      November. In the reporting month, Banadir region alone
                      accounted for 94.2% (619) of all the reported cases with
                      majority reported from Banadir hospital. While there were
                      cases meeting the recommended case definition for
                      suspected cholera, most did not. All diarrhea cases are
                      still being reported as suspected cholera. Some
                      improvement in adherence to case definition among
                      health workers and partners working in central zone has
                      been observed, but in Banadir region this still remains a
                      challenge.

                      There were 317 cases of suspected measles reported
                      in December, which compares to 314 cases reported in
                      November. Mogadishu still receives IDPs from areas
                      that have had no access to vaccination interventions,
                      hosting thousands in makeshift and overcrowded
                      settlements, which provide for easy transmission. A
                      significant proportion of this population is reported to be
                      malnourished. Measles cases are expected to continue
                      to be reported. Plans for a number of vaccination
                      interventions are underway by to prevent cases and
                      deaths.

                      From week 49-52, central zone reported a total of
                      1758 confirmed malaria cases, which accounted for a
                      25% increase compared to November where 1317 confirmed malaria cases were reported. In
                      Mogadishu, Ministry of Health (MOH), WHO and partners for the National Malaria Control Programme
                      conducted an Insecticide-Residual Spraying (IRS) campaign at the internally displaced persons (IDPs)
                      settlements, covering 51,000 households. This is expected to protect an estimated 300,000 population
                      from malaria infection over the coming months.

                      Like southern zone, case of suspected shigellosis continues to be reported and verification reveals poor
                      adherence to the recommended case definition.
                      ...
                      SOMALILAND
                      There were no reported cases of suspected cholera
                      reported in December from the 54 health sentinel
                      sites in Somaliland.

                      From week 49-52, Somaliland reported a total of 54
                      suspected measles cases, which accounted for a
                      70.3% increase compared to cases reported in
                      November (weeks 45-48) in which 16 cases were
                      registered. The cases were reported from
                      Maroodijeh, Sahil, Togdheer and Sanag regions.
                      Maroodijeh alone accounted for over 50% of all the
                      cases.

                      In December, 6 cases of confirmed malaria were
                      reported in Somaliland compared to 2 cases which
                      were reported in the previous month.
                      ...
                      PUNTLAND
                      During week 52, two confirmed malaria cases (both
                      above the age of five) were reported in Bossaso district,
                      Bari region. One case was from Bossaso hospital and the
                      other case was reported from Bossaso mother and child
                      health center (MCH). MOH has since declared an outbreak
                      of malaria in the district. Sentinel sites are not reporting
                      these cases (outbreak). A total of 119 malaria cases were
                      confirmed by RDT in the last week of December (see
                      graph below) majority reported from private health facilities
                      (see below graph on trends in the month of December).
                      ...
                      Twitter: @RonanKelly13
                      The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                      Comment


                      • #26
                        Re: Somalia Health updates 2012/2013

                        Somalia Emergency Weekly Health Update
                        HIGHLIGHTS
                        Reporting January 2013 - Epidemiological weeks 1-3
                         DENGUE FEVER 23 cases of Dengue fever reported from Mogadishu
                         MALARIA 410 cases detected in Bossaso outbreak
                         ACUTE FLACCID Three cases reported in Berbera and Wardighley districts
                        PARALYSIS

                        23 cases of Dengue fever reported from Mogadishu
                        Mogadishu – Twenty three (61%) of 28 serum samples collected from patients at health facilities in
                        Mogadishu have tested positive for dengue fever. In recent weeks, dengue infections have also been
                        reported among AMISOM troops in Mogadishu. Blood samples that were collected in Mogadishu in the
                        previous years had a 30-38% dengue positivity rate, calling for interventions related to dengue control in
                        Mogadishu and other parts of Somalia. Follow-up of past patients that have since been traced, indicate
                        that they had improved. Results of an entomological survey conducted in Mogadishu at the end of 2011
                        showed that 19% of the adult mosquito and over 18% of the larvae populations collected were Aedes
                        aegypti, the carrier for dengue virus, as well as Chikungunya and yellow fever viruses.

                        Ongoing response to malaria outbreak in Bossaso
                        Response to the outbreak of malaria in Bossaso (Puntland) is ongoing. Since the beginning of the
                        outbreak in December 2012, 410 cases have been reported including 61 (15%) children under the age of
                        five. Mixed Plasmodium falciparum and P. vivax infections accounted for 67% of the cases, while the
                        remaining 33% had single infection with P. falciparum. No single infection case with P. vivax alone has
                        been detected. Health authorities and partners continue to respond and undertake preventive measures.

                        Alert for Acute Flaccid Paralysis (AFP) cases reported in two districts
                        In the reporting weeks, two cases of AFP were reported from Berbera district and another in Wardhigley
                        district. Stool samples were collected by and referred for further investigation.
                        Meanwhile, vaccination campaigns continue in newly accessible areas of Southern and Central Somalia.
                        From 14 to 16 January 2013, Health Authorities, UNICEF and WHO conducted a second round of polio
                        vaccination in urban areas of Kismayo district in Lower Jubba region. Over 17 000 children under the age
                        of five were reached. However, 30% of the children in rural areas of Kismayo still remain inaccessible.
                        ...
                        SUSPECTED CHOLERA
                        Central Somalia accounted for 98% of the
                        suspected cholera cases reported from weeks1-3,
                        i.e. 358 out of 366 cases reported. Majority of the
                        cases were from Banadir region.
                        Poor adherence to the recommended case
                        definition for suspected cholera has been
                        observed. On-the-job training during weekly and
                        monthly visits to the sentinel sites is planned to
                        improve case detection and data quality.
                        In week 1-3, seven rumors of outbreak of
                        suspected cholera were reported in Lower Jubba region. WHO and partners collected stool samples of
                        the cases from affected villages of Jedecaley and Kulbio for verification. All samples tested negative for
                        any enteric bacterial infection including shigella and salmonella. Following response activities by
                        partners the situation is under control and stable. The Lower Jubba region remains a high risk area for
                        cholera and other water-borne disease outbreaks and access is still a challenge.
                        In Galgaduud region, the cholera situation has remained stable and partners on the ground have
                        ongoing preventive and control activities. Adequate water and sanitation supplies have been provided
                        by UNICEF and case management supplies were provided by WHO. Adequate stocks are available in
                        the event of a potential outbreak.

                        SUSPECTED MEASLES
                        With low vaccination coverage and poor access to
                        vulnerable populations across Somalia, especially
                        in Southern and Central Somalia, suspected
                        measles remains a challenge. Central zone
                        reported 64% of the 366 suspected measles
                        cases: Somaliland 22%; Southern 13% and
                        Puntland 1%.
                        Suspected measles cases continue to be reported
                        across Somalia. Four alerts were reported from
                        Lower Jubba region and Somaliland. Response
                        activities are ongoing in collaboration with the
                        health authorities.

                        CONFIRMED MALARIA
                        Confirmed malaria was the leading cause of
                        morbidity for the 3 week reporting period, with over
                        2000 cases reported from sentinel sites across
                        Somalia. Central and Southern zones reported
                        63% and 33% of all cases respectively.
                        Following the malaria outbreak in Bossaso
                        declared by the health authorities on 29 December
                        2012, a joint team, composed by Health
                        Authorities, UNICEF and WHO, has initiated
                        response activities. A total of 410 confirmed
                        malaria cases, including 61 children under the age
                        of five, have been recorded in the past seven
                        weeks (see Confirmed Malaria Trend graph).
                        Provision of supplies include rapid diagnostic
                        testing kits and Artemisinin Combination Therapies
                        (ACTs) to health facilities, training of both public
                        and private health facility workers, distribution of
                        malaria treatment guidelines and long-lasting
                        insecticide treated nets. Outreach initiatives
                        including social mobilization will continue.

                        OTHER HEALTH EVENTS
                        All zones except Puntland continue to report cases of suspected shigellosis. Although this have been
                        decreasing gradually, adherence to the recommended case definition for shigellosis of visible blood
                        remains a challenge. On-the-job trainings are being conducted to improve this. Central Somalia reported
                        145 (65%) of the 223 cases, while Southern Somalia and Somaliland reported 69 (31%) and 9 (4%)
                        cases respectively.
                        An alert on 25 cases of suspected neonatal tetanus had been reported from one zone. Subsequent
                        verifications proved that the reported cases were a data entry error.
                        Alerts on suspected diphtheria have been reported from Galinsoor district in Galgaduud region. Sample
                        collection for further investigation is currently being initiated.
                        Whooping cough control continues to remain a challenge.
                        ...
                        Twitter: @RonanKelly13
                        The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                        Comment


                        • #27
                          Re: Somalia Health updates 2012/2013

                          Somalia Emergency Weekly Health Update

                          Reporting 21-27 January 2013 - Epidemiological week 4

                          Response plan following reports of cases of Dengue fever in Mogadishu
                          Following the detection of 28 cases of Dengue Fever in Mogadishu, the World Health Organization
                          (WHO) has taken immediate action to integrate vector control of Aedes aegypti in the malaria elimination
                          programme. Dengue fever is a flu-like illness, transmitted to humans primarily through Aedes aegypti
                          mosquito, which is a day biter. Dengue fever should be suspected when a sudden onset of fever (above
                          38°C) is accompanied by two of the following symptoms: severe headache, pain behind the eyes, muscle
                          and joint pains, measles-like rash. Complicated cases develop bleeding from eyes, nose, mouth, birth
                          canal, anus or any opening.
                          WHO urges health workers to report any case that meets the above description to WHO staff, when
                          diagnosis of malaria or any other sever disease has been excluded by Rapid Diagnostic Testing (RDT) or
                          microscopy testing.

                          Ongoing response to malaria outbreak in Bossaso
                          Health authorities and partners continue to respond and undertake preventive measures. A total of 1227
                          confirmed cases of malaria have been reported since 2 December 2012, including 171 (14%) children
                          under the age of five and four-related deaths. Mixed Plasmodium falciparum and Ovale infections account
                          for the majority of the cases reported.

                          Disease alerts
                          Alerts for suspected measles have been reported in parts of Bay and Bakool regions, where health
                          partners have reported more than 47 cases, including 31 (66%) children under the age of five.

                          Virology results are still pending for the Acute Flaccid Paralysis (AFP) cases reported in the first three
                          weeks from Berbera district in Somaliland and Wardhigley in Mogadishu.

                          An alert for suspected diphtheria from Galinsor (Galgadud region) was verified. Samples collected from
                          two cases are under further investigation.

                          EPIDEMIOLOGICAL SURVEILLANCE (EPI WEEK 4, 21 – 27 January 2013)
                          During the reporting week, more than 29 000 health facility visits were reported, including over 44%
                          children under the age of five. Central Somalia accounted for over 58% of the reported visits, Southern
                          Somalia 23% and Somaliland and Puntland accounted for 18%. Confirmed malaria was the leading cause
                          of disease. The number of reported suspected cholera increased by over 50%, with a majority of the
                          cases reported from Banadir region of Central Somalia.

                          TIMELY REPORTING
                          In week 4, the 45 health sentinel sites in Puntland and the 36 sites in Southern Somalia currently
                          reporting to the Communicable disease Surveillance and Response (CSR) network reported timely. In
                          Central Somalia 98% (60 out of the 61) reported on time. No data was received from Somaliland due to
                          technical reasons.

                          SUSPECTED CHOLERA
                          Central Somalia accounted for nearly all of the
                          suspected cholera cases reported in week 4, i.e.
                          139 out of 140 cases reported. All the suspected
                          cases were reported from Banadir region.
                          Poor adherence to the recommended case
                          definition for suspected cholera1 has been
                          observed, since 67% of the reported cases are
                          children under the age of two. On-the-job training
                          during weekly and monthly visits to the sentinel
                          sites is planned to improve case detection and
                          data quality. Following an observed increase since
                          the previous week, WHO teams collected stool
                          samples from three facilities in the region. Results are still pending.

                          SUSPECTED MEASLES
                          With low vaccination coverage and poor access to vulnerable populations across Somalia, especially in Southern and Central Somalia, suspected measles remains a challenge. In week 4, Central Somalia reported 76% of the 115 suspected measles cases, while Southern Somalia reported 14% and Puntland 10%.
                          In collaboration with the Health Authorities, partners are undertaking response activities.

                          CONFIRMED MALARIA
                          Confirmed malaria was the leading cause of morbidity during week 4, with 679 cases reported from sentinel sites across Somalia. Central and Southern Somalia reported 55% and 34% of all cases respectively.
                          Puntland reported 75 (11%) of the cases, mainly from Bossaso district, where response activities to a malaria outbreak are ongoing. With active case finding, the number of reported malaria cases has increased by 69% in the affected areas.

                          OTHER HEALTH EVENTS
                          During week 4, Central and Southern Somalia reported cases of suspected shigellosis. Although this have been decreasing gradually, adherence to the recommended case definition for shigellosis of visible blood remains a challenge. On-the-job trainings are being conducted to improve adherence to case definition. Central Somalia reported 59 (69%) of the 85 cases, while Southern Somalia reported 26 (30%) cases.

                          Whooping cough control continues to remain a challenge. In the reporting week, 48 cases of suspected whooping cough were reported from Central and Southern Somalia. Parts of these areas have issues of insecurity and inaccessibility for vaccination interventions to be undertaken.

                          Suspected neonatal tetanus has been reported in Central Somalia. Verifications need to be undertaken to confirm tetanus but tracking these patients in the past has remained a major challenge. Prevention needs to be strengthened through vaccination activities among pregnant women and clean delivery methods
                          ...
                          Twitter: @RonanKelly13
                          The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                          Comment


                          • #28
                            Re: Somalia Health updates 2012/2013

                            Somalia Emergency Weekly Health Update
                            Reporting 28 January to 3 February 2013 - Epidemiological week 5

                            Seven cholera cases detected in Mogadishu
                            In week 5 seven cholera cases were confirmed in Mogadishu. Samples of suspected cases were
                            collected in Banadir hospital, and in Hodan’s and Ceel Gaab’s Cholera Treatment Centres (CTC). Six of
                            the eight stool samples from Hodan CTC and one of the 15 samples from Banadir Hospital tested positive
                            for Vibrio cholera, serotype ‘Inaba’. The five samples collected from Ceel Gaab CTC were negative. High
                            positive rates, like in Hodan CTC, are expected among admissions, when the case definition is followed.
                            Since December 2012, the number of admissions to Hodan facility related to cholera has remained
                            stable, with an average of 69 cases per week and no related deaths.
                            Bio-surveillance for cholera has begun in preparation for the Gu rains (end of March to beginning of April),
                            which marks the beginning of the first annual cholera transmission season in Somalia.

                            Ongoing response to malaria outbreak in Bossaso
                            The number of confirmed malaria cases detected in Bossaso remains stable compared to previous
                            weeks. Health authorities and partners are planning to initiate response activities, such as Insecticide-
                            Residual Spraying (IRS) campaigns and community social mobilization. A total of 1137 cases of malaria
                            have been reported since 2 December 2012, including 14% children under the age of five and two-related
                            deaths (Case Fatality Rate: 0.18). Mixed Plasmodium falciparum and Ovale infections account for about
                            67% of the cases, while Falciparum accounts for 33%. Three locations reported over 98% of all cases,
                            i.e. Biyo Kulule (41.2%), New Bossaso (31.2%) and Baalade (26.1%).

                            Dengue Fever
                            Following the detection of cases of Dengue Fever in Mogadishu, WHO urges health workers to report any
                            case, presenting the symptoms described below, to WHO staff, when diagnosis of malaria or any other
                            severe disease has been excluded by Rapid Diagnostic Testing (RDT) or microscopy testing.
                            Dengue fever is a flu-like illness, transmitted to humans primarily through Aedes aegypti mosquito, which
                            is a day biter. Dengue fever should be suspected when a sudden onset of fever (above 38°C) is
                            accompanied by two of the following symptoms: severe headache, pain behind the eyes, muscle and joint
                            pains, measles-like rash. Complicated cases develop bleeding from eyes, nose, mouth, birth canal, anus
                            or any opening.

                            Disease alerts
                            Alerts of 47 suspected measles cases were reported from parts of Bay and Bakool regions. Results of
                            investigation are still pending.
                            An alert for suspected diphtheria from Galinsor (Galgadud region) was verified, and samples collected
                            from two cases are under further investigation. No more cases were reported.
                            ...
                            SUSPECTED CHOLERA
                            Cholera is endemic in Somalia, with sporadic
                            cases and occasional outbreaks occurring in a
                            number of areas all year round. 74% of the
                            reported cases were children under the age of
                            two which does not meet the case definition of
                            suspected cholera1. Collaborative activities (like
                            tracing patients) and on-the-job training are being
                            carried out to address this issue. Adequate water
                            and sanitation supplies have been, prepositioned
                            in strategic warehouses by UNICEF and WHO, to
                            be distributed in the event of an outbreak.
                            Central Somalia accounted for all the 102 suspected cholera cases reported in week 5, which represents a
                            27% decrease compared to week 4 (140 cases). All the suspected cases were reported from Banadir region.

                            SUSPECTED MEASLES
                            Suspected measles cases continue to be reported
                            from Somalia, with poor access to vulnerable
                            populations still a challenge in many areas.
                            The number of cases reported remained stable in
                            week 5. Central Somalia reported over 57% of the
                            119 suspected measles cases, while Southern
                            Somalia accounted for 27% of those. Somaliland
                            and Puntland reported 13% and 3%of the total
                            cases respectively. In collaboration with the health
                            authorities, partners are undertaking response
                            activities.

                            CONFIRMED MALARIA
                            Confirmed malaria was the leading cause of
                            morbidity during week 5, with 794 cases reported
                            from sentinel sites across Somalia. This
                            represents a 17% increase as compared to week
                            4, when Central and Southern Somalia reported
                            76% of the cases.
                            Puntland reported 190 (24%) cases, mainly from
                            Bossaso district.

                            OTHER HEALTH EVENTS
                            In week 5, 109 cases of suspected shigellosis were reported, including 81 children under the age of
                            five. Banadir Hospital alone reported 70% of these cases. No case with “visible blood in stool” was
                            identified. Adherence to the recommended case definition for shigellosis2 remains a challenge in
                            Southern and Central Somalia. It has been observed that health workers classify cases as suspected
                            shigellosis based on patient reports during history taking, and not the actual physical examination. WHO,
                            in collaboration with partners and staffs from health facilities, is on high alert and will trace reported cases
                            and collect stool samples.

                            Whooping cough control continues to remain a challenge. In the reporting week, 52 cases of suspected
                            whooping cough
                            were reported, all from Central and Southern Somalia. Parts of these areas have issues
                            of insecurity and inaccessibility for vaccination interventions to be undertaken.

                            Three cases of suspected neonatal tetanus have been reported in Central Somalia. Mechanisms are
                            being put in place for purposes of verification to confirm tetanus cases. Tracking these patients in the past
                            has remained a major challenge. Prevention needs to be strengthened through vaccination activities
                            among pregnant women and clean delivery methods.
                            ...
                            Twitter: @RonanKelly13
                            The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                            Comment


                            • #29
                              Re: Somalia Health updates 2012/2013

                              WHO Somalia Emergency Health Update

                              Reporting 13 May-2 June 2013 - Epidemiological weeks 20 to 22
                              http://reliefweb.int/sites/reliefweb..._June_2013.pdf

                              ...
                              MILLIONS OF CHILDREN PROTECTED FROM POLIO OUTBREAK
                              Outbreak response vaccination campaigns started on 14 May 2013,
                              within four days after the first case of polio was confirmed on 9 May
                              in Mogadishu. As of 30 May 2013 four cases have been confirmed
                              (three from Banadir and one from Bay region).
                              In the month of May, two outbreak response campaigns were
                              conducted. More than 400,000 children were vaccinated in the 16
                              districts of Banadir region and the neighbouring district of Afgooye
                              during the first round between 14 and 18 May. A second round of
                              mass vaccinations took place between 26 May and 2 June, targeting
                              1.6 million children in southern and central Somalia and Puntland. The response took place smoothly with
                              encouraging local leadership from authorities in all areas, high-quality coverage and strong community
                              participation.
                              A third round will target 3.9 million people countrywide starting from 12 June. As adults are also deemed
                              to be at risk of the current outbreak, in Banadir all age groups will be targeted for polio vaccination, while
                              children under the age of 10 will be targeted in the remaining regions of South Central Zone, and children
                              under the age of five in Somaliland and Puntland.

                              DISEASE ALERTS
                              During the reporting period, a total of 85 disease
                              alerts, were reported through MAY the surveillance
                              network. Central Somalia and Somaliland accounted
                              for 30 alerts respectively, accounting for 71% of all
                              reported alerts. Suspected measles cases accounted
                              for 74% of the alerts, with Acute Flaccid Paralysis
                              accounting for 10 alerts;
                              Central zone reported eight
                              alerts while Somaliland reported two alerts. There were three alerts for suspected cholera, all reported from Central
                              Somalia. Monitoring of alerts through the weekly database and reporting of outbreak rumors outside the sentinel
                              surveillance network continues to be undertaken.

                              SUSPECTED CHOLERA
                              During the reporting period, 451 suspected cholera cases were
                              reported from Banadir Hospital in Banadir region of Central
                              Somalia. Adherence to the recommended case definition for
                              suspected cholera remains a challenge. However, the current
                              trend shows a steady reduction in the number of reported cases
                              due to seasonal change, as observed in previous years at the end
                              of the rainy season.

                              SUSPECTED MEASLES
                              A total of 199 suspected measles cases were reported in the four
                              zones. Central Somalia accounted for 38% (76) of the cases,
                              Somaliland for 27% (54), Southern zone for 11% (21) and
                              Puntland for 24% (48) of the cases. Immunization activities are
                              ongoing in accessible areas, to increase vaccination coverage.

                              CONFIRMED MALARIA
                              Confirmed malaria remained the leading cause of morbidity
                              during this reporting period. A total of 2400 cases were reported
                              from the four zones. 37% (889) of the reported cases were
                              children under the age of five. Central zone accounted for 52%
                              (1252) cases, Southern 42% (1018), Somaliland 0.6% (16) and
                              Puntland 5 % (114).

                              OTHER HEALTH EVENTS
                              Cases of suspected shigellosis are still being reported in some areas. Although tracing patients remains a challenge, all
                              the cases that were found did not show signs or symptoms that conform to the recommended case definitions.
                              Training and monitoring of health workers and has shown improvement of the adherence to case definition.
                              16 cases suspected whooping cough were reported. Similarly, a case of suspected diphtheria was reported. Low
                              vaccination coverage, and a large number of unvaccinated children, due to lack of access to large geographical areas
                              in southern and central zones, will continue to pose a challenge in the event of an outbreak. Vaccination activities are
                              ongoing and routine immunization programmes have been re-initiated in accessible locations.
                              ...
                              Twitter: @RonanKelly13
                              The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

                              Comment


                              • #30
                                Re: Somalia Health updates 2012/2013

                                Humanitarian Bulletin
                                Somalia
                                September 2013 | Issued on 15 October 2013
                                http://reliefweb.int/sites/reliefweb...ber%202013.pdf
                                ...
                                Health indicators among the worst in the world
                                Joint five-year commitment aims to strengthen health sector

                                Somalia is battling an outbreak of polio with over 170 cases confirmed since the outbreak
                                started in May this year. Health authorities, with the support of the UN’s Children’s Fund
                                (UNICEF) and the World Health Organization (WHO) have continued mass vaccination
                                campaigns, the seventh in September reached 3.4 million children up to the age of 10.
                                Since 19 July, no new cases have been reported in Mogadishu, where the outbreak
                                started, which indicates that the emergency response activities have been effective. But
                                up to 600,000 children in the most difficult-to-reach areas remain at risk. The health
                                challenges do not stop there.

                                After decades of civil war, Somalia has some of the worst humanitarian indicators in the
                                world. In an effort to address this, in early October, the Somali health authorities, UN
                                agencies and donors renewed their commitment to improve maternal and child health and
                                reduce mortality. The five-year plan to strengthen the Somali health system focuses on
                                improving the health of mothers and children and access to quality health care. It aims to
                                reach 3.4 million people for service delivery across the country.

                                70,000 children every year die before their fifth birthday
                                206,000 children are acutely malnourished
                                30.5% of women of reproductive age die of pregnancy related causes
                                25,000 people, on average, are served by one physician
                                9,000 people, on average, served by one nurse/midwife


                                Sources: WHO – World Health Statistics 2013 and trends in maternal mortality 1990-2010 (WHO, UNICEF, UNFPA and World Bank estimates)

                                The scope of health and nutrition needs is sobering

                                Almost one in five children die before their fifth birthday. According to WHO, the main
                                causes of death are preventable diseases such as pneumonia, diarrhoea, measles and
                                malaria. Poor hygiene and sanitation and high malnutrition rates among children are
                                directly correlated with high child mortality and morbidity in Somalia. Sanitation coverage
                                in Somalia remains very low and only 29 per cent of the population has access to safe
                                drinking water. Water, sanitation and hygiene (WASH) partners are improving awareness
                                of sanitation, including the importance of washing hands with soap, which is one of the
                                simplest, most affordable and effective ways of preventing disease and saving lives. The
                                Global Handwashing Day is marked on 15 October and WASH partners are spreading
                                the message aiming to reach out to millions of Somalis, especially children.

                                Conflict further complicates the picture, making access to healthcare more difficult and
                                too often resulting in civilian casualties. Over 3,500 civilians with weapon-related injuries
                                have so far been treated at four hospitals supported by WHO in Mogadishu this year,
                                while another 1,500 were treated at the main hospital in Kismayo.

                                Women in Somalia also suffer from alarming levels of morbidity and mortality related to pregnancy and childbirth. It is estimated that every two hours a Somali woman dies due to complications during pregnancy; this is higher than the number of deaths due to conflict in Somalia. Early detection of pregnancy-related complications can allow for timely referral of the woman to proper facilities with skilled health personnel. In the past two years, health partners working to address the gap have strengthened emergency obstetric care, including through deployment of medical doctors, on-the-job and specialized training for health service providers, provision of medical equipment and supplies and technical assistance to partners and hospitals. To improve access for people in rural areas to essential services, 200 female health workers have been recruited and trained on reproductive, maternal, neonatal and child healthcare. They will be based in communities across Somalia.

                                Efforts ongoing to mitigate the health gap after MSF departure

                                Humanitarian partners together with Médecins Sans Frontierès (MSF) have continued to work to fill as much of the gap as possible left by the aid group’s withdrawal from Somalia to meet the needs of the most vulnerable people. The Health Cluster estimates that US$14 million will be needed to continue running for one year 14 of the 20 facilities that MSF had supported, across Somalia. The facilities provide basic healthcare, including maternal and child health services, malnutrition treatment, treatment of common illnesses, surgery, epidemic response, and immunization campaigns. The Somalia Common Humanitarian Fund emergency reserve will provide $3 million, to give time for development partners to mobilize further support.
                                ...
                                Twitter: @RonanKelly13
                                The views expressed are mine alone and do not represent the views of my employer or any other person or organization.

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