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Bangladesh

Rohingya Emergency Response

Ministry of Health and Family Welfare

BangladeshPrinted: 13:46 Tuesday, 09 January 2018 UTC

Early Warning, Alert and

Response System (EWARS)

Epidemiological Bulletin W1 2018

Highlights

Slide 1 Table 1 Coverage

Table 2 Early warning performance

Table 3 Alert performance

Early Warning

Slide 2 Map 1a Ukhia completeness by site/zone

Map 1b Teknaf completeness by site/zone

Slide 3 Table 4 Ukhia (Northern group) performance by site/zone

Map 2 Ukhia (Northern group) completeness by site/zone

Slide 4 Table 5 Ukhia (Southern group) performance by site/zone

Map 3 Ukhia (Southern group) completeness by site/zone

Slide 5 Table 6 Teknaf performance by site/zone

Map 4 Teknaf completeness by site/zone

Slide 6 Table 7 Performance by partner

Alert

Slide 7 Table 8 Ukhia (Northern group) alerts by site/zone

Map 5 Ukhia (Northern group) alerts site/zone

Slide 8 Table 9 Ukhia (Southern group) alerts by site/zone

Map 6 Ukhia (Southern group) alerts site/zone

Slide 9 Table 10 Teknaf alerts by site/zone

Map 7 Teknaf alerts site/zone

Slide 10 Table 11 Performance by type of alert

Table 12 Risk Assessment

Morbidity

Slide 11 Figure 1 Proportional morbidity

Sources of data

1. Weekly EWARS Reporting Form

2. Mortality Case Report Form

3. Event-based Surveillance Form

Contents

W1 2018

1. A total population of 728,786 (84%) is under surveillance. 139 (88%) of health facilities enrolled.

2. Completeness of reporting was 48% (67/144 health facilities).

• Action: all partners requested to submit reports and to ask for support if needed.

3. A total of 37 alerts were reported, of which 68% were verified. • 25 suspected measles/rubella alerts triggered (total

of 106 cases). All reported to have met the clinical case definition of measles and treated symptomatically. Ongoing measles transmission camps highly likely. Majority of cases referred to, or seen at, SCI, MSF and Ukhia UHC. No sample collection done.

• Action: review guidance and lab protocol for measles case investigation and specimen collection in the camps.

• 5 indicator-based alerts and 1 event-based alert due to acute jaundice syndrome reported. Weekly reports from Zones EE, PP SS, TT. MTI reported a cluster of 7 cases from same block in Block G, Zone EE.

• Action: AJS risk assessment and case investigation planned on 11 Jan 2018.

• 2 suspected AFP cases reported from BDRCS (Zone YY) and IHA (Jamtoli). Both referred to Ukhia UHC, but further investigation and sample collection not possible and cases lost to follow up.

• Action: review lab protocols for AFP stool sample collection in camps.

• 4 suspected haemorrhagic fever alerts (Zones SS and TT) were discarded upon verification due to reporting errors. No further action needed.

• 1 EBS report of mumps (3 cases, 2 different blocks B55 and F20, no epi-link). Treated symptomatically. no further action needed.

• 1 EBS report of bloody diarrhoea (3 cases, 3 blocks (C2, E5, G53), observed blood in stool, no epi-link). Given oral antibiotics. No further action needed.

• 1 EBS report of suspected diphtheria cases (2 cases, G57 and G53, referred to IOM DTC). No further action needed.

Thank you to all partners who contributed to EWARS.

Please sign-up for an account at http://bd.ewars.ws

Highlights W1 2018

Table 1 | Coverage

# %

866,000 - Estimated total Rohingya population

728,786 84% Total population under surveillance

158 - Total number of health facilities

139 88% Number of EWARS reporting sites

Table 2 | Early warning performance indicators

W1 Cumulative (2018)

67 67 Number of weekly reports received

48% 48% Completeness

48% 48% Timeliness

Table 3 Alert performance indicators


37 39 Total alerts raised

68% 69% % verified

0% 0% % auto-discarded

3% 5% % undergoing risk assessment

0% 0% % completed risk assessment

Source: IOM. Bangladesh: Needs and Population Monitoring - NPM R7 Report. 15 December 2017

Source: REACH. Health Facility Mapping Exercise. 12 December 2017

Excluding non-operational health facilities; and excluding specialised services (DTCs, SRH clinics) and mobile clinics (which report under fixedsites)

Highlights W1 2018

1 W1 2018

1

2

1

2

Map 1a | Ukhia completeness by site/zone

Completeness

0 25% 50% 75% 100%

Map 1b | Teknaf completeness by site/zone

Completeness

0 25% 50% 75% 100%

Early Warning | Ukhia and Teknaf

2 W1 2018

1

23

4

5

6

7

8

9

10

11

12

13

1415

16

17

18

19

20

21

22

23

24

25

26

27

2829

3031

32

33

34

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

Zone ZZ

Zone VV

Zone QQ

Zone OO

Zone LL

Zone BB

Zone ZA

Balukhali MS

Zone NN

Jamtoli

Thangkhali / Burmapara /

Tasnimarkhola

Kutupalong MS

Zone AA

Zone SS

Zone XX

Zone MM

Zone JJ

Moynarghona / Bagghona

Hakimpara

Kutupalong RC

Zone YY

Zone WW

Zone UU

Zone TT

Zone RR

Zone PP

Zone KK

Zone II

Zone HH

Zone GG

Zone FF

Zone EE

Zone DD

Zone CC

1

2

3

4

5

6

1

2

3

4

5

6

Leda MS

Unchiprang

Nayapara

RC

Chakmarkul

Shamlapur

Jadimura

Northerngroup

Reporting Performance

# healthfacilities

# reportsreceived

Completeness Timeliness

Table 4 | Performance by site/zone (W1 2018) Map 2 | Completeness by site/zone

Completeness

0 25% 50% 75% 100%

Early Warning | Ukhia (Northern Group)

3 W1 2018

Balukhali MS 12 6 50% 50%

KutupalongMS

6 3 50% 50%

KutupalongRC

4 2 50% 50%

Zone AA 4 3 75% 75%

Zone BB 0 0 0% 100%

Zone CC 1 0 0% 0%

Zone DD 7 2 29% 29%

Zone EE 3 3 100% 100%

Zone FF 3 1 33% 33%

Zone GG 2 2 100% 100%

Zone HH 2 1 50% 50%

Zone II 0 0 0% 100%

Zone JJ 3 2 67% 67%

Zone KK 1 1 100% 100%

Zone LL 0 0 0% 100%

Zone MM 1 1 100% 100%

Zone NN 8 5 63% 63%

Zone OO 0 0 0%

1

2

3

4

5

6

7

8

9

10

11

1213

1415

16

17

18

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

Zone OO

Zone LL

Zone BB

Balukhali

MS

Zone NN

Kutupalong

MS

Zone AA

Zone MM

Zone JJ

Kutupalong

RC

Zone KK

Zone II

Zone HH

Zone GG

Zone FF

Zone EE

Zone DD

Zone CC

Southerngroup

Reporting Performance

# healthfacilities

# reportsreceived



Completeness

0 25% 50% 75% 100%

Early Warning | Ukhia (Southern Group)

4 W1 2018

EastPalongkhali

1 1 100% 100%

Hakimpara 6 4 67% 67%

Jamtoli 8 4 50% 50%

Moynarghona /Bagghona

8 3 38% 38%

Thangkhali /Burmapara /Tasnimarkhola

12 4 33% 33%

Zone PP 2 1 50% 50%

Zone QQ 0 0 0% 100%

Zone RR 2 2 100% 100%

Zone SS 5 3 60% 60%

Zone TT 6 4 67% 67%

Zone UU 2 0 0% 0%

Zone VV 0 0 0% 100%

Zone WW 3 1 33% 33%

Zone XX 3 1 33% 33%

Zone YY 1 1 100% 100%

Zone ZA 2 0 0% 0%

Zone ZZ 1 0 0%

1

23

4

5

6

78

9

10

11

12

13

14

15

16

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

Zone ZZ

Zone VV

Zone QQ

Zone ZA

Jamtoli


Tasnimarkhola

Zone SS

Zone XX


Hakimpara

Zone YY

Zone WW

Zone UU

Zone TT

Zone RR

Zone PP

Teknaf Reporting Performance

# healthfacilities

# reportsreceived



Completeness

0 25% 50% 75% 100%

Early Warning | Teknaf

5 W1 2018

Baharchora 2 0 0% 0%

Chakmarkul 2 2 100% 100%

Leda MS 4 1 25% 25%

MoH CC 1 0 0% 0%

Nayapara RC 3 1 33% 33%

Shamlapur 1 0 0% 0%

Teknaf UHC 0 0 0% 100%

Unchiprang 5 1 20%

1

2

3

4

5

6

1

2

3

4

5

6

Leda MS

Unchiprang

Nayapara

RC

Chakmarkul

Shamlapur

Jadimura

Partner Performance Reporting

# sites# reportsreceived


AIDOCT 1 1 100% 100%

BDRCS 10 4 40% 40%

BRAC 10 10 100% 100%

CARE 4 4 100% 100%

Doc Mobile 2 0 0% 0%

FHM 1 1 100% 100%

FRNDS 4 0 0% 0%

HMBDF 1 0 0% 0%

IHA 2 1 50% 50%

IOM 19 3 16% 16%

IRC 10 7 70% 70%

MERCY 2 2 100% 100%

MOAS 2 0 0% 0%

MSF 27 9 33% 33%

Table 7 | Performance by partner (W1 2018)

Partner Performance Reporting

# sites# reportsreceived


MTI 1 1 100% 100%

OBAT 1 0 0% 0%

PHD 8 8 100% 100%

PROTTYASHI 1 1 100% 100%

PWJ 1 0 0% 0%

RI 5 4 80% 80%

RTMI 3 0 0% 0%

SAJ 1 0 0% 0%

SCI 9 7 78% 78%

Early Warning | Partner performance

6 W1 2018

Northerngroup


# alerts % verif. # alerts % verif.

Table 8 | Performance by site/zone Map 5 | Number of alerts by site/zone

# of alerts

0 2 5 10

Alert | Ukhia (Northern Group)

7 W1 2018

Balukhali MS 2 1 2 1

KutupalongMS

2 0 2 0

KutupalongRC

1 1 1 1

Zone AA 3 1 3 1

Zone BB 0 0 0 0

Zone CC 0 0 0 0

Zone DD 0 0 0 0

Zone EE 5 4 7 6

Zone FF 1 1 1 1

Zone GG 2 2 2 2

Zone HH 0 0 0 0

Zone II 0 0 0 0

Zone JJ 0 0 0 0

Zone KK 1 0 1 0

Zone LL 0 0 0 0

Zone MM 0 0 0 0

Zone NN 2 1 2 1

Zone OO 0 0 0

1

2

3

4

5

6

7

8

9

10

11

1213

1415

16

17

18

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

17

18

Zone OO

Zone LL

Zone BB

Balukhali

MS

Zone NN

Kutupalong

MS

Zone AA

Zone MM

Zone JJ

Kutupalong

RC

Zone KK

Zone II

Zone HH

Zone GG

Zone FF

Zone EE

Zone DD

Zone CC

Southerngroup




# of alerts

0 2 5 10

Alert | Ukhia (Southern Group)

8 W1 2018

EastPalongkhali

0 0 0 0

Hakimpara 0 0 0 0

Jamtoli 2 2 2 2

Moynarghona /Bagghona

1 0 1 0

Thangkhali /Burmapara /Tasnimarkhola

1 1 1 1

Zone PP 2 2 2 2

Zone QQ 0 0 0 0

Zone RR 0 0 0 0

Zone SS 3 2 3 2

Zone TT 4 3 4 3

Zone UU 0 0 0 0

Zone VV 0 0 0 0

Zone WW 1 1 1 1

Zone XX 1 0 1 0

Zone YY 1 1 1 1

Zone ZA 0 0 0 0

Zone ZZ 0 0 0

1

23

4

5

6

78

9

10

11

12

13

14

15

16

1

2

3

4

5

6

7

8

9

10

11

12

13

14

15

16

Zone ZZ

Zone VV

Zone QQ

Zone ZA

Jamtoli


Tasnimarkhola

Zone SS

Zone XX


Hakimpara

Zone YY

Zone WW

Zone UU

Zone TT

Zone RR

Zone PP

Teknaf W1 Cumulative (2018)



# of alerts

0 2 5 10

Alert | Teknaf

9 W1 2018

Baharchora 0 0 0 0

Chakmarkul 1 1 1 1

Leda MS 1 1 1 1

MoH CC 0 0 0 0

Nayapara RC 0 0 0 0

Shamlapur 0 0 0 0

Teknaf UHC 0 0 0 0

Unchiprang 0 0 0

1

2

3

4

5

6

1

2

3

4

5

6

Leda MS

Unchiprang

Nayapara

RC

Chakmarkul

Shamlapur

Jadimura

Event W1 Cumulative (2018)


Indicator-based surveillance

Malaria 0 0% 0 0%

Measles/Rubella 25 60% 25 60%

Bloody Diarr. 0 0% 0 0%

AFP 2 100% 2 100%

Meningitis 0 0% 0 0%

Haem. fever(susp.)

4 100% 4 100%

NNT 0 0% 0 0%

Unexp. fever 0 0% 0 0%

AWD 0 0% 0 0%

ARI 0 0% 0 0%

AJS 5 60% 5 60%

Event-based surveillance

EBS total 1 100% 3 100%

Table 11 | Performance by type of alert Table 12 | Risk assessment


0 0 Low risk

0 0 Moderate risk

0 0 High risk

0 0 Very high risk

Alert | Event risk assessment

10 W1 2018

Figure 1 | Proportional morbidity (2018)

Malaria (confirmed)

Malaria (suspected)

Acute Respiratory Infection (ARI)

Acute Watery Diarrhoea

Bloody diarrhoea

Other diarrhoea

Acute Jaundice Syndrome (AJS)

Measles/Rubella

Other

Syndrome W1 2018

# cases % morbidity # cases % morbidity

AWD 5,691 8.7% 5,691 8.7%

Bloodydiarrhoea

2,680 4.1% 2,680 4.1%

Other diarrhoea 844 1.3% 844 1.3%

ARI 5,196 7.9% 5,196 7.9%

Measles/Rubella 106 0.2% 106 0.2%

AFP 1 0.0% 1 0.0%

Suspectedmeningitis

3 0.0% 3 0.0%

AJS 60 0.1% 60 0.1%

Susp. haem.fever

16 0.0% 16 0.0%

Neonataltetanus

0 0.0% 0 0.0%

Adult tetanus 0 0.0% 0 0.0%

Malaria (conf.) 3 0.0% 3 0.0%

Malaria (susp.) 641 1.0% 641 1.0%

Unexplainedfever

14,267 21.7% 14,267 21.7%

SevereMalnutrition

122 0.2% 122 0.2%

Injuries/Wounds 709 1.1% 709 1.1%

Other 35,273 53.8% 35,273 53.8%

Total 65,612 100% 65,612 100%

Proportional morbidity

11 W1 2018

For more help and support,

please contact:

Dr. Md. Alamgir

Medical Officer

Civil Surgeon Office

Ministry of Health and Family Welfare

Cox's Bazar, Bangladesh

Telephone: +88 018 1961 4952

Dr Uzzal Roy

Surveillance and Outbreak Response Officer

World Health Organization

Cox's Bazar, Bangladesh

Telephone: +88 017 0120 8837

Email: [email protected]

Notes

WHO and the Ministry of Health and Family Welfare gratefully acknowledge all partners who have

reported the data used in this bulletin.

The data been collected with support from the EWARS project. This is an initiative to strengthen early

warning, alert and response in emergencies. It includes an online, desktop and mobile application that

can be rapidly configured and deployed in the field. It is designed with frontline users in mind, and built

to work in difficult and remote operating environments. This bulletin has been automatically published

from the EWARS application.

More information can be found at http://ewars-project.org

Sign-up for an account with EWARS Bangladesh at http://bd.ewars.ws

Ministry of Health

and Family Welfare

Bangladesh

ewars - report viewer...obat 1 0 0% 0% phd 8 8 100% 100% prottyashi 1 1 100% 100% pwj 1 0 0% 0% ri 5...

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