Refugee Surveillance Update by IDSR department, MOH-RSS Page 1

REFUGEE SURVEILLANCE UPDATE (MABAN AND YIDA)

Epidemiological Week 7 18th- 24th February 2013

In this issue:

Highlights ..........................................................................................................................................1

Reporting Performance ......................................................................................................................2

Epidemic Prone Disease Reported ......................................................................................................3

Highlights

The proportion of health facilities in Maban submitting weekly reports to the state and central level

increased this week to 73% (16 out of 22) as compared to week 6 (see list of health facilities in

Maban and supporting partners in page 2). Six health facilities serving refugees in Maban reported

this week out of Seven facilities (Batil clinic supported by MSF Holland did not report this week),

while reporting from facilities serving the host communities improved this week 10 out of 15

facilities reported (Doro SIM started submitting reports)

All three health facilities serving Yida refugee camp reported on time this week

Acute watery diarrhea was the leading priority diseases recorded in the refugee camps (50%),

followed by Malaria (33%) and acute jaundice syndrome (11%).

Six hundred and thirty five (635) suspected Acute Jaundice Syndrome (AJS) cases (or Hepatitis E

cases) and two (2) related deaths were recorded from Maban and Yida. Of these cases and deaths,

97% of cases and 100% of deaths were reported from Maban refugee camps, only 3% of cases were

reported from Yida refugee camp. Of the cases from Maban, 52% were reported from Yusuf Batil,

followed by Gendrassa (28%), Jamam (17%) and Doro (3%).The cumulative AJS cases recorded from

Maban refugee camps was 7287 and 124 related deaths, while 168 AJS cases and 4 related deaths

were recorded in Yida since the beginning of the outbreak till week 7

Two cases of suspected measles were reported from Doro Camp and Gendrassa camps.

There was no report of suspected cholera, VHF cases reported from all the refugee camps.

Refugee Surveillance Update by IDSR department, MOH-RSS Page 2

Reporting Performance The total number of health facilities expected to report for Early Warning and Alert Response Surveillance (EWARS) system is 22 facilities in Maban and 3 facilities in Yida (Banishowa removed from the list), of these seven facilities are serving refugees camps in Maban and 3 facilities are serving Yida refugee camp. Nonetheless, few health facilities serving host communities in Maban county are not functioning or there functionality various week by week. Table 1: health facilities serving refugee and host communities in Maban and Yida

FACILITY IN MABAN WK1 WK2 WK3 WK4 WK5 WK6 WK7 Doro camp clinic MSF-B 1 1 1 1 1 1 1

Jamam CAMP MSF-H CLINIC 1 1 1 1 1 1

Batil GOAL clinic(west & South) 1 1 1 1 1 1 1

Batil MSF-H 1 1 1 1 1 1

Batil Medair SE Clinic

1 1 1 1 1 1

Gendrassa MSF H 1 1 1 1 1 1 1

Gendrassa IMC 1 1 1 1 1 1 1

Bounj PHCC Relief International 1

1 1 1

Bounj Hospital SP/GOAL 1

1 1 1

Dangaji PHCU Relief International 1

1 1 1

Gesm Allah PHCU Relief International 1

1 1 1

Jamam PHCU GOAL 1 1 1 1 1 1 1

Genkwatta PHCU MOH

Thauye PHCU MOH 1

1 1

New Guffa PHCU MOH

Khor Tumbak PHCU MOH

Puomkl PHCU SCiSS-MRDO

Doro PHCU SIM

1 1 1 1

Liang PHCU SCiSS-MRDO 1

1 1 1 1 1

Nila PHCU SCiSS-MRDO 1

1 1 1 1 1

Sheta PHCU SCiSS-MRDO 1

1 1 1 1 1

Baugaya PHCU GOAL

Total Facilities Reporting 14 8 11 11 14 15

FACILITIES IN YIDA WK1 WK2 WK3 WK4 Wk5 WK6 WK7 Wang Kuat PHCC 1 1 1 1 1 1

Yida PHCC 1 1 1 1 1 1

MSF-France Clinic 1 1 1 1 1 1 1

Total Facilities Reporting 3 3 3 3 1 3 3

Silent Facilities: Genkwatta PHCC, Khortumbak PHCC, New Guffa, Baugaya PHCC

Refugee Surveillance Update by IDSR department, MOH-RSS Page 3

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Figure 1: AWD TREND IN MABAN (WEEK 30-52 2012 - WKS 1-7 2013

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Fig 2: ABD TREND IN MABAN BY EPI Weeks (WEEK 30-52 2012 - WKS 1-7 2013

Epidemic Prone Disease Reported

Acute Watery Diarrhea (AWD) A total of 1829 AWD cases were reported in

Maban and Yida Refugee camps during this

reporting week with no related deaths.

Children below five years of age accounted

for 68% of all reported AWD cases.

Figure 1 shows a comparison of AWD cases

reported by Epi-week in year 2012 -2013 in

Maban. The overall incidence rate of AWD across the camps in Maban County increased in Week 7,

despite the fact that Yusuf Batil clinic supported by MSF Holland did not report this week. In Yida camp,

the AWD incidence remained stabled in week 7.

Dysentery (ABD)

A total of 140 cases of ABD with no related deaths were reported in week 7. Children below five years

of age accounted for 38% of all reported ABD cases. Figure 2 below shows a comparison of ABD cases

reported by Epi-week and year 2012 - 2013. The ABD trend reported from the refugee camps in Maban

increased slightly in week 7, although Yusuf Batil clinic supported by MSF Holland did not report this

week, as such the incidence could be much higher.

Refugee Surveillance Update by IDSR department, MOH-RSS Page 4

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Fig 3: MALARIA TREND IN MABAN BY EPI WEEKS (WEEK 30-52 2012 - WKS 1-7 2013

Malaria A total of 1194 malaria cases were reported in week 7 from Yida and Maban, with one related death in

a child under five from Yida camp. Out of all the cases, 32% were reported in children below five years

of age. Meanwhile trend across Yida has continued to increase this week with 61 % of all cases

coming from Yida alone.

Figure 3 below shows malaria trend in Maban from Epi-week 30-52 (2012) to Epi-week 1-7 (2013). The

trend had peaked in week 39 (2012) and has been declining gradually in the last few weeks. Figure 4

below shows malaria trend in Yida from Epi-week 30-52 (2012) to Epi-week 1-7 (2013) and the trend

slightly increased in week 6 and 7 as compared to the previous weeks.

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Fig 4: MALARIA TREND IN YIDA BY EPI WEEKS (WEEK 30-52 2012 - WKS 1-7 2013

Refugee Surveillance Update by IDSR department, MOH-RSS Page 5

Acute Jaundice Syndrome (AJS)

A total of six hundred and thirty five (635) suspected Acute Jaundice Syndrome (AJS) cases (or Hepatitis

E cases) and two (2) related deaths were recorded from Maban and Yida in week 7. Over 97% of new

AJS cases were recorded in Maban refugee camps (figure 5 for AJS Epi-Curve in Maban and Yida). One

death was recorded in Doro and the second one in Gendrassa camp. As shown figure 5, a total of 7287

AJS/Hepatitis E cases and 128 related deaths were reported since the beginning of the outbreak in the

refugee camps in Maban and Paring Counties, Upper Nile and Unity States respectively. Yusuf Batil

camp is still reporting increased number of AJS/HEV cases and deaths since epidemiological week 48 in

2012 to date. Jamam, Gendrassa and Doro also recorded increased cases of hepatitis E in the past 10

weeks. UNHCR together with health and WASH partners are taking steps to contain the surge of the

AJS/HEV cases in all camps by scaling up the sanitation and hygiene interventions to address gaps

identified in the earlier assessment done by partners.

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figure 5: Epi-Curve of Acute Jaundice Syndrome cases in the Refugee camps and host communities in Maban and Pariang County (May 2012-February 2013)

Refugee Surveillance Update by IDSR department, MOH-RSS Page 6

Measles: Only two (2) suspected measles cases were reported from Doro and Gendrassa camps in week

7. Health partners are currently investigating the reported cases, and it’s expected to collect blood

specimens for confirmation. The measles surveillance has been enhanced across the camps, and

county surveillance officers were equipped with the required materials for the investigation.

Other Disease: No suspected case of ILI and VHF was reported during this reporting period.

Table 3: Summary of Priority Diseases in Maban and Yida Refugee camps week 7

Camps Doro Batil Gendrassa Jamam Maban TOTAL Yida Yida TOTAL

Cases/ Death

C D C D C D C D C D C D C D

Suspected Cholera 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AWD 560 0 343 0 139 0 363 0 1405 0 422 0 422 0

BD 64 0 8 0 2 0 49 0 123 0 66 0 66 0

Meningitis 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Measles 1 0 0 0 1 0 0 0 2 0 0 0 0 0

AFP 0 0 0 0 0 0 0 0 0 0 0 0 0 0

AJS 18 1 322 0 171 1 105 0 616 2 19 0 19 0

VHF 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Malaria 315 0 83 0 38 0 31 0 467 0 727 1 727 1

Neonatal Tetanus 0 0 0 0 0 0 0 0 0 0 0 0 0 0

Total 958 1 756 0 351 1 548 0 2613 2 1234 1 1234 1

Key : AWD – Acute Watery Diarrhoea, , ABD – Blood Diarrhoea/Dysentery, Men – Meningitis, AJS – Acute Jaundice Syndrome, , AFP – Acute Flaccid Paralysis/Polio , NT - Neonatal Tetanus, 0 -Zero Report, C – Cases , D - Deaths , Timely reports - Reports received before Wednesday 10:00am, Completeness - Proportion of health facilities reporting in a county/state, Timeliness - Proportion of county in a state reporting on time. HFs- Health Facilities, EPI-Expanded program for immunization

For comments or questions, please contact: Surveillance Department, MoH-RSS, Tel: 0955551147; 0922186571; E-mail:

outbreak_ss_2007@yahoo.com, HF radio frequency: 8015 USP; CELL CALL: 7002

The Weekly Surveillance Bulletin is produced with the support UNHCR, ECHO, USAID and Common Humanitarian Fund (CHF) and WHO