Cholera Outbreak by Ministry of Health 06-06-2018

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REPUBLIC OF YEMENMinistry of Poblic Health&Population

Health Services Sector.& CareD.G. for Diseases Control and Surviellance

NATIONAL DIARRHEAL DISEASES CONTROL PROGRAMME

Meeting of Health Cluster

Cumulative from 27 April 2017 to 3 June 2018

• Suspected Cases 1104703• Deaths Cases 2299• Case Fatality Rate 0.21• Attack Rate 388• Confirmed Cases by Lab 1152 • Governorates Affected 96%• Districts Affected 92%• District with AWD 305• Positive Districts by LAB 132• Negative Districts by LAB 195

In week 22The Cumulative Total From

27 April 2017 To 3 June 2018

1975Suspected Cases

4Deaths Cases

0.20Case Fatality Rate

10Confirmed Cases by Lab

257Positive Cases by Rapid Test

1715Negative Cases by Rapid Test

Figure 1. Epi curve of suspected cholera.

Table 1: Distribution of suspected cholera cases by Governorate in Yemen, JUNE 3, 2018

* Higher attack rate indicates that these governorates had the highest risk of cholera transmission as compared to other governorate

Attack Rate* (per 10,000)Cumulative DeathsCumulative casesGovernorate

495285162363Al Hudaydah520424121443Hajjah37872108952Amanat Al Asimah530165109127Dhamar906183107277Amran53012379823Sana'a23429970567Ibb21819066646Taizz88615266097Al Mahwit6448347225Al Dhale'e4393835350Al Bayda4943528243Abyan2392224351Lahj2256220995Aden30112418868Raymah2782216207Al Jawf117510713Sa, adeh20377296Marib2231399Shabwah7611168Almaharah 72568Moklla0025Say,on

38822991104703Grand Total

Figure : (1) shows the distribution of cases by Governorate

Figure : (2) shows the distribution of cases by Gender

Cholera Outbreak by Ministry of Health 06-06-2018

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Figure : (3) shows the distribution of cases by age group

-The most cases are for children under 5 years (316693) , .percentage 29% and this age group has the highest attack rate as compare to other age groups.

- 19% of all deaths associated with suspected cholera were children below five years of age

. The lowest age groups are (> 60 Y) (53833) and percentage (6%)

- 31% of all deaths associated with suspected cholera were age groups are (> 60 Y)

Complete and Detailed Analysis of the Cholera

Epidemic For Last 3 Weeks :-

(20 , 21 , 22 ) - 2018

Key Indicators (During Last 3 Weeks 20,21,22)

Number of Cases = 6282 Cases

Number of Deaths = 11 Deaths

Number of Confirmed By Lab = 10 Cases

Attack Rate = 3 /10,000

Case Fatality Rate = 0.18 %

Number of Negative By Lab = 220 Cases

Number of Governorates = 15 Governorates

Number of Districts = 123 Districts

Figure : (4) shows the distribution of cases by age group During Last 3 Weeks

-The most cases are for children under 5 years (1842) , .percentage 29% and this age group has the highest attack rate as compare to other age groups.

- 73% of all deaths associated with suspected cholera were children below five years of age

. The lowest age groups are (> 60 Y) (354) and percentage (6%)

- 9 % of all deaths associated with suspected cholera were age groups are (> 60 Y)

Figure : (5) shows the distribution of cases by Confirmed Culture During Last 3 Weeks

In week 22

•- 1975 suspected cases and 4 associated deaths were reported

•- The districts reporting the highest number of cases are Al Hali(123),, Al Mighlaf (88),, At Taffah (82),

•- 16 % are severe cases•- 1,975 RDTs were performed,

257 were positive

Cholera Outbreak by Ministry of Health 06-06-2018

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الب موجب اف س اف شديد الجف ط الجف اف متوس ال يوجد جفAl Hali الي 12324999114الح

Al Mighlaf الف 882862779المغAt Taffah ة 8211711171الطف

Far Al Udayn دين 6746367فرع العMa'ain ن 6336063معي

At Tawilah ة 6135843423الطويلAmran 586524522عمران

Mukayras يراس 583552533مكAz'zal 50203050أزال

Hamdan دان 48444444همRadman Al Awad 48444741ردمانDhamar City ار ة ذم 4744347مدين

Ath'thaorah ورة 41239383الثAl Madan دان 4023840المــ

Zabid د 37136136زبيAttyal ال 3633336الطي

Jihanah ة 3543135جحانShibam Kawkaban ان 355308243شبام كوكب

Bani Suraim ريم ني ص 342322302بAnss 31301615عنس

Al Ashah ه ــ 3032730العشـــNihm 30301317نهم

Ad Dahi حي 28226127الضAl Bayda City اء ة البيض 2812728مدين

Al Haymah Ad Dakhiliyah ة ة الداخلي 2828523الحيمAl Haymah Al Kharijiyah ة ة الخارجي 281276220الحيم

Al Jabin ن 2612526الجبيAs Sabain بعين 26188251الس

Bani Matar ر 26620125بني مطSanhan ول ني بهل 24123420سنحان وب

ة االت المديري عدد الحة الفحص السريع اف نتيخ نوع الجف Figure :(6) showing the distribution of

cases by Districts in week (22) , 2018

In week 22 RDT positive

•- 257 positive cases and 1 associated deaths were reported

•- The districts reporting the highest number of cases are Al Hali(24),, Az'zal(20),, As Sabain(18),

•- 83 % are severe cases•- Over 78 stool specimens were

collected and analyzed and 10 specimens tested positive for V. Cholera,

Figure :(7) showing the distribution of RDT positive by Districts in week (22) , 2018

severmildno dehydrationAl Hali الي 247175الحAz'zal 20201أزال

As Sabain بعين 18171السAt Taffah ة 1165الطفAl Husha 734الحشاءAmran ران 615عم

Assafi'yah افية 66الصBani Matar ر ني مط 615ب

Raydah 66ريدهAsh Sharyah رية 55الش

Rada' 5234رداعHuth 55حوث

Kharif 541خارفShibam Kawkaban ان 541شبام كوكب

Thula 55ثالءAl Malagim م 44المالج

Bani Hushaysh 413بني حشيشDhamar City ار ة ذم 44مدينFar Al Udayn دين رع الع 44ف

Hamdan دان 413همJihanah 44جحانةMazhar 44مزهر

Radman Al Awad 431ردمانAl Ashah ه ــ ــ 33العـشAl Hawak وك 33الح

Al Mahwait ت 312المحويAl Mansuriyah ورية 33المنص

At Tawilah ة 321الطويلAttyal ال 33الطي

Bilad Ar Rus روس 312بالد الDamt 312دمت

Habur Zulaymah ة ور ظليم 312حبMa'ain ن 33معي

Mukayras يراس 33مك

dehydrationDistirct positive RDTConfirmed Culture

Challenges•Lack of operational budget for cholera program

to supervise field workق على عدم توفر ميزانية تشغيلية لبرنامج الكوليرا لإلشرا•

العمل الميداني•Because of the aggression on Yemen, the health

system was destroyedبسبب العدوان على اليمن ، تم تدمير النظام الصحي••Lack of operational expenses for health facilities

and the Districtةنقص النفقات التشغيلية للمرافق الصحية والمديري•

Cholera Outbreak by Ministry of Health 06-06-2018

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Thank you

Dr. Abdul Ghani Al Kabeer Dr . Yahya Alabdulli