weekly epidemiological bulletin - humanitarian response

Weekly Epidemiological Bulletin Electronic Disease Early Warning System & Response (eDEWS)

in Khyber Pakhtunkhwa and FATA

Epidemiological Week no. 24 (10 to 16 June, 2012)

Highlights

17 districts and 3 agencies provided surveillance data to the eDEWS this week from 496

health facilities.

A total of 145,964 consultations were reported through eDEWS of which 17% or 24,400 cases

were Acute Upper Respiratory Infection, is still the highest cause of morbidity of total

consultations were showing 1% decrease in percentage as compared to week 23.

Other Acute Diarrhoea shared 11.4% or 16,623 cases of the total consultations showing no

change in percentage as compared to previous week.

Pyrexia of Unknown Origin accounted for 5% or 7,564 cases out of total consultations.

Skin Infection (Skin Inf.) reported at 3% or 4,061 cases and suspected Typhoid Fever comprised

only 0.4% or 586 cases out of total consultations.

A total of 78 alerts including 11 outbreaks (9 for Measles, 1 for AWD and 1 for Enteric Fever)

were received. 67 alerts for suspected Measles including 9 outbreaks, 5 alerts for Cutaneous

Leishmaniasis, 2 for Enteric Fever including 1 outbreak while 1 each for AWD, DF, NNT and

Pertussis were shared and responded.

Priority diseases

under surveillance

in eDEWS

Respiratory Diseases

Acute (upper) respiratory infections

Pneumonia <5 years

Pneumonia > 5 years

Suspected Diphtheria

Suspected Pertussis

Gastro Intestinal Diseases

Acute Watery Diarrhea <5 year

Acute Watery Diarrhea > 5 year

Bloody Diarrhea <5 years

Bloody Diarrhea > 5 years

Other Acute Diarrhea < 5 years

Other Acute Diarrhea > 5 years

Suspected Enteric/Typhoid Fever

Other Communicable

Suspected Malaria

Suspected Meningitis

Suspected Dengue Fever

Suspected Viral Hemorrhagic Fever Pyrexia Of Unknown Origin

Vaccine Preventable

Suspected Measles

Suspected Acute Viral Hepatitis

Chronic Viral Hepatitis

Neonatal Tetanus

Acute Flaccid Paralysis

Skin Disease

Scabies

Cutaneous Leishmaniasis

Injuries /Poisoning

Injuries Snake bite

Other unusual diseases

Other unusual diseases

Epidemiological Bulletin: eDEWS, KPK/FATA, Week no.24 (10th to 16th June, 2012)

This weekly Epidemiological Bulletin is published jointly by the Ministry of Health, Government of Khyber Pakhtunkhwa, FATA and eDEWS (Electronic Disease Early Warning System & Response) team. For Correspondence; Peshawar WHO-EHA Office: Tel: +92-091-5701831, E-mail: [email protected].

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Compiled situation in Khyber Pakhtunkhwa & FATA Figure-1: Four years trend of Other Acute Diarrhea (OAD) in Khyber Pakhtunkhwa/FATA (2009, 2010, 2011 and 2012)

The above graph shows the trend of Other Acute Diarrhoea (OAD) cases out of total consultations reported to DEWS in

2009, 2010, 2011 and 2012 up until now. In this week 24, 2012 OAD consultations show 11.4% or 16,623 cases of total

cases which shows no change percentage as compared to week 23.

During this week high percentage of OAD consultations were reported from district Swat 18% followed by district Buner

17%, Malakand 15%, Dir Lower 15%, Tank 15%, D.I. Khan 13%, Mohmand agency 13%, Swabi 12%, Haripur 11%,

Abottabad 11%, Hangu 11%, Shangla 11% and Charsadda 11%.

Figure-2: Alerts reported in Khyber Pakhtunkhwa/FATA (year 2011 and 2012 comparison)

The above graph shows the different reported alerts to DEWS from year 2011 and 2012. High number of alerts reported in year 2012

due to more active surveillance and response. A cumulative figure for the current year is 1,798 alerts (3,914 cases) including of 131

outbreaks were reported. Measles alerts are leading in Khyber Pakhtunkhwa and FATA with 1,343 alerts (2,377 cases) including 98

outbreaks. Followed by C. Leishmaniasis 214 alerts (613 cases) including 11 outbreaks, Neonatal Tetanus 92 alerts (94 cases),

suspected Typhoid 25 alerts (84 cases) including 6 outbreaks, AWD 23 alerts (51 cases) including 1 outbreak, Diphtheria 17 alerts (17

cases), Bloody diarrhoea 12 alerts (62 cases) including 4 outbreaks, Pertussis 12 alerts (22 cases) including 1 outbreak, AFP 11 alerts

(11 cases), suspected Acute Viral Hepatitis 7 alerts (58 cases) including 2 outbreaks, Rabies 7 alerts (15 cases) including 1 outbreak,

Scabies 6 alerts (308 cases) including 5 outbreaks, Dengue Fever 6 alerts (6 cases), H1N1 5 alerts (11 cases) including 1 outbreak,

Tetanus 4 alerts (4 cases), Other Acute Diarrhoea 3 alerts (165 cases), CCHF 3 alerts (3 cases), Falciparum Malaria 3 alerts (3 cases)

including 1 outbreak, Chickenpox 2 alerts (5 cases), Dengue Hemorrhagic Fever 1 alert (4 cases), suspected DHF/CCHF 1 alert (1 case)

and Unexplained Fever 1 alert (1 case) were shared.



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Figure-3: Number of alerts and alert cases reported in Khyber Pakhtunkhwa/FATA (Week 24, 2012)

The above left side graph shows different alerts and their cases reported in KP/FATA and right side graph shows different alerts

shared by district wise in week 24, 2012. In this week a total of 78 alerts (175 cases) including 11 outbreaks (9 for Measles while 1

each for AWD and Enteric Fever) were reported and responded. Highest number of alerts reported from district Haripur 14 alerts

including 11 suspected Measles while 1 each for AWD, DF and Enteric Fever were shared, followed by district D.I. Khan 14 suspected

Measles alerts, Swat 8 suspected Measles, Mansehra 6 suspected Measles, Abottabad 5 alerts including 4 suspected Measles and 1

CL, Charsadda 5 suspected Measles, Mohmand agency 4 alerts including 2 each suspected Measles and CL, Swabi 4 alerts including

3 suspected Measles and 1 Pertussis, Battagram 3 suspected Measles, Mardan 3 suspected Measles, Shangla 3 alerts including 1

each for suspected Measles, CL and Enteric Fever, FR Bannu 2 suspected Measles, Bannu 1 NNT, FR Lakki Marwat 1 NNT, Khyber

agency 1 suspected Measles, Lakki Marwat 1 suspected Measles, Malakand 1 CL, Nowshera 1 suspected Measles and Tor Ghar 1

suspected Measles were reported and responded.

11 outbreaks (Measles 9, AWD 1 and Enteric Fever 1) were reported in this week. 2 Measles, 1 AWD and 1 Enteric Fever were shared from district Haripur

4 suspected measles cases were reported from village Bagra. Gave vitamin A. An alert of 4 measles cases was responded in the same area in week 21 during which 8 children were identified with missing either measles 1 or 2 vaccine and weakness in immunization was identified and communicated to EPI coordinator. Outbreak has been declared. Outreach vaccination scheduled during current week.

16 suspected measles case were from Khoi Dara. Initially 1 case reported to BHU, 15 cases identified on active surveillance, gave vitamin A. 12 houses assessed. No child completely vaccinated for measles. 11 children without BCG scar. Several children with missing pentavalent vaccine dosage. No routine immunization activity in the area. No EPI technician in the adjacent health facility.

Outbreak declared in area. Line list was maintained. Outreach vaccination is scheduled during current week. 9 suspected AWD cases were reported from BHU Amgah. Epidemiological and environmental assessments were carried out.

Assessment indicated all the cases were liked with history of shared food. Active surveillance done, 2 other case found. Stool sample was taken and sent to NIH. Water samples were taken awaited for results. Rx given, Aqua tabs, ORS and filters distributed. Health education sessions conducted to the family as well as in the community. EDO Health informed.

7 suspected Enteric Fever cases reported from RHC Ghazi. Blood samples were tested and IgM came back positive for S.Typhi, field

investigation found possible source as contaminated water supply. No shared food intake history. Water samples from source,

homes were taken and assessed for contamination. Health and hygiene sessions were conducted for affected families.

Environmental interventions will be carried out depending on water sample results. Aqua tabs were distributed. EDO health

informed of the cases.

2 Measles outbreaks were shared from district Mardan

6 suspected Measles cases were reported in this outbreak. An alert for suspected Measles was reported from RHC Gumbat. On field

investigation 5 more clinical cases were found in surrounding. WHO along with EPI vaccinator and health staff investigated the alert.

Vitamin A given. During field visit 18 children were checked for routine immunization; 16 children were found unimmunized for

measles 1 vaccine, 18 were unimmunized for measles 2 vaccine. EPI team vaccinated 97 under 5 years’ children with measles

vaccine. Health education sessions conducted with the LHW's, family members and community, patient isolated. EDO-H Focal

person, EPI Coordinator and LHS were informed.

A total of 12 suspected Measles cases were reported from village Shakardand. An alert of suspected Measles was received. Field

investigation carried out in the area and a cluster of 8-10 houses was taken for identification of new cases and routine vaccination

status. 11 more clinical cases were found in the family and surrounding. 2 children had no BCG scar, 19 children were unimmunized

for measles 1 and 23 for measles 2 vaccine. During outreach vaccination by EPI team 110 under 5 years’ children were vaccinated in

the area and surrounding. Vit-A was given. Session was conducted with 23 LHW's of entire UC on importance of routine vaccination.

Health education session conducted with the family members and community, patient isolated, EDO-H Focal person & EPI

Coordinator were informed.



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1 Measles outbreak was shared from district Swabi

5 suspected cases of Measles were reported from BMC Swabi. An alert case was investigated and responded in the presence of Health department personal. During investigation 4 more cases were found in the same locality. EPI Card not available with all these kids. Proper information regarding routine is not available. Vit. A given, health education sessions conducted, EDO-H and EPI coordinator Informed, EPI Technician of the relevant UC was also present and briefed by WHO for Mop up campaign.

1 Measles outbreak was shared from district Abottabad 6 suspected cases of Measles were reported from Dalola. A suspected case of measles reported from BHU Dalola, Vitamin A given.

EPI coordinator informed. On active surveillance along with EPI Coordinator, EPI worker, MT, LHS and LHW 5 more cases were found. 23 houses visited, 13 children less than 5 years examined. 7 children had no vaccination. They were vaccinated and vitamin A given to them.

1 Measles outbreak was shared from district D.I. Khan 5 suspected Measles cases were from Darban Kalan. 2 cases of suspected Measles were admitted in Isolation Ward of DHQ hospital.

One boy aged 3 years and a girl aged 2 years. They belonged to Tehsil Daraban Kalan. Both were unvaccinated. Visit was paid to the area on 14

th June where 03 more children were found with the symptoms. One boy 19 months old, one girl 3 years old and the

other 8 years of age. Parents of all kids gave history of no vaccination. A total of 17 children below the age of 13 years were vaccinated at EPI Center Civil Hospital Daraban Kalan.

1 Measles outbreak was shared from district Lakki Marwat 2 suspected cases were reported from City hospital Siraye Naurang, during field investigation found 2 more cases. All had zero

vaccination status. No measles vaccines available in nearby facility. EDO informed, two mobile teams deployed for routine immunization for one week. Vaccinated children data will be shared next week.

1 Measles outbreak was shared from Khyber agency The measles cases were reported by Medical Technician. On active surveillance 6 cases were found (with the ages of 36 months, 72

months, 96 months, 24 months, 18 months and 60 months). Blood sample was taken from one of the case. Vitamin A given to suspects. Health education imparted. A total of 50 children vaccinated for measles. Report shared with Agency Surgeon and FSMO.

Table-1: Leading causes of seeking health care in flood affected districts, compiled weekly reports

Disease name Week-21 Week-22 Week-23 Week-24 Total Consultations

(1st

Jan to 16th

June, 2012)

Acute Diarrhoea 17,631 (10%) 16,559 (11%) 16,814 (11.4%) 16,623 (11.4%) 252,521 (8%)

Bloody Diarrhoea 1,544 (1%) 1,166 (1%) 1,181 (1%) 1,187 (1%) 24,685 (1%)

Suspected Malaria 4,098 (2%) 3,270 (2%) 3,846 (3%) 4,115 (3%) 52,736 (1.6%)

Skin Diseases 4,639 (3%) 4,159 (3%) 4,242 (3%) 4,061 (3%) 88,251 (3%)

Pyrexia of Unknown Origin 8,174 (5%) 7,664 (5%) 7,478 (5%) 7,564 (5%) 152,764 (5%)

Acute Respiratory Infection 30,490 (17%) 27,056 (18%) 26,204 (18%) 24,400 (17%) 771,319 (24%)

Total Consultations 176,830 152,299 147,496 145,964 3,245,610

The above table shows compiled communicable diseases cases from weekly reports and proportional morbidity through eDEWS reported. Since January 1, 2012, approximately 3,245,610 patient consultations have been reported to the eDEWS from Khyber Pukhtunkhwa province and Federal Administered Tribal Areas (FATA). In this week 24, 2012 (10th to 16th June, 2012) reports were received from 496 health centres and the major causes for seeking health care by the communities in almost all of the regions were diarrhoeal diseases 16,623 cases or 11.4%, acute respiratory infections 24,400 cases or 17%, skin diseases 4,061 cases or 3% and suspected malaria 4,115 cases or 3%.

Figure-4: Total number of HFs reported and consultations (Week no.1 to 24, 2012)

Figure‐5: Leading communicable diseases percentage trend in Khyber

Pakhtunkhwa and FATA (Week no.1 to 24, 2012)



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Figure 4 shows the number of health facilities and total number of consultations reported. Figure 5 shows the weekly

percentage trend of ARI, Other Acute Diarrhoea, suspected Malaria and Pyrexia of Unknown Origin in Khyber

Pakhtunkhwa and FATA from week 1 to 24, 2012. ARI percentage is showing fluctuation since week 15 and OAD

showing no change in percentage in week 24 as compared to previous week.

Table-2: Respiratory Diseases situation in Khyber Pakhtunkhwa and FATA

Respiratory Diseases Week-23 Week-24

Upper Respiratory Infection 25,145 23,266

Pneumonia <5 557 640

Pneumonia >5 502 494

Figure-6:

Table 2 shows the last two weeks Acute Respiratory Tract Infection (Upper Respiratory Tract Infection and Lower Respiratory Tract Infection (Pneumonia)) consultations comparison and figure 5 shows the last four weeks percentage situation of ARI.

Table-3: Gastro Intestinal Diseases situation in Khyber Pakhtunkhwa and FATA

Gastro Intestinal Diseases Week-23 Week-24

Bloody Diarrhea <5 477 484

Bloody Diarrhea >5 704 703

Other Acute Diarrhea <5 8,725 8,727

Other Acute Diarrhea >5 8,089 7,896

Suspected Typhoid Fever 590 586

Figure-7:

Table 3 shows the last two weeks cases of Gastro Intestinal Diseases and figure 6 shows the Gastro Intestinal Diseases percentage of last four weeks.

Province Khyber Pakhtunkhwa: Figure-8: Percentage of consultations by gender and age wise

Figure-9: Weekly diseases (ARI, OAD, MAL and PUO) percentage trend

Figure 8 shows percentage of consultations by gender and age wise in health events in over all diseases, male to female patients’ ratio reported was 41.4% or 53,821 cases and 58.6% or 76,113 cases respectively.

Figure 9 shows weekly percentage trend of ARI, OAD, MAL and PUO from week 1 to 24, 2012.

This week 17 districts reported to eDEWS from 445 health facilities with a total of 129,934 patients’ consultations.

Acute Respiratory Tract Infection 22,607 cases reported were showing 1% decrease in percentage as compared to week 23 patients’ visits and accounted for 17% of the total consultations.

Other Acute Diarrhea cases 15,168 or 12% showing 1% increase in percentage as compared to previous week and suspected Malaria 2,889 cases or 2% were reported.

Pyrexia of Unknown Origin cases were shared 7,275 or 6%.

Suspected Typhoid Fever (TF) cases 538 or <1% and Scabies cases 3,725 or 3% were reported.



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Figure-10: ARI, OAD, MAL and PUO percentage situation of Khyber Pakhtunkhwa district wise in week 24, 2012

The above figure shows ARI, OAD, MAL and PUO percentage situation district wise in week 24, 2012. During this week high

percentage of OAD consultations were reported from district Swat 18% (2,840 cases), followed by district Buner 17%

(1,247 cases), Malakand 15% (1,228 cases), Dir Lower 15% (742 cases), Tank 15% (70 cases), D.I. Khan 13% (926 cases),

Swabi 12% (298 cases), Haripur 11% (1,126 cases), Abottabad 11% (503 cases), Hangu 11% (582 cases), Shangla 11% (548

cases) and Charsadda 11% (1,184 cases) . Similarly high percentage of ARI cases were reported from district Swat 26%

(4,157 cases), Buner 25% (1,780 cases), Shangla 21% (1,081 cases), Dir Lower 20% (1,001 cases), Haripur 20% (2,007 cases)

and Battagram 20% (1,900 cases). High percentages of suspected Malaria were reported from district Hangu 10% (542

cases), Dir Lower 8% (401 cases) and Mardan 5% (391 cases). High percentage of Pyrexia of Unknown Origin (PUO)

consultations were reported from district Tank 28% (136 cases), Dir Lower 12% (618 cases), D.I. Khan 12% (878 cases),

Kohat 9% (873 cases), Charsadda 7% (816 cases), Shangla 7% (367 cases), Mardan 6% (512 cases), Battagram 6% (607

cases) and Abottabad 6% (280 cases).

Current week’s Alert/Outbreak in Khyber Pakhtunkhwa: A total of 70 alerts including 10 outbreaks (8 for Measles, 1 for AWD and 1 for Enteric Fever) were received. 61 alerts for

suspected Measles including 8 outbreaks, 3 alerts for Cutaneous Leishmaniasis, 2 for Enteric Fever including 1 outbreak while 1

each for AWD, DF, NNT and Pertussis were shared and responded..

S. No.

Date Investigated

Suspected Disease

District Location <5 M

>5 M

<5 F

>5 F

Sample Positive Cases Death

1 12-Jun-12 Measles Battagram Village Pairy ubbo, UC Biari, Tehsil

Alli 0 1 0 0 1 r 1 0

2 13-Jun-12 Measles Battagram Village Kar, UC Biari, Tehsil Allai 0 0 0 1 1 r 1 0

3 13-Jun-12 Measles Tor Ghar Village Markharian 1 0 0 0 1 r 1 0

4 15-Jun-12 Measles Battagram Village Sarpalango, UC Ajmaira 1 0 0 0 1 r 1 0

5 14-Jun-12 NNT Bannu Village Spina Tangi Pir Bakhel UC

Domel 0 0 1 0 0 r 1 0

6 12-Jun-12 Measles Lakki

Marwat Village Tarkha Bazi Khel 1 2 1 0 1 r 4 0

7 13-Jun-12 Measles Charsadda Shah Pasand Khan Kallay 0 0 1 0 1 r 1 0

8 13-Jun-12 Measles Charsadda Village Maroof Khel 0 1 0 0 1 r 1 0

9 13-Jun-12 Measles Charsadda village Ghurambak 0 1 0 0 1 r 1 0



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10 14-Jun-12 Measles Charsadda village Panjpao 0 0 0 1 1 r 1 0

11 15-Jun-12 Measles Charsadda MM khel 1 1 1 0 3 r 3 0

12 12-Jun-12 Leishmaniasis Malakand Aagra 0 1 0 0 0 r 1 0

13 11-Jun-12 Measles Mansehra Batpara Neelor Khaki UC Bherkund 1 1 1 2 3 r 5 0

14 12-Jun-12 Measles Mansehra Bakhla Battal Near Police Station 1 0 1 1 0 r 3 0

15 12-Jun-12 Measles Mansehra Basala Dadar UC Bhogarmang 1 0 0 0 0 r 1 0

16 12-Jun-12 Measles Mansehra Village Malookra UC Oghi 1 0 0 0 0 r 1 0

17 14-Jun-12 Measles Mansehra Battal Doraha UC Battal 0 1 0 0 0 r 1 0

18 11-Jun-12 Measles Shangla Village Lelonai 0 1 0 1 1 r 2 0

19 13-Jun-12 Enteric Fever Shangla Village Taloon Gunahgar 0 2 0 0 2 r 2 0

20 14-Jun-12 Leishmaniasis Shangla Village Kotkay 0 1 0 0 0 r 1 0

21 11-Jun-12 Measles Swat Village Banjut, UC Dureshkhela,

Tehsil Matta 1 0 0 0 1 r 1 0

22 11-Jun-12 Measles Swat Village Kolakarin, UC Miandam,

Tehsil Khwazakhela 1 0 0 0 1 r 1 0

23 12-Jun-12 Measles Swat Village Durdyal, UC Tindodag, Tehsil

Kabal 2 0 0 0 1 r 2 0

24 12-Jun-12 Measles Swat Village Khas Dadahara, UC

Dadahara, Tehsil Kabal 1 0 1 0 1 r 2 0

25 12-Jun-12 Measles Swat Mohallah Daulat Khel, UC Qambar,

Tehsil Babuzai 0 0 1 0 1 r 1 0

26 13-Jun-12 Measles Swat Village Thekadari, UC and Tehsil

Khwazakhela 0 0 0 1 1 r 1 0

27 13-Jun-12 Measles Swat Mohallah Langar, UC & Tehsil


28 13-Jun-12 Measles Swat Village Gashkor, UC and Tehsil


29 12-Jun-12 Measles Mardan Village Ajab Gul, UC Gumbat, 1 2 1 2 1 r 6 0

30 13-Jun-12 Measles Mardan Village Shakardand, UC Fathma 3 2 2 5 1 r 12 0

31 15-Jun-12 Measles Mardan Village Sangar, UC Gumbat 0 0 1 0 0 r 1 0

32 11-Jun-12 Measles Abbottabad Kunj, near Fawara Chowk. 2 0 1 0 0 r 3 0

33 12-Jun-12 Measles Abbottabad Mohalla Usman Ghani 0 1 0 0 1 r 1 0

34 13-Jun-12 Leishmaniasis Abbottabad Hotrol, Birot 0 0 0 1 0 r 1 0

35 14-Jun-12 Measles Abbottabad Dana, Shimla Pahari 1 0 0 0 1 r 1 0

36 15-Jun-12 Measles Abbottabad Riyala, Dalola 2 0 1 3 2 r 6 0

37 13-Jun-12 Measles Swabi BMC Swabi, Qibla Cham Bazar Kale

Tordher 1 1 1 2 2 r 5 0

38 13-Jun-12 Measles Swabi BMC Swabi, Kota 0 1 0 1 1 r 2 0

39 14-Jun-12 Pertussis Swabi BMC Swabi, Sheikh Deray Anbar 1 0 0 0 1 r 1 0

40 14-Jun-12 Measles Swabi BMC Swabi 0 0 1 0 1 r 1 0



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41 08-Jun-12 Measles D. I. Khan Muryali, UC Muryali 1 0 0 0 0 r 1 0

42 08-Jun-12 Measles D. I. Khan Tariq Abad, City 1 1 0 0 0 0 r 1 0

43 08-Jun-12 Measles D. I. Khan Qayyum Nagar, City 2 2 0 0 0 0 r 2 0

44 09-Jun-12 Measles D. I. Khan Eid Gah Colony, City 2 1 0 0 0 0 r 1 0

45 09-Jun-12 Measles D. I. Khan Mohallah Juma Shah, City 1 1 0 0 0 0 r 1 0

46 10-Jun-12 Measles D. I. Khan Nizam Pump, Bannu Road 0 0 1 0 0 r 1 0

47 10-Jun-12 Measles D. I. Khan Zameer Abad, City 1 2 0 1 0 0 r 3 0

48 11-Jun-12 Measles D. I. Khan Keich, Chashma Road 1 0 1 1 0 r 3 0

49 12-Jun-12 Measles D. I. Khan Kotli Imam, Bannu Road 0 0 0 1 0 r 1 0

50 12-Jun-12 Measles D. I. Khan Chehkan, Tank Road 1 0 1 0 0 r 2 0

51 12-Jun-12 Measles D. I. Khan Pusha Pul, Bannu Road 0 0 1 0 0 r 1 0

52 12-Jun-12 Measles D. I. Khan CRBC Colony 0 0 0 1 0 r 1 0

53 13-Jun-12 Measles D. I. Khan Choudwan, tehsil Daraban 1 1 1 0 0 r 3 0

54 13-Jun-12 Measles D. I. Khan Kamran Colony, Daraban Kalan 2 0 2 1 0 r 5 0

55 16-Jun-12 Measles Mansehra Kaarh Near Petrol Pump Buttal UC

Battal 0 1 0 0 0 r 1 0

56 11-Jun-12 Measles Nowshera Bahadar Khail, Manki Sharif 0 1 0 0 0 r 1 0

57 09-Jun-12 Measles Haripur Muhallah Darshakhel Village Bagra,

UC Bagra, BHU Bagra 1 2 0 1 0 r 4 0

58 13-Jun-12 Measles Haripur Village Khoi Dara, UC Kotehra, BHU

Amgah 4 3 3 6 1 r 16 0

59 13-Jun-12 Measles Haripur Afghan Refugee camp Bassu Mera 1 0 0 0 0 r 1 0

60 11-Jun-12 Measles Haripur Afghan Refugee camp 16, DHQ 0 0 1 0 0 r 1 0

61 11-Jun-12 Measles Haripur Muhallah Bun Mera, Alloli, DHQ 1 0 0 0 0 r 1 0

62 12-Jun-12 Measles Haripur Near, Central Jail, Haripur city,DHQ 0 0 0 1 0 r 1 0

63 12-Jun-12 Measles Haripur Koka, UC Rehana, DHQ 0 0 0 1 0 r 1 0

64 15-Jun-12 Measles Haripur Muhallah Mora, UC Bareela, DHQ 0 0 1 0 0 r 1 0

65 14-Jun-12 Measles Haripur Qazi Mera, Kholian Bala, RHC

Havellian 0 1 1 0 0 r 2 0

66 12-Jun-12 Measles Haripur Afghan Refugee Turkman Camp 0 0 1 0 0 r 1 0

67 11-Jun-12 Measles Haripur Khalabut Township, CH Khalabut 1 0 2 0 0 r 3 0

68 13-Jun-12 DF Haripur Faisal Colony, Near Nehr, UC Ali

Khan, DHQ 0 1 0 0 1 r 1 0

69 16-Jun-12 AWD Haripur Village Amgah, UC Kotehra 1 5 0 3 1 r 9 0

70 12-Jun-12 Enteric Fever Haripur Ghazi City, UC Ghazi, RHC Ghazi 1 3 1 2 2 r 7 0



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Federal Administered Tribal Areas (FATA): Figure-11: Two years trend of Other Acute Diarrhoea in FATA

DEWS was started in FATA three agencies (Bajaur, Khyber, Mohmand) since February, 2011 during FATA IDPs crisis.

Figure 11 shows 2 years weekly percentage trend of OAD percentage trend. In week 24 OAD 1,455 cases or 9% were

shared showing 2% decrease in percentage as compared to previous week.

Figure-12: Percentage of consultations by gender and age wise

Figure-13: Weekly diseases (ARI, OAD, MAL and PUO) percentage trend

Figure 12 shows percentage of consultations by gender and age wise in health events in over all diseases, male to

female patients’ ratio reported was 42% or 7,720 cases and 52% or 8,310 cases respectively

Figure 13 shows weekly percentage trend of ARI, OAD, MAL and PUO from week 1 to 24, 2012.

This week, 51 health facilities reported from 3 agencies to eDEWS with a total of 16,030 patients’ consultations.

Acute Respiratory Tract Infection (ARI) 1,793 cases reported were showing 1% decrease in percentage as compared

to week 23 patients’ visits and accounted for 11% of the total consultations.

Other Acute Diarrhea (OAD) 1,455 cases or 9% were showing 2% decrease in percentage as compared to week 23

and suspected Malaria (Mal) 1,226 cases or 8% were shared.

Pyrexia of Unknown Origin (PUO) shared 289 cases or 2% which shows 1% decrease in percentage as compared to

previous week , suspected Typhoid Fever (TF) 48 cases or <1% and Scabies 336 cases or 2% were reported.

Figure-14: ARI,OAD, MAL and PUO percentage situation of Federal Administered Treaty Agency (FATA) in last four weeks



Page: 10

The above figure 14 shows ARI, OAD, MAL and PUO percentage situation in FATA three agencies. During week 24, 2012

high percentage of ARI consultations were reported as compared to other diseases. In this week high percentage of Other

Acute Diarrhoea consultations were reported from Mohmand as compared to Bajaur and Khyber agency. In this week

OAD 13% or 342 cases, 10% or 571 cases and 7% or 542 cases were shared respectively from Mohmand, Bajaur and

Khyber agencies. Similarly ARI 16% or 400 cases, 12% or 888 cases and 8% or 505 cases respectively from Mohmand,

Khyber and Bajaur agencies. Pyrexia Unknown Origin (PUO) cases percentage were reported 3% or 169 cases, 3% or 76

cases and 1% or 44 cases respectively from Bajaur, Mohmand and Khyber agencies were reported. Suspected Malaria

were shared 10% or 616 cases from Bajaur, 7% or 504 cases from Khyber and 4% or 106 cases from Mohmand agency.

Current week’s Alert/Outbreak in FATA: A total of 8 alerts (6 for suspected Measles and 2 for C. Leishmaniasis) were reported and responded in this week.

S. No.

Date Investigated

Suspected Disease

Agency Location <5 M

>5 M

<5 F

>5 F

Sample Positive Cases Death

1 13-Jun-12 Measles FR Bannu Village Baka Khel 1 0 0 0 0 r 1 0

2 13-Jun-12 Measles FR Bannu Village Zoni Khel 1 0 0 0 0 r 1 0

3 12-Jun-12 Measles FR Lakki Village Herama Bittani 1 0 0 0 1 r 1 0

4 14-Jun-12 Measles Khyber Agency

Village Shagai,UC Lala China,Tehsil Jamrud

1 1 2 2 1 r 6 0

5 11-Jun-12 Leishmaniasis Mohmand

Agency Gagezi 0 0 1 0 0 r 1 0

6 12-Jun-12 Measles Mohmand

Agency Char Nahaqi 2 1 0 0 0 r 3 0

7 14-Jun-12 Leishmaniasis Mohmand

Agency Carcani 0 0 0 1 0 r 1 0

8 15-Jun-12 Measles Mohmand

Agency Dorba khel 0 0 1 0 0 r 1 0

Figure-15: Total number of alerts/outbreaks situation in Khyber Pakhtunkhwa & FATA through eDEWS System (Week 24, 2012)

weekly epidemiological bulletin - humanitarian response

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