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  • Ronan Kelly
    replied
    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.
    ...

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  • Ronan Kelly
    replied
    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.
    ...

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  • Ronan Kelly
    replied
    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.
    ...

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  • Ronan Kelly
    replied
    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
    ...

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  • Ronan Kelly
    replied
    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.
    ...

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  • Ronan Kelly
    replied
    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).
    ...

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  • Ronan Kelly
    replied
    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.
    ...

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  • Ronan Kelly
    replied
    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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    ...

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  • Ronan Kelly
    replied
    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.
    ...

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  • Ronan Kelly
    replied
    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.
    ...

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  • Ronan Kelly
    replied
    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.

    ...

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  • Ronan Kelly
    replied
    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.
    ...

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  • Ronan Kelly
    replied
    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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  • Ronan Kelly
    replied
    Re: Somalia Health updates 2012

    Somalia Emergency Weekly Health Update

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

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  • Ronan Kelly
    replied
    Re: Somalia Health updates 2012

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

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    ...
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    ...

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