epidemiological highlights · weekly ewars reporting form 2. ... source: iom. bangladesh: needs and...

W2 2019 | Highlights

Epidemiological Highlights Week 2, 2019

Highlights:

• Varicella has been included under Indicator-Based (IBS) and Event-

Based surveillance (EBS) in EWARS

• Varicella cases showing increasing trend due to improvements of

reporting.

• Acute respiratory infection (ARI), diarrhoeal diseases and

unexplained fever are the diseases with highest morbidity in last week

• No notable changes in trends of other diseases and syndromes.


EWARS Reporting Updates:

Total 166/ 212 (78%) health facilities registered in EWARS

Only 126/166 weekly reports received last week • Completeness and Timeliness for this week is 74%

Total 54 alerts were triggered this week which is more than previous week. This is because of introducing varicella for the first time to indicator-based surveillance (IBS).

All alerts were reviewed and verified by EWARS team.



Varicella

• Varicella added is added to Indicator-Based (IBS) & Event-

Based surveillance (EBS).

• This week we received 1358 varicella cases via weekly report

form which in more than previous week (336 Cases in week 1).

• Health Partners were trained on varicella reporting.

Measles

• 13 new suspected case reported via weekly reporting this week.

• All these cases have been notified and being traced by WHO-

IVD team.

• WHO is supporting ministry of health (MoH) in routine measlse

surveillance in FDMN population.


Diphtheria

• 10 new diphtheria case-patients (1 probable and 9 suspected)

were reported this week. • Total case-patients reported in (2018) = 8 372

▪ Confirmed case = 293

▪ Probable case = 2 710

▪ Suspected case = 5 369

• The last confirmed case was reported on 31 December 2018

(Epi week 1 2019).

• Total number of deaths reported till now is 44.

• Form host community 199 diphtheria case-patients were

reported • Confirmed cases = 30

• Probable = 63

• Suspected = 106

• No death reported from host community.

BangladeshRohingya Emergency Response

Ministry of Health and FamilyWelfare Bangladesh Printed: 03:13 Wednesday, 16 January 2019 UTC

Early Warning, Alert and Response System (EWARS)Epidemiological Bulletin W2 2019

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

Sources of data

1. Weekly EWARS Reporting Form 2. Mortality Case Report Form 3. Event-based Surveillance Form

Contents

W2 2019

Table 1 | Coverage

# %

918,936 - Estimated total Rohingya population

904,056 98% Total population under surveillance

212 - Total number of health facilities

166 78% Number of EWARS reporting sites

Table 2 | Early warning performance indicators

W2 Cumulative (2019)

126 266 Number of weekly reports received

74% 68% Completeness

74% 66% Timeliness

Table 3 Alert performance indicators


54 84 Total alerts raised

100% 100% % verified

0% 0% % auto-discarded

0% 0% % undergoing risk assessment

0% 0% % completed risk assessment

Source: IOM. Bangladesh: Needs and Population Monitoring - NPM R11 Report. 14 June 2018.

Highlights W2 2019

1 W2 2019

1

1

Map 1a | Ukhia completeness by camp

Completeness 0 25% 50% 75% 100%

Map 1b | Teknaf completeness by camp

Completeness 0 25% 50% 75% 100%

Early Warning | Ukhia and Teknaf

2 W2 2019

1

2

3

45

6 7

8910

1112 13 14 15

1617 18

19

20

21

22

2324

25

26

1 Camp 132 Camp 143 Camp 164 Camp 1W5 Camp 1E6 Camp 8W7 Camp 8E8 Camp 79 Camp 610 Camp 511 Camp 4 Ext12 Camp 413 Camp 314 Camp 2W15 Camp 2E16 Camp 917 Camp 20 Ext18 Camp 2019 Camp 1920 Camp 1821 Camp 1722 Camp 1523 Camp 1224 Camp 1125 Camp 1026 Kutupalong RC

12

3

4

5

6

78

1 Camp 22 Unchiprang2 Camp 23 Shamlapur3 Nayapara RC4 Camp 21 Chakmarkul5 Camp 27 Jadimura6 Camp 26 Nayapara7 Camp 25 Ali Khali8 Camp 24 Leda

Northerngroup Reporting Performance

# healthfacilities

# reportsreceived Completeness Timeliness

Table 4 | Performance by camp (W2 2019) Map 2 | Completeness by camp

Completeness 0 25% 50% 75% 100%

Early Warning | Ukhia (Northern Group)

3 W2 2019

Camp 1E 6 3 60% 60%

Camp 1W 5 4 75% 75%

Camp 2E 1 0 0% 0%

Camp 2W 6 4 60% 60%

Camp 3 8 4 57% 57%

Camp 4 7 4 100% 100%

Camp 4 Ext 1 1 100% 100%

Camp 5 5 2 40% 40%

Camp 6 2 1 50% 50%

Camp 7 8 5 71% 71%

Camp 8E 10 5 71% 71%

Camp 8W 9 8 89% 89%

KutupalongRC

2 2 100% 100%

12

3 4

567

89 10 11 12

13

1 Camp 1W2 Camp 1E3 Camp 8W4 Camp 8E5 Camp 76 Camp 67 Camp 58 Camp 4 Ext9 Camp 410 Camp 311 Camp 2W12 Camp 2E13 Kutupalong RC

Southerngroup Reporting Performance

# healthfacilities



Completeness 0 25% 50% 75% 100%

Early Warning | Ukhia (Southern Group)

4 W2 2019

Camp 10 5 4 80% 80%

Camp 11 9 7 78% 78%

Camp 12 6 2 40% 40%

Camp 13 15 8 89% 89%

Camp 14 7 4 80% 80%

Camp 15 9 6 86% 86%

Camp 16 8 5 63% 63%

Camp 17 6 5 83% 83%

Camp 18 8 6 86% 86%

Camp 19 3 2 100% 100%

Camp 20 4 2 50% 50%

Camp 20 Ext 1 1 100% 100%

Camp 9 10 5 44% 44%

1

2

3

45 6

7

8

9

10

1112

13

1 Camp 132 Camp 143 Camp 164 Camp 95 Camp 20 Ext6 Camp 207 Camp 198 Camp 189 Camp 1710 Camp 1511 Camp 1212 Camp 1113 Camp 10

Teknaf Reporting Performance

# healthfacilities



Completeness 0 25% 50% 75% 100%

Early Warning | Teknaf

5 W2 2019

Camp 21Chakmarkul

5 4 100% 100%

Camp 22Unchiprang

7 4 100% 100%

Camp 23Shamlapur

4 2 100% 100%

Camp 24 Leda 1 1 100% 100%

Camp 25 AliKhali

2 2 100% 100%

Camp 26Nayapara

4 4 100% 100%

Camp 27Jadimura

1 1 100% 100%

Nayapara RC 2 1 100% 100%

12

3

4

5

6

78


Partner Performance Reporting

# sites # reportsreceived Completeness Timeliness

BDRCS 4 2 50% 50%

BRAC 11 11 100% 100%

CARE 4 4 100% 100%

FHM 1 1 100% 100%

FRNDS 13 13 100% 100%

GK 9 10 111% 111%

HMBDF 1 1 100% 100%

IHA 0 0 0% 0%

IOM 20 17 85% 85%

IRC 9 9 100% 100%

MOAS 0 0 0% 0%

MSF 18 9 50% 50%

MoH 0 0 0% 0%

Table 7 | Performance by partner (W2 2019)

Partner Performance Reporting

# sites # reportsreceived Completeness Timeliness

MTI 5 2 40% 40%

OBAT 0 0 0% 0%

PHD 8 0 0% 0%

Prottyashi 2 0 0% 0%

PWJ 1 0 0% 0%

RHU 2 2 111% 111%

RI 8 8 100% 100%

RTMI 8 8 100% 100%

SCI 10 10 100% 100%

TdH 1 1 100% 100%

Early Warning | Partner performance

6 W2 2019

Northerngroup W2 Cumulative (2019)

# alerts % verif. # alerts % verif.

Northerngroup W2 Cumulative (2019)


Table 8 | Performance by camp Map 5 | Number of alerts by camp

# of alerts 0 2 5 10

Alert | Ukhia (Northern Group)

7 W2 2019

Camp 1E 3 100% 3 100%

Camp 1W 1 100% 1 100%

Camp 2E 0 0% 0 0%

Camp 2W 4 100% 5 100%

Camp 3 2 100% 3 100%

Camp 4 1 100% 2 100%

Camp 4 Ext 0 0% 0 0%

Camp 5 1 100% 3 100%

Camp 6 0 0% 1 100%

Camp 7 0 0% 0 0%

Camp 8E 0 0% 0 0%

Camp 8W 8 100% 10 100%

KutupalongRC

1 100% 2 100%

12

3 4

567

89 10 11 12

13

1 Camp 1W2 Camp 1E3 Camp 8W4 Camp 8E5 Camp 76 Camp 67 Camp 58 Camp 4 Ext9 Camp 410 Camp 311 Camp 2W12 Camp 2E13 Kutupalong RC

Southerngroup W2 Cumulative (2019)




Alert | Ukhia (Southern Group)

8 W2 2019

Camp 10 2 100% 4 100%

Camp 11 1 100% 1 100%

Camp 12 0 0% 3 100%

Camp 13 7 100% 8 100%

Camp 14 1 100% 1 100%

Camp 15 3 100% 5 100%

Camp 16 0 0% 0 0%

Camp 17 5 100% 9 100%

Camp 18 1 100% 1 100%

Camp 19 0 0% 0 0%

Camp 20 1 100% 1 100%

Camp 20 Ext 0 0% 0 0%

Camp 9 3 100% 3 100%

1

2

3

45 6

7

8

9

10

1112

13

1 Camp 132 Camp 143 Camp 164 Camp 95 Camp 20 Ext6 Camp 207 Camp 198 Camp 189 Camp 1710 Camp 1511 Camp 1212 Camp 1113 Camp 10

Teknaf W2 Cumulative (2019)




Alert | Teknaf

9 W2 2019

Camp 21Chakmarkul

1 100% 7 100%

Camp 22Unchiprang

3 100% 4 100%

Camp 23Shamlapur

0 0% 1 100%

Camp 24 Leda 1 100% 1 100%

Camp 25 AliKhali

1 100% 2 100%

Camp 26Nayapara

1 100% 1 100%

Camp 27Jadimura

1 100% 1 100%

Nayapara RC 0 0% 0 0%

12

3

4

5

6

78


Event W2 Cumulative (2019)


Indicator-based surveillance

Malaria 0 0% 0 0%

Measles/Rubella 8 100% 16 100%

Bloody Diarr. 0 0% 0 0%

AFP 0 0% 0 0%

Meningitis 0 0% 0 0%

Haem. fever(susp.)

0 0% 0 0%

NNT 0 0% 0 0%

Unexp. fever 5 100% 9 100%

AWD 5 100% 7 100%

ARI 12 100% 16 100%

AJS 0 0% 0 0%

Event-based surveillance

EBS total 2 100% 14 100%

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 W2 2019

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. Md Khadimul Anam Mazhar Surveillance and Outbreak Response Officer World Health Organization Cox's Bazar, Bangladesh

Telephone: +88 017 0120 8845

Email: [email protected]

NotesWHO and the Ministry of Health and Family Welfare gratefully acknowledge all partners who havereported the data used in this bulletin. The data been collected with support from the EWARS project. This is an initiative to strengthen earlywarning, alert and response in emergencies. It includes an online, desktop and mobile application thatcan be rapidly configured and deployed in the field. It is designed with frontline users in mind, and builtto work in difficult and remote operating environments. This bulletin has been automatically publishedfrom 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 ofHealth andFamilyWelfare Bangladesh

BangladeshRohingya Emergency Response

Ministry of Health and FamilyWelfare Bangladesh Printed: 02:41 Wednesday, 16 January 2019 UTC

Early Warning, Alert and Response System (EWARS)Annex W2 2019

Figure 1 | Proportional morbidity (W2 2019)

Acute Respiratory Infection (ARI) Acute Watery Diarrhoea Bloody diarrhoea Other diarrhoea Varicella (susp.)

Unexplained fever Acute Jaundice Syndrome (AJS) Measles/Rubella Other Vector-borne disease Combines malaria and dengue cases (suspected and confirmed)

Disease W2 2019

# cases % morbidity # cases % morbidity

AWD 3,463 4.8% 6,351 4.9%

Bloody diarr. 283 0.4% 497 0.4%

Other diarr. 1,923 2.7% 3,603 2.8%

Susp. Varicella 1,358 1.9% 1,606 1.2%

ARI 9,659 13.3% 18,356 14.2%

Measles/Rub. 13 0.0% 23 0.0%

AFP 0 0.0% 0 0.0%

Susp. menin. 0 0.0% 0 0.0%

AJS 5 0.0% 9 0.0%

Susp. HF 0 0.0% 0 0.0%

Neo. tetanus 0 0.0% 0 0.0%

Adult tetanus 0 0.0% 0 0.0%

Malaria (conf.) 0 0.0% 1 0.0%

Malaria (susp.) 0 0.0% 0 0.0%

Dengue (conf.) 0 0.0% 0 0.0%

Dengue (susp.) 0 0.0% 0 0.0%

Unexpl. fever 2,699 3.7% 5,556 4.3%

Sev. Malnut. 71 0.1% 131 0.1%

Inj./Wounds 1,449 2.0% 2,714 2.1%

Other 51,555 71.1% 90,439 69.9%

Total 69,838 100% 129,384 100%

Proportional morbidity

1 W2 2019

*

*

Figure 2 | Trend in proportional morbidity for key diseases (W2)

Other consultations Acute Respiratory Infection (ARI) Unexplained fever Acute Jaundice Syndrome (AJS)

Acute Watery Diarrhoea (AWD) Other diarrhoea Vector-borne disease Combines malaria and dengue cases (suspected and confirmed)

Trend in consultations and key diseases

2 W2 2019

% m

orbi

dity

W01

201

8

W05

201

8

W09

201

8

W13

201

8

W18

201

8

W22

201

8

W26

201

8

W31

201

8

W35

201

8

W40

201

8

W44

201

8

W48

201

8

W01

201

9

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

*

*

Acute Respiratory Infection | Trend

3 W2 2019

Total ARI cases - Cox's Bazar

W26

201

7

W35

201

7

W44

201

7

W01

201

8

W09

201

8

W18

201

8

W26

201

8

W35

201

8

W44

201

8

W01

201

9

0

2,000

4,000

6,000

8,000

10,000

12,000

14,000

16,000

18,000

20,000

Figure 3 | Trend in number of cases over time (W38 2017 - W2 2019)

a. Ukhia | Number of cases b. Ukhia | Number of alerts c. Teknaf | Number of cases d. Teknaf | Number of alerts

Acute Respiratory Infection | Maps and Alert Management

Map 1 | Map of cases by camp (W2 2019)

4 W2 2019

Map legendNumber of cases 0 1 100 200 500

Number of alerts 0 1 10

Alert thresholdTwice the average number of casesover the past 3 weeks. Source: IEDCR

0Alerts

0%Verified

0Low Risk

0Moderate

Risk

0High Risk

0Very High

Risk

Alert management (W2 2019) Figure | % sex Figure | % age

Male Female >=5 < 5

Measles | Trend

5 W2 2019

Total suspected measles/rubella cases - Cox's Bazar

W26

201

7

W35

201

7

W44

201

7

W01

201

8

W09

201

8

W18

201

8

W26

201

8

W35

201

8

W44

201

8

W01

201

9

0

20

40

60

80

100

120

140

160

180

200

Figure 4 | Trend in number of suspected cases over time (W38 2017 - W2 2019)


Measles | Maps and Alert Management

Map 2 | Map of cases by camp (W2 2019)

6 W2 2019



Alert threshold1 case. Source: IEDCR

8Alerts

100%Verified

0Low Risk

0Moderate

Risk

0High Risk

0Very High

Risk


Male Female >= 5 < 5

Acute Jaundice Syndrome | Trend

7 W2 2019

Total suspected AJS cases - Bangladesh

W26

201

7

W35

201

7

W44

201

7

W01

201

8

W09

201

8

W18

201

8

W26

201

8

W35

201

8

W44

201

8

W01

201

9

0

20

40

60

80

100

120

140

160

180



Acute Jaundice Syndrome | Maps and Alert Management

Map 3 | Map of cases by camp (W37 2017 - W2 2019)

8 W2 2019



Alert thresholdA cluster of 3 or more cases seen in ahealth facility. Source: IEDCR

0Alerts

0%Verified

0Low Risk

0Moderate

Risk

0High Risk

0Very High

Risk



Acute Watery Diarrhoea | Trends

9 W2 2019

Total AWD cases - Bangladesh

W26

201

7

W35

201

7

W44

201

7

W01

201

8

W09

201

8

W18

201

8

W26

201

8

W35

201

8

W44

201

8

W01

201

9

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000


Dengue | Trends

11 W2 2019

Total Dengue Cases - Suspected - Bangladesh Total Dengue Cases - Confirmed - Bangladesh

W01

201

8

W05

201

8

W09

201

8

W13

201

8

W18

201

8

W22

201

8

W26

201

8

W31

201

8

W35

201

8

W40

201

8

W44

201

8

W48

201

8

W01

201

9

0

1

2

3

4

5

6

7



Dengue | Maps and Alert Management


12 W2 2019



Alert thresholdTwice the average number of casesover the past 3 weeks. Source: IEDCR

0Alerts

0%Verified

0Low Risk

0Moderate

Risk

0High Risk

0Very High

Risk



Varicella (Susp.) | Trends

13 W2 2019

Total Varicella Cases - Suspected - Bangladesh

W01

201

8

W05

201

8

W09

201

8

W13

201

8

W18

201

8

W22

201

8

W26

201

8

W31

201

8

W35

201

8

W40

201

8

W44

201

8

W48

201

8

W01

201

9

0

200

400

600

800

1,000

1,200

1,400

1,600


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. Md Khadimul Anam Mazhar Surveillance and Outbreak Response Officer World Health Organization Cox's Bazar, Bangladesh

Telephone: +88 017 0120 8845

Email: [email protected]

NotesWHO and the Ministry of Health and Family Welfare gratefully acknowledge all partners who havereported the data used in this bulletin. The data been collected with support from the EWARS project. This is an initiative to strengthen earlywarning, alert and response in emergencies. It includes an online, desktop and mobile application thatcan be rapidly configured and deployed in the field. It is designed with frontline users in mind, and builtto work in difficult and remote operating environments. This bulletin has been automatically publishedfrom 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 ofHealth andFamilyWelfare Bangladesh

epidemiological highlights · weekly ewars reporting form 2. ... source: iom. bangladesh: needs and...

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