Ethiopia - Dengue fever 2023

[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 21: 15-21 May 2023
Data as reported by: 17:00; 21 May 2023

...

ETHIOPIA

DENGUE FEVER

1 638 Affected
9 Deaths
0.6% CFR

EVENT DESCRIPTION

Since 4 April 2023, two districts (Logia and Mille) of
Afar region in north-eastern Ethiopia are experiencing
Dengue fever outbreak. As of 10 May 2023, a total of 1
638 suspected and confirmed cases and nine associated
deaths (case fatality ratio= 0.5%) have been reported.
Mille district has reported most cases (1 573, 96%) while
Logia district has reported 4% (65) of the total cases. Of
the nine suspected deaths reported, four occurred at the
health facility and five at community level.

Of the 10 samples tested by Reverse Transcriptase –
Polymerase Chain Reaction (RT- PCR), eight (80%) were
positive for Dengue virus. Furthermore, 48 (50%) samples
out of 97 tested through Rapid Diagnostic Tests (RDTs) in
Mille district were positive while 47 (67%) samples out of
70 tested in Logia district were also positive for Dengue
fever with RDTs.

Out of the 1 615 cases listed, 837 (51.1%) are male and
778 are female (48.0%). Most cases are 15 years old and
above (1147, 70%). Most common clinical manifestations
were joint pain (99.4%), headache (98%), chills (97%),
vomiting (80%) and fever (64%).

As per the epi-curve, the trend in number of reported
cases increased from 11 April and peaked on 22 April, 11
days of the ascending phase of the first wave, followed
by a decrease in number of cases reported through 10
May.

PUBLIC HEALTH ACTIONS

Response activities are being coordinated by
Afar regional Emergency Operating Centre and
coordination meeting are being organized with health
cluster partners working in Afar region.

Dengue fever response plan was developed and
shared with partners and stakeholders for support.
Surveillance tools (case definition, line list form,
guidelines) distributed to at- risk districts.

Line listing of cases at health facility still ongoing as
well as daily data cleaning, analysis, and visualization
Case management of cases still ongoing at Mille and
Logia health centers

Training on Dengue fever outbreak response was
provided to health workers in the afar region and
onsite orientation was provided to Dubti General
hospital staff on Dengue fever.

Sensitization and social mobilization activities are
conducted in neighbouring districts (Aysaita, Chifra,
Adaar, and Dubti) as well as in the two affected
districts (Logia and Mille).

Entomological survey activities were conducted, and
onsite orientation was provided about vector behavior
and control measure for district Health office worker,
health facility staff, kebele leaders, schoolteachers
and visited household’s head.

SITUATION INTERPRETATION

Dengue fever infections were first reported in Ethiopia in
2013 when a dengue fever related outbreak occurred in
Dire Dawa city administration. Since then, dengue cases
and outbreaks have increased with a significant public
health impact. Ethiopia has had nearly annual outbreaks
since 2013, devastating an already fragmented health
system and economy. Some of the following contributing
factors for contracting dengue in Ethiopia have been reported:
non-uses of bed nets, the presence of stagnant water
around communities, and the weakened nutritional status of
the population due to prolonged drought. The control on
the ongoing outbreak is facing some challenges, among
these are include the poor surveillance system in the affected
areas and limited vector control and environmental management
activities.

https://apps.who.int/iris/bitstream/handle/10665/368189/OEW21-1521052023.pdf


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[Pathfinder]

WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 41: 09 October - 15 October 2023
Data as reported by: 17:00; 15 October 2023
...
Ethiopia

Dengue Fever

10 180 Cases
4 Deaths
0.04% CFR

EVENT DESCRIPTION

Since 2 April 2023, Ethiopia has been grappling with a
dengue fever outbreak which was initially reported in
the Logia and Mille districts within the Afar region and
has now spread to three additional regions: Dire Dewa,
Oromia, and Somali. Since 10 May 2023, when 1 638
cases and nine deaths (CFR 0.5%), were reported, a
sharp increase in cases have been noted with over 8
500 new cases, resulting in a weekly average of 407
cases. The peak of the outbreak was observed during
epidemiological week 26 (ending 2 July), followed by
a decline in cases in subsequent weeks, reaching less
than 50 cases, by epidemiological week 40.

From 2 April to 5 October 2023, a cumulative total of 10
180 suspected cases, 127 confirmed and four deaths
(CFR. 0.04%) have been reported from 16 woredas
across four regions: Afar, Dire Dewa, Oromia, and
Somali. Of 10 156 cases with available information,
88.0% (8936) were reported from Afar Region, followed
by Dire Dawa (8.0%, n=799), Oromia (3.5%, n=356), and
Somali Region (0.6%, n=65).

Logia, Mile and Awash districts were the most affected,
with 4 162 cases, 1 942 cases and 1 216 cases
respectively. Melka district was the least affected, with
only two reported cases.

The epi-curve below shows a multimodal distribution with
three increasing peaks observed during weeks 17, 21
and 26. After week 26. The trend has been decreasing
since week 26, suggesting that the outbreak is under
control and nearing its end.

PUBLIC HEALTH ACTIONS

Coordination of the response activities is still ongoing
at national level with regular meetings with each
of the affected woredas Health Offices and Health
Centers

Capacity building activities particularly on case
management and surveillance activities are
continuously provided for health workers and health
officials.

Intensified surveillance with active case search,
contact tracing is ongoing in the affected communities.
Case management continues in the peripheral health
facilities of the affected areas including Mille, Semera,
Logia, Gewane, Gelealo health centers as well as,
Awash, Chifra and Dupti Hospitals

Risk communication and community engagement
activities are ongoing within the community, schools,
and religious institutions.

Vector breading site identification and control
measures, including the application of abate
chemical (larvicidal) are being conducted in all
affected woredas within the Afar, Dire Dawa, Oromia
and Somali Regions.

SITUATION INTERPRETATION

The ongoing dengue fever outbreak in Ethiopia is one
of several concurrent outbreaks the country is facing,
including cholera, covid-19, malaria, and measles.
Although the current trend for dengue fever is declining,
it is crucial to maintain and sustain surveillance activities.
This is particularly important as the current climate
change led by the El Niño phenomenon could extend
the transmission period of major vector-borne diseases
including dengue. Furthermore, the humanitarian crisis
including the internal displacement of the population due
to insecurity, is exacerbating the public health challenges
in the country.

https://www.afro.who.int/health-topics/disease-outbreaks/outbreaks-and-other-emergencies-updates