week-34 - humanitarianresponse · weekly afp cases reported by provinces, 2016-2017 somalia. (cases...

Somalia Weekly Update

Week-34Ending 27th August 2017

Part -I

AFP-Surveillance

Week-34 Somalia Weekly EPI/POL Update

Epidemiological Curve January 1, 2014 – August 27, 2017

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Pending Lab Pending ERG Discarded Compatable WPV aVDPV

Weekly AFP cases reported by Provinces, 2016-2017 Somalia. (cases are distributed across weeks based on date of onset of paralysis).

- 4 new AFP cases were reported this week making the total 237 AFP cases reported in 2017.- In addition 711 contact samples (3 contacts for each case) and 83 community samples were collected from 14 districts.- Nugal and Mudug regions are silent for 8 or more consecutive weeks. Silent regions are advised to collect community samples


Tab

le n

o.-

1

Silent (not reporting) for > 8 weeks

Reported AFP cases

Community Samples collected in silent regions

Community Samples collected but regions not silent

PROVINCE

2016

W28

2016

W29

2016

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2016

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2016

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2016

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2016

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2016

To

tal

2017

W01

2017

W02

2017

W03

2017

W04

2017

W05

2017

W06

2017

W07

2017

W08

2017

W09

2017

W10

2017

W11

2017

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2017

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2017

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2017

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2017

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2017

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W34

2017

To

tal

BANADIR 2 1 1 1 1 2 1 2 1 30 1 1 1 2 1 3 1 2 1 1 1 1 1 2 1 1 2 23

GALGADUD 1 1 1 2 2 1 1 25 1 1 1 1 1 1 1 2 1 1 1 1 1 2 1 1 18

M. SHABELLE 1 1 1 1 1 1 1 19 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 16

L. SHABELLE 1 1 2 1 1 1 1 1 2 1 24 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 17

HIRAN 2 1 1 1 15 1 1 1 1 1 1 1 1 1 1 1 1 1 1 14

BARI 1 1 1 1 1 1 1 2 1 1 24 1 2 1 1 1 2 1 1 1 1 1 2 1 16

NUGAL 1 2 1 1 1 11 2 1 1 1 1 6

MUDUG 1 1 1 1 1 2 1 1 14 1 2 1 1 1 1 1 1 9

TOGDHER 1 1 1 1 1 1 11 1 1 1 1 1 1 1 7

GALBEED 1 1 1 1 1 1 1 1 1 1 19 1 3 1 1 1 1 1 1 1 1 2 14

SANAQ 1 1 2 1 7 1 1 1 1 1 5

AWDAL 2 1 1 1 1 1 1 1 18 1 1 1 1 2 1 1 1 1 1 1 1 1 1 15

SAHIL 1 1 1 8 1 1 1 1 1 1 1 7

SOOL 1 1 5 1 2 1 1 1 1 7

LOWER JUBA 1 2 1 2 1 1 1 1 2 1 1 26 2 1 1 2 2 1 1 1 1 1 1 1 1 2 2 1 1 22

BAY 1 1 1 2 1 2 19 3 1 3 1 1 1 1 1 1 13

GEDO 1 2 1 1 1 21 1 2 1 1 1 1 1 1 1 1 1 1 2 15

MIDDLE JUBA 1 1 1 1 1 1 11 1 1 1 1 2 1 7

BAKOOL 1 1 1 1 9 1 1 1 1 1 1 6

Total Somalia 2 6 9 9 3 7 5 1 6 5 6 6 7 5 11 7 3 4 4 12 7 7 3 5 4 316 6 8 10 6 3 8 9 11 7 12 8 6 9 8 8 4 10 8 6 9 8 5 9 10 2 5 9 3 7 6 7 7 2 1 237

REGION2016 2017

Pending Discarded VDPV Total Discarded Pending Total

BANADIR 0 30 0 30 23 0 23

GALGADUD 0 25 0 25 16 2 18

HIRAN 0 15 0 15 12 2 14

L. SHABELLE 0 24 0 24 15 2 17

M. SHABELLE 0 19 0 19 14 2 16

BARI 0 24 0 24 14 2 16

MUDUG 0 14 0 14 9 0 9

NUGAL 0 11 0 11 6 0 6

AWDAL 0 18 0 18 14 1 15

GALBEED 0 19 0 19 12 2 14

SAHIL 0 8 0 8 6 1 7

SANAQ 0 7 0 7 4 1 5

SOOL 0 5 0 5 7 0 7

TOGDHER 0 10 1 11 6 1 7

BAKOOL 0 9 0 9 5 1 6

BAY 0 19 0 19 12 1 13

GEDO 0 21 0 21 15 0 15

LOWER JUBA 0 26 0 26 20 2 22

MIDDLE JUBA 0 11 0 11 7 0 7

Grand Total 0 315 1 316 217 20 237

Classification of AFP cases by status (2016 & 2017)

20In process

(lab)

0Pending

ITD

217Discarded

0 WPV

20Pending

0 Compatible

0VDPV

237 AFP Cases Reported in 2017


Tab

le n

o.-

2

Chart no. 1

Surveillance Indicators by Zone and Region 2017


Graph no. 2

Graph no. 3

Map no. 1

4.9

10.9

6.16.8

6.0

0.0

2.0

4.0

6.0

8.0

10.0

12.0

Central Puntland Somaliland South Total Somalia

Annualized NP-AFP Rate by Zone, 2017

7.9

5.7 5.9 6.0

-

2.0

4.0

6.0

8.0

10.0

In-accessible PartiallyAcceessible

Accessible Somalia

Annualized NPAFP rate by accessibility status, 2017

Map no. 2

Surveillance Indicators (NP-AFP rate and Stool adequacy) by district, 2017

▪ 98% (n=113) of the 115 districts in Somalia

have reported at least one AFP case since the

beginning of 2017.

▪ The NP-AFP rate for all the 109 districts is

>2/100,000 U-15 Population.

▪ 110 districts had stool adequacy of above

80% while three districts (Badade,Kismayo

and Bossaso) did not meet the required stool

adequacy rate. Badade and kismayo are

partially while Bossaso is fully accessible

district.


Map no. 3 Map no. 4

Distribution of NP-AFP cases and zero-dose cases Vs accessibility of districts


▪ AFP cases were reported from across

the country from all zones, all regions

and also from the accessible and the

inaccessible parts of the country.

▪ All but one of the total 32 zero dose

AFP cases reported in 2017 were

reported from access compromised

districts. Map no.6Map no. 5

Number of NP-AFP cases reported across years during the same period (2013-2017) by zone

▪ Overall number of AFP cases reported in 2017 exceeded the number of AFP cases reported in 2015 and 2016 in all zones for the same period.


34 16 25 17

92

23 2344

93

390

133

47 44

77

305

84

42 3848

212

80

2842

51

201

88

31

5563

237

-40

10

60

110

160

210

260

310

360

410

CENTRAL Puntland Somaliland SOUTH SOMALIA

2012 2013 2014 2015 2016 2017

Number of AFP Cases and Contact samples with Entero virus and Sabin like Virus Isolation

Zone

NP-AFP Cases Contact Cases

# S

amp

les

fro

m

Cas

es w

ith

lab

res

ult

# S

amp

les

fro

m

case

s w

ith

NP

-EV

# S

Ls

# S

amp

les

fro

m

Co

nta

cts

wit

h la

b

resu

lt

# S

amp

les

fro

m

con

tact

s w

ith

NP

-EV

# S

LVs

Central 160 28 7 240 33 15

Puntland 58 6 4 89 14 6

Somaliland 98 5 5 147 10 3

South 118 17 2 173 26 3

Somalia 434 56 18 649 83 27


Table no.-3

17.5%

13.8%

9%

6%

10.3%

15.7%

14%

7%

5.1%

6.8%

10%

2%

14.4%15.0%

3%

2%

12.9% 12.8%

8%

4%

0.0%

2.0%

4.0%

6.0%

8.0%

10.0%

12.0%

14.0%

16.0%

18.0%

20.0%

% Specimens from cases withNPEV

% Specimens fromContactswith NPEV

% SL from cases % SL from Contacts

CASES AND CONTACT SAMPLES WITH LAB RESULT OFNP-EV AND SLV

Central Puntland Somaliland South Somalia

▪ 93% (n=221/237) of AFP cases reported in 2017 are notified within 7 days of onset. ▪ 16 cases were notified more than seven days after the onset of paralysis from 7 regions {Lower Jubba (8), Gedo (3) , Middle Juba (1), Bari (1), Sanaq (1), Bakool (1), Bay (1) and Galbeed (1)}.

Early case detection within 7 days from onset of paralysis at zonal and region levels


Graph no.6

8830 53

50

221

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CENTRAL NE NW SOUTH SOMALIA

Notification within 7 days, Zonal

23 18 14 17 16

15

9 6 15

13

7

4

7 7 6

12

12

14

6

221

0%

20%

40%

60%

80%

100%

CENTRAL NE NW SOUTH SOMALIA

Notification within 7 days, Regional

Graph no.7

ZONE

# A

FP c

ases

NP

-AFP

Rat

e

# C

ases

wit

h

Ad

q.

Spec

imen

% tool Adq. % inv. within 48 hrs.

% Notif. within 7 days

Cas

es

pe

nd

ing

lab

res

ult

s

Cas

es w

ith

lab

. re

sult

.

Cas

es

wit

h s

too

l in

go

od

co

nd

.

% C

ases

wit

h

sto

ol i

n g

oo

d

con

d.

#o

f sa

mp

les

wit

h N

P-E

V

Iso

late

d

% S

amp

les

wit

h

NP

EV

Iso

late

d

# c

ases

wit

h

Sab

in li

ke v

iru

s Is

ola

tio

n

% o

f ca

ses

wit

h

S L

Vir

us

Iso

lati

on

Central 88 4.9 88 100% 99% 100% 8 80 80 100% 28 18% 7 9%

Puntland 31 10.9 30 97% 100% 97% 2 29 29 100% 6 10% 4 14%

Somaliland 55 6.1 55 100% 98% 96% 6 49 49 100% 5 5% 5 10%

South 63 6.8 61 95% 98% 79% 4 59 59 100% 17 14% 2 3%

Total 237 6.0 234 98% 99% 93% 20 217 217 100% 56 13% 18 8%

Summary of AFP surveillance key indicators by Zone, 2017

▪ Surveillance indicators at national and sub-national levels perform above global standard, however, notification within 7 days in south zone particularly in Bakool and L. Juba regions is deteriorating.

▪ Except 3 AFP cases; one from El-Waq district of Gedo region in South zone, one from Ainabo district of Togdheer region in Somaliland and one from Buloburti distrct of HiranRegion in Central zone, all the other AFP cases were investigated within 48 hrs of notification.

▪ Three cases from Badade, Bosaso and Kismayo districts (one from each) had low stool adequacy levels.


Table no.-4


Summary of AFP surveillance key indicators by Province, 2017

ZONE PROVINCENumber of AFP cases

reportedNP-AFP Rate % Stool Adq.

% inv. within 48 hrs.

% Notif. within 7 days

% Stool condition

% Samples with EV isolated

% cases with SL isolated

# Cases with late 60 days

followup

CENTRAL

BANADIR 23 3.4 100% 100% 100% 100% 26% 9% 1

GALGADUD 18 10.9 100% 100% 100% 100% 19% 6% 2

HIRAN 14 9.7 100% 93% 100% 100% 4% 0% 6

LOWER SHABELLE 17 2.9 100% 100% 100% 100% 20% 27% 1

MIDDLE SHABELLE 16 6.9 100% 100% 100% 100% 11% 0% 0

PUNTLAND

BARI 16 14.3 94% 100% 92% 100% 7% 14% 3

MUDUG 9 7.8 100% 100% 100% 100% 17% 22% 1

NUGAL 6 10.7 100% 100% 100% 100% 8% 0% 1

SOMALILAND

AWDAL 15 9.9 100% 100% 100% 100% 0% 7% 1GALBEED 14 4.1 100% 100% 92% 100% 0% 8% 0SAHIL 7 13.2 100% 100% 100% 100% 0% 33% 1SANAQ 5 5.4 100% 100% 75% 100% 0% 0% 1SOOL 7 9.4 100% 100% 100% 100% 21% 14% 3TOGDHER 7 3.6 100% 86% 100% 100% 17% 0% 1

SOUTH

BAKOOL 6 5.3 100% 100% 75% 100% 0% 0% 0BAY 13 3.9 100% 100% 91% 100% 0% 0% 2GEDO 22 7.8 100% 93% 75% 100% 10% 13% 5LOWER JUBA 7 11.9 91% 100% 68% 100% 30% 0% 7MIDDLE JUBA 237 7.0 100% 100% 86% 100% 14% 0% 2

SOMALIA237 6.0 99% 99% 93% 100% 13% 8% 38

ZONE# AFP Cases

# CONTACTS

# Contactsamples with Lab

result

Average contacts per cases

% contacts < 5 age

% Contact collected within 7

days of AFP notified

# Contact with stool in Good

Condition

# Contactpending

lab results

# specimens with NPEV

isolated

% Specimens with NPEV

Isolated

# Contacts

with Sabin virus

isolated

% contacts

with Sabin

like virus Isolated

Central 88 264 240 3 94% 100% 240 24 33 14% 15 6%

Puntland 31 93 89 3 98% 97% 89 4 14 16% 6 7%

Somaliland 55 165 147 3 94% 96% 147 18 10 7% 3 2%

South 63 189 173 3 94% 79% 173 16 26 15% 3 2%

Somalia 237 711 649 3 94% 93% 649 62 83 13% 27 4%

Note: One specimen is collected for each contact


Table no.-5

Summary of AFP surveillance key indicators for Contacts, 2017

ZoneNumber of VPVs

Number of cases reported

# of cases Notified by

VPV

Proportion of cases reported

by VPV

CENTRAL 190 88 66 75%

PUNTLAND 105 31 15 48%

SOMALILAND 81 55 19 35%

SOUTH 159 61 30 49%

Somalia 535 237 130 55%

Distribution of AFP cases by source of case notification, 2017

Key: 1. VPVs: Village polio volunteers2. HFs: MCH, Hospitals and Private clinics3. Others: community members, district field assistants, traditional healers


Table no.-6

66

15

19

30130

14

12

2514

65

8 411

1742

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Pro

p. c

ases

no

tife

d b

y

Zones

Source of AFP cases notification

VPV HFs Other

Distribution of AFP cases by life style, age group and sex, 2017

▪ Of the total 237 AFP

cases reported in 2017,

41% (n=96) and 38%

(n=89) are from Urban

and Rural population

respectively. Nomadic

communities account for

only 22% (n=5).

▪ 92% (n=218) of the cases

are less than 5 years old.

▪ 46% (n=108) AFP cases

are female.


Graph no.-10 Graph no.- 11 Graph no.-12

129

129

348249

105

218

19

83

7232

33

19

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2012 2013 2014 2015 2016 2017

Distribution of AFP cases by Age group

<5 Yrs ≥ 5 Yrs

31 97 9180

70 52

51

150

144

87117 89

65

281

181 112 129 96

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2012 2013 2014 2015 2016 2017

Distribution of AFP cases by Life style

Nomadic Rural Urban

56 221 167 115

164108

92 324 252 166

152129

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2012 2013 2014 2015 2016 2017

Distribution AFP cases by Sex

Female Male

AFP surveillance indicators by accessibility status of districts

Accessibility# of

districtsU-15 Pop

in this area

# of AFP cases

Reported

# of Casesreported by VPVs

% of Casesreported by VPVs

NP AFPrate

Number of cases with lab

result

% of Stool

adequacy

% inv.Within 48 hrs.

% of Notif.

within 7 days

%Specimens with

NPEV

% cases with

Sabin like virus

Inaccessible 17 601,282 30 24 80% 7.9 28 100% 100% 86% 30% 0%

Partially accessible

23 1,670,705 60 30 50% 5.7 52 94% 98% 87% 2% 8%

Accessible 75 3.907,440 147 76 52% 5.9 137 99% 99% 96% 13% 11%

National 115 6,179,427 237 130 55% 6.0 217 98% 99% 93% 13% 8%

▪ VPVs continue to support AFP surveillance and have reported 80% (n=24/30) of cases from inaccessible and 50% (n=30/60) from partially accessible districts.

▪ Most of the surveillance indicators in the accessible and access compromised areas are above global standards; however, SL and NP-EV isolation is very low in the access compromised districts.


Table n

o.-7

Accessibility% of <15

population in the

area

# of AFP cases

Reported

# of Casesreported by VPVs

% of Casesreported by VPVs

Number of cases with lab

result

% of cases with lab

result within 14

days

% of Stool

adequacy

% inv.Within 48 hrs.

% of Notified within 7

days

%Specimens with

NPEV

% cases with Sabin like virus

Nomadic 28.8% 52 34 65% 47 89% 96% 98% 92% 12% 8%

Rural 25.9% 89 58 65% 81 91% 99% 99% 93% 14% 9%

Urban 45.3% 96 38 40% 89 93% 99% 99% 94% 13% 9%

National 100% 237 130 55% 217 92% 98% 99% 93% 13% 8%

AFP surveillance indicators by Life Style of Population 2017


All major AFP surveillance indicators have met global standard across all life styles

Validation and zero dose investigation of AFP cases, 2017

AFP cases Validation

Zone

# of AFP cases Reported

# of AFP cases

Validated

% of AFP cases

Validated

Central 88 46 52%

Somaliland 55 41 75%

South Zone 63 26 41%

Puntland 31 15 48%

Somalia 237 128 54%

▪ Of the total 237 cases, 54% (n=128) were validated by the RPOs.▪ There were 32 zero OPV dose AFP cases reported in 2017, 66% (n=21/20) were investigated.


Table no.-8

Zero dose Investigation

Zone

# of Zero dose AFP cases Reported

# of Zero dose AFP cases

investigated

% of Zero dose AFP cases

investigated

Central 13 9 69%

Puntland 1 1 100%

Somaliland ----- ----- -----

South 18 11 61%

Somalia 32 21 66%Table no.-9

Tracking lab results of AFP cases

Total AFP cases

237

Total AFP cases with stool specimens

Total AFP cases without stool

specimens

237 0

With lab results

En route In the lab

217 0 20

cVSPV2 SL EV -ve

0 18 32 167

50

167

20

Tracking AFP with stool specimens

cVDPV2

Other viruses

neg st

in lab

en route


Samplesource

#Specimen collected

# Specimen with culture

result

# Specimens pending lab

result

# Specimenwith culture result within

14 days

% of specimen with culture

result within 14 days

Number of specimen with NPEV

% of specimen

with NPEV

Number of Specimens with Sabinisolation

% of Specimen

s with Sabin

isolation

Cases 474 434 40 391 90% 56 13% 18 8%

Contacts 711 649 62 584 90% 83 13% 27 4%

Total 1185 1083 102 975 90% 139 13% 45 5%

Lab performance indicators for AFP surveillance in Somalia, 2017


Table no.-10

Median days from onset of paralysis up to final lab result (all cases) - 2017

Date of Notification

Second stool collected

Specimen reached to Lab

Primary Culture result

Date of onset ITD result

17 days

Date second stool

collected

Date final ITD results

3 days 11 days4 days1 day 2 day


Chart no. 2

Village polio volunteers weekly house to house visit and AFP cases notified , 27 Aug 2017

Week-34 Somalia Weekly Polio Update

Zones

January Feberuary March April May June July Aug Sept October November December

No. of HH

visited

No. of AFP

cases notified

No. of HH

visited

No. of AFP cases notified

No. of HH visited

No. of AFP

cases notified

No. of HH

visited


No. of HH

visited

No. of AFP

cases notifi

ed

No. of HH

visited

No. of AFP

cases notified

No. of HH

visited

No. of AFP

cases notified

No. of HH visited


No. of HH

visited

No. of AFP

cases notified

No. of HH

visited

No. of

AFP cases notifi

ed

No. of HH

visited

No. of AFP

cases notified

No. of HH

visited

No. of AFP

cases notifie

d

Central31757 6 31780 6 39997 10 35672 12 37438 10 46730 13 38112 2 27645 7 0 0 0 0 0 0 0 0

South33599 4 32985 4 41237 5 34252 3 33505 4 43001 2 32761 6 24823 2 0 0 0 0 0 0 0 0

Puntland 15237 2 15591 4 18903 4 15193 1 15291 1 14887 2 15175 0 11420 1 0 0 0 0 0 0 0 0

Somaliland36646 5 36882 2 45971 0 35634 2 35446 3 41710 3 33807 0 26351 4 0 0 0 0 0 0 0 0

Total 117239 17 117238 16 146108 19 120751 18 121680 18 146328 20 119855 8 90239 14 0 0 0 0 0 0 0 0

Routine Immunization Services, status of Cold Chain & Vaccine stocks in AFP Surveillance Sites as of 20 Aug 2017


Region

Expected weekly

AFP sites visits

Health facility have a

routine EPI service

AFP sites with EPI service and

functional cold chain

Health facility have EPI

vaccine available

Health facility have IPV vaccine

available

No No. % No. % No. % No. %

Nugal 33 19 58% 19 100% 19 100% 17 89%

Bari 116 34 29% 32 94% 34 100% 31 91%

Mudug 58 39 67% 38 97% 38 97% 32 84%

Galbeed 40 23 58% 23 100% 23 100% 23 100%

Sahil 24 10 42% 10 100% 10 100% 8 80%

Sanag 19 11 58% 11 100% 11 100% 11 100%

Sool 28 10 36% 10 100% 10 100% 10 100%

Awdal 43 23 53% 23 100% 23 100% 23 100%

Togdher 52 21 40% 21 100% 21 100% 21 100%

Middle Shabelle 35 18 51% 15 83% 16 89% 15 94%

Hiran 24 23 96% 6 26% 23 100% 23 100%

Galgadud 36 23 64% 14 61% 23 100% 23 100%

Banadir 101 51 50% 22 43% 51 100% 51 100%

L. Shabelle 49 27 55% 13 48% 25 93% 20 80%

Middle Juba 15 1 7% 0 0% 1 100% 0 0%

Bakool 26 10 38% 10 100% 10 100% 10 100%

Gedo 51 20 39% 20 100% 20 100% 17 85%

Bay 75 30 40% 30 100% 30 100% 30 100%

Lower Juba 46 23 50% 8 35% 23 100% 20 87%

Somalia 870 416 48% 325 78% 411 99% 385 94%

Part -II

Fever and rash Surveillance

▪ Number of reported cases has been showing a steady decline since week 24 except this week.▪ The cumulative reported cases also still remain higher than the number of cases reported at the same period in the past 4 years. ▪ All regions have reported suspected measles cases in 2017. Banadir, Togdhere, Hiran, Lower shabelle and Glbeed regions of Central and Somaliland are the top 5 regions with a very high

number of cases reported.


Epi-curve on suspected measles cases by week, Somalia (Week 20, 2015-Week 32, 2017)

2017(15,548)

2015 (n=7498)

2016 (n=5657)

163

149

144

208

182

172

174

199 21

4

175

140 15

6

161 18

0

134 15

1

113 12

7

96 95

85

107 12

4

86 90 84

72

102

72

89 88

115

100

125

97

111

158

105

87

66

86

103

125

112

95

122

109

87 88 83

105

140

132

102 11

5

116

142

127 14

1

145

109

98

124

90

82

74 79

60

91 92

81 76 70

84

76 74 71 67

85

101

170

102

93 93

128

117

122 13

3

154

122

155 17

3

196 21

0 228

222

309

255

408

373

399

383

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441

670

496

699

657

685

663

696 70

3 720

686 69

3

584

560

538 55

4

463

488

444

400

325

436

0

100

200

300

400

500

600

700

800

2015

W1

3

2015

W1

4

2015

W1

5

2015

W1

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2015

W1

7

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W1

8

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W1

9

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W2

0

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W2

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W2

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W2

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2015

W2

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W2

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W2

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2015

W2

7

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W2

8

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W2

9

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W3

0

2015

W3

1

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W3

2

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W3

3

2015

W3

4

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W3

5

2015

W3

6

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W3

7

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W3

8

2015

W3

9

2015

W4

0

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W4

1

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W4

2

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W4

3

2015

W4

4

2015

W4

5

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W4

6

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W4

7

2015

W4

8

2015

W4

9

2015

W5

0

2015

W5

1

2015

W5

2

2016

W0

1

2016

W0

2

2016

W0

3

2016

W0

4

2016

W0

5

2016

W0

6

2016

W0

7

2016

W0

8

2016

W0

9

2016

W1

0

2016

W1

1

2016

W1

2

2016

W1

3

2016

W1

4

2016

W1

5

2016

W1

6

2016

W1

7

2016

W1

8

2016

W1

9

2016

W2

0

2016

W2

1

2016

W2

2

2016

W2

3

2016

W2

4

2016

W2

5

2016

W2

6

2016

W2

7

2016

W2

8

2016

W2

9

2016

W3

0

2016

W3

1

2016

W3

2

2016

W3

3

2016

W3

4

2016

W3

5

2016

W3

6

2016

W3

7

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W3

8

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W3

9

2016

W4

0

2016

W4

1

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W4

2

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W4

3

2016

W4

4

2016

W4

5

2016

W4

6

2016

W4

7

2016

W4

8

2016

W4

9

2016

W5

0

2016

W5

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2016

W5

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2017

W0

1

2017

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2017

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2017

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8

2017

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9

2017

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2017

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2017

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2017

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3

2017

W2

4

2017

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5

2017

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6

2017

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7

2017

W2

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9

2017

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0

2017

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1

2017

W3

2

2017

W3

3

2017

W3

4

Fever & Rush cases reported by AFP surveillance System 27 Aug 2017


RegionTotal 201

6

Fever and Rash Cases by weeklyTotal 2017W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12

W13

W14 W15 W16 W17 W18 W19 W20 W21 W22 W23 W24 W25 W26 W27 W28 W29 W30 W31 W32 W33

Nugal 112 3 1 1 2 2 0 1 1 0 2 0 0 4 3 4 5 15 3 6 18 27 25 23 21 17 22 19 38 42 42 53 70 82 552

Bari 202 1 7 5 3 7 0 1 4 4 12 0 11 23 21 31 26 22 47 74 73 74 81 114 85 44 90 98 67 75 47 62 44 34 1287

Mudug 270 1 3 7 2 1 21 18 15 29 28 16 35 50 24 53 51 27 26 26 45 72 82 78 77 93 73 44 52 70 73 51 42 51 1336

N/East Zone 584 5 11 13 7 10 21 20 20 33 42 16 46 77 48 88 82 64 76 106 136 173 188 215 183 154 185 161 157 187 162 166 156 167 3175

Galbeed 45 0 3 1 5 2 7 10 8 8 12 18 19 30 29 50 60 45 63 85 41 44 19 29 19 22 9 11 14 12 13 5 3 2 698

Sahil 226 12 18 37 25 22 17 28 17 28 18 31 20 27 16 24 10 27 11 11 10 13 17 15 9 39 2 17 7 17 2 3 0 5 555

Sanag 16 0 3 0 0 1 0 0 0 0 5 0 1 2 1 9 0 11 1 5 5 19 5 11 19 22 11 13 19 10 10 16 0 8 207

Sool 24 8 11 6 22 26 24 41 20 32 36 37 36 37 40 28 24 14 24 14 13 15 16 5 5 11 13 9 5 3 0 0 2 4 581

Awdal 56 0 1 4 1 6 0 0 0 0 0 0 0 0 1 0 0 3 0 11 1 2 0 6 4 23 2 24 0 4 0 4 1 0 98

Togdher 223 42 22 26 18 63 28 103 36 105 66 118 87 88 111 162 87 157 108 141 98 88 31 50 37 23 29 42 13 22 8 29 2 30 2070

N/West Zone 590 62 58 74 71 120 76 182 81 173 137 204 163 184 198 273 181 257 207 267 168 181 88 116 93 140 66 116 58 68 33 57 8 49 4209

M. Shabelle 206 5 10 6 18 7 10 8 11 5 19 23 23 20 20 12 14 25 10 8 7 6 16 18 20 20 16 20 16 28 13 9 14 14 471

Hiran 107 0 4 9 3 19 15 23 66 28 29 28 37 45 63 78 75 74 76 78 84 57 52 69 24 48 58 15 21 0 21 14 3 3 1219

Galgadud 261 4 3 2 5 5 6 3 11 4 7 4 5 149 17 28 23 19 17 13 7 9 13 8 12 9 13 29 19 14 17 13 18 5 511

Banadir 2226 89 78 76 71 95 79 119 128 91 83 93 108 110 65 134 184 172 209 162 225 205 226 202 181 116 138 140 123 117 134 93 71 140 4257

L. Shabelle 1217 25 27 45 23 37 25 33 42 42 45 36 32 45 53 45 45 59 30 38 47 52 52 49 47 47 40 59 58 45 36 33 43 39 1374

Central Zone 4017 123 122 138 120 163 135 186 258 170 183 184 205 369 218 297 341 349 342 299 370 329 359 346 284 240 265 263 237 204 221 162 149 201 7832

Middle Juba 51 0 0 0 0 2 0 0 2 3 3 0 2 0 0 0 3 3 3 0 0 3 5 0 3 0 0 0 0 6 3 0 3 3 47

Bakool 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 15 5 8 2 40

Gedo 104 0 0 4 1 1 6 0 0 0 0 0 0 0 0 6 0 5 0 0 12 13 14 2 0 0 0 0 0 0 0 1 0 0 65

Bay 9 0 0 0 3 0 0 0 0 14 0 23 9 33 19 23 42 3 31 18 12 18 28 12 19 26 22 8 8 12 6 7 1 10 407

Lower Juba 265 6 19 0 12 15 17 20 14 6 7 1 7 7 8 12 8 4 4 6 5 3 4 2 2 0 0 6 3 1 4 2 0 4 209

South Zone 466 6 19 4 16 18 23 20 16 23 10 24 18 40 27 41 53 15 38 24 29 37 51 16 24 26 22 14 11 29 28 15 12 19 768

Grand Total 5657 196 210 229 214 311 255 408 375 399 372 428 432 670 491 699 657 685 663 696 703 720 686 693 584 560 538 554 463 488 444 400 325 436 15984

Regional distribution of fever and rash cases reported in 2014, 2015, 2016 & 2017.


Map no.7 Map no.8

▪ Data source: from the Polio surveillance system and CSR.

Region

Fever & rash cases (2014)




Nugal 1110 82 112 552

Bari 1284 226 202 1,287

Mudug 542 561 270 1,336

Galbeed 121 212 45 698

Sahil 30 60 226 555

Sanag 115 114 16 207

Sool 187 86 24 581

Awdal 1 15 56 98

Togdher 407 864 223 2,070

M. Shab. 285 500 206 471

Hiran 63 663 107 1,219

Galgadud 299 229 261 511

Banadir 2594 1974 2226 4,257

L. Shab. 1978 1611 1217 1,374

M. Juba 177 48 51 47

Bakool 3 26 37 40

Gedo 126 8 104 65

Bay 309 145 9 407

L.Juba 648 74 265 209

Total 10,279 7,498 5,657 15,984

Map no.9

Fever & Rush cases reported by AFP surveillance System, 27 Aug 2017

Week -34 Somalia Weekly Polio Update

<1yr, 2801, 18%

1_4 yrs, 7853, 49%

5_9yrs, 2640, 16%

Yrs10+, 2690, 17%

Age-wise distribution of fever and rash cases reported by AFP surveillance system during 2017

7832

3175

4209

768

15984

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

Central North East North West South Total Somalia

Zone-wise cases of fever and rash reported by AFP surveillance system in 2017

Trend of reported fever and rash cases by zone in 2015 /16/17 Source AFP surveillance,


• Number of fever and rash cases reported is shown decline in July and Agugust compared to the previous month; However, it is still very high/4 times higher (n=15,223) than cases reported during the same period in 2016 (n=3,228).

Mea

sles

Cam

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Mea

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gn

(24

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Mea

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Mea

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161 133 115 97 14062 43 39 19 33 12 1539 30 48 70

119 8324 27 27 11 40 036 71

214282

491

925

667

489

0

200

400

600

800

1000

January February March April May June July AUG Sept. Oct. Nov. Dec

Puntland

2015 2016 2017

161 142

269202

243

93 72 47 29 47 29 1514 3682 104

33 35 16 9 4296

37 8

265

459

861909

823

503

275

114

0

200

400

600

800

1000


Somaliland

2015 2016 2017

455 443 441 348545

450 514328 281

388 383 401367 315 401265 324 307 278 271 310

142350

30

503

742

1111 12051340

1494

925

512

0

500

1000

1500

2000


Central

2015 2016 2017

4027 27 30

46

22 2719 14 13 18 18

9

3729

46

75

50

921

7

3346

26

45

77

115

136128

139

82

46

0

50

100

150


South

2015 2016 2017

Part -IIIPopulation Immunity

Supplemental Immunization Activities

Maps showing accessibility and security/ risk level, Somalia


Map no.11Map no.10

Somalia Total 501 869 457 11689 6,179,427

Summary Strategic features and initiatives in Somalia by accessibility

ZonesAccessibility

statusVPV

AFP active Surveillance site

TPVP Settlement Under 15- POP.

CENTRALAccessible 128 216 147 2354 2,230,697Inaccessible 62 29 21 1042 619,775Total 190 245 168 3396 2,850,471

PUNTLANDAccessible 105 207 53 1076 446,241Inaccessible 0 0 0 0 0Total 105 207 53 1076 446,241

SOMALILANDAccessible 81 206 53 3435 1,426,642Inaccessible 0 0 0 0 0Total 81 206 53 3435 1,426,642

SOUTHAccessible 75 179 123 2234 1,010,326Inaccessible 84 33 22 1548 445,747Total 159 212 145 3782 1,456,073

SomaliaAccessible 389 808 376 9099 5,113,906Inaccessible 146 62 43 2590 1,065,522Somalia Total 535 870 419 11689 6,179,428


2017 SIA Calendar, Implementation status and coverage Summary


Tab

le n

o.-

14

Somalia SIA Callender for 2017

Planned DateCampaign

Type Geographic Areas to be covered

Target

Age

Group

Total Target

Pop. for the

Rnd

Target

Population Implementation date

Vaccine

type

#

Reached/

Vaccinate

d

Admin

Coverage

in %

IM

Coverage in

%

LQAS Report timeliness

26-Feb-17 NIDs R-1

All accessible areas of Central zone

Under 5 years

2,441,996

904,454 26-29 Feb. 2017 b-OPV 848,340 94% 94%Of 11 lotes, 9=passed and 2=Satisfactory Received

Puntland all districts 530,201 05-08 April 2017 b-OPV 546,302 103% 97%Of 31 lotes, 27=Passed, 3= Satisfactory and 1=Failed Received

Somaliland all districts 621786 26-29 Feb. 2017 b-OPV 612,911 99% 97%

Of 29 lotes, 19=Passed,6=satisfactory, 3 =failed and 1 discarded Received

All accessible areas of South zone 385,555 26-29 Feb. 2017 b-OPV 369,517 96% 91% Of 5 lotes, 4=Passed and 1=Failed Received

02-04, April-17 NIDs R-2


Under 5 years 2,455,942

904,451 02-05 April 2017 b-OPV 850,772 94% 93%Of 11 lots, 9=passed, 2= Satisfactory and 0=failed Received

Puntland all districts 529602 6-9 May 2017 b-OPV 546,673 103% 98% Received

Somaliland all districts 623462 02-05 April 2017 b-OPV 609,734 98% 97%Of 28 lotes, 25=Passed, 1= Satisfactory and 2=Failed Received

All accessible areas of South zone 398427 02-05 April 2017 b-OPV 385,584 97% 95%Of 5 lotes, 3=Passed, 1= Satisfactory and 1=Failed Received

23-Jul-17 HtR - R-1

Nomadic; Agro pastoral; Scattered, remote, far settlements & Small villages with difficult / no road access

Under 5 years 438,074

73,447 C. Z: 23-26 July 2017

b-OPV

64,160 87% No IM No LQAS Received

32,803 S.Z: 23-26 July 2017 31,095 95% 92% No LQAS Received

185,844 P.L: 15-18 August 2017

145,980 SL: 23-26 July 2017 142,794 98% No IM No LQAS Received

14-Aug-17 HtR - R-2

Nomadic; Agro pastoral; Scattered, remote, far settlements; & Small villages with difficult / no road access

Under 5 years 735,752

275,010 C. Z: 29 Aug-01 Sept.

2017

b-OPV

157,991 S.Z: 29- Aug-01 Sept.

2017

185,844

116,908 SL: 09- 12 Sept. 2017

22-Oct-17 NIDs R-3


Under 5 years 2,452,976

904,451

b-OPV

Puntland all districts 526636

Somaliland all districts 623462

All accessible areas of South zone 398427

A) Target population: includes all accessible areas including the areas/districts that became accessible in 2015 and 3% population growth added 2016.

B) Buffer stock: 1 million bOPV doses kept in country for: Transit/Cross Border Permanent Vaccination Teams and SIADs for new areas accessible.

C) Country team strategy for newly accessible areas: conduct house to house bOPV vaccination, 4 Rounds at 10 days interval, R-1 target U<5 years, R-2 target U10 years, R-3 target all age groups; R-4 target U 5 years OPV + Measles.

NID-1, NID-2 2017 Summary

▪NID1 & NID 2 was conducted as scheduled in March and April 2017.

▪HtR 1 also conducted in South, Central and Somaliland, Puntland will conducted in August

▪ Cumulatively 5,336,012 under 5 children were targeted in the two NIDs and 1 HTR rounds and 5,007,882 million children were reached.

▪ IM data showed overall national coverage of 95%, 96% and 92% respectively for NID-1 and NID 2.

▪ Regional summary anddistrict level IM coverageis presented on the tableand the maps on the left


ZONE/REGION

NID-1 NID-2 HtR-1

# U -5 Targeted

# U-5 Reached

IM coverage# U -5

Targeted # U-5

reached

IM # U -5 Targeted

# U-5 reached

IM

Coverage Coverage

Banadir 424086 398999 96% 424083 399509 95% 19,323 18,056

No IM

Galgadud 100060 91815 86% 100060 91077 86% 25,047 20,559

Hiran 77692 72736 97% 77692 70991 94% 8,025 6,699

L. Shabelle 182368 167848 94% 182368 171852 94% 8,304 7,618

M. Shabelle 120248 116942 98% 120248 117343 98% 12,748 11,228

Central Total 904454 848340 94% 904451 850772 93% 73,447 64,160

Ayn 12662 12157 97% 12662 12375

Bari 138029 167908 103% 138029 163261 99%

Karkar 48509 47142 99% 48509 47807 98%

Mudug 208301 201496 94% 208401 202736 100%

Nugal 81659 77952 94% 80961 80267 94%

Sanag 27755 26773 96% 27755 27068 96%

Sool 13286 12874 97% 13286 13159 97%

Puntland Total 530201 546302 98% 529602 546673 99%

Awdal 107324 104100 100% 107324 105201 98% 23,910 23,351 92%

Sanag 65777 62900 96% 205431 201208 95% 15,965 15,212 92%

Sool 59781 64651 98% 46202 44442 96% 14,510 15,843 70%

Togder 138946 134347 99% 65777 61014 97% 30,519 29,294 97%

Marodijeh 203756 203756 93% 59781 63193 94% 49,862 48,407 74%

Sahil 46202 43157 100% 138946 134676 100% 11,214 10,687 100%

Somaliland Total 621786 612911 97% 623462 609734 96% 145,980 142,794 92%

Bakool 36758 35575 90% 36758 34187 95% 2,088 1,938

No IM

Bay 162935 157910 93% 162935 158629 95% 7,275 6,678

Middle Juba NO NID (Inaccessible Region)

Gedo 111491 106423 89% 111491 108737 93% 11,448 10,845

Lower Juba 74371 69609 93% 87243 84031 96% 11,992 11,634

South Total 385555 369517 92% 398427 385584 95% 32,803 31,095

Grand Total2,441,99

62,377,07

0 96% 1,926,340 1,846,090 95% 252,230 238,049


Transit Points Vaccination Activities as of August 27, 2017

Table no.-16

▪ A total of 1,456,434 < 10 years individuals were vaccinated week 33,2017. Among them,76,032 (5%) were vaccinated for the first time

Zones

January February March April May June July August

Nu

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ated

Zero

do

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% Z

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ses

Nu

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% Z

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do

ses

Nu

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ated

Zero

do

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% Z

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do

ses

Nu

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ated

Zero

do

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% Z

ero

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ses

Nu

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ated

Zero

do

ses

% Z

ero

do

ses

Nu

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ated

Zero

do

ses

% Z

ero

do

ses

Nu

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ated

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do

ses

% Z

ero

do

ses

Nu

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ated

Zero

do

ses

% Z

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do

ses

CENTRAL 102390 12082 11.8% 109859 7779 7.1% 144262 7777 5.4% 110748 3902 3.5% 102455 2583 2.5% 130637 1742 1.3% 102700 786 0.8% 76438 427 0.6%

PUNTLAND 22653 93 0.4% 21444 71 0.3% 27405 83 0.3% 21282 67 0.3% 20612 59 0.3% 28689 91 0.3% 23886 63 0.3% 16538 45 0.3%

SOMALILAND 14367 208 1.4% 15220 428 2.8% 18818 752 4.0% 14696 426 2.9% 15646 485 3.1% 18904 515 2.7% 15998 477 3.0% 12074 371 3.1%

SOUTH 39301 12498 31.8% 41710 14632 35.1% 39045 2388 6.1% 29791 1125 3.8% 29842 1135 3.8% 38680 1332 3.4% 29127 929 3.2% 21217 681 3.2%

SOMALIA 178711 24881 13.9% 188233 22910 12.2% 229530 11000 4.8% 176517 5520 3.1% 168555 4262 2.5% 216910 3680 1.7% 171711 2255 1.3% 126267 1524 1.2%

Performance of Permanent Vaccination sites in inaccessible areas of S/C zone and distribution as of August 27, 2017


Since the first weeks of 2017, a total of 106,702 <10 years children were reached through the newly established permanent vaccination sites in fully inaccessible area in South and Central zones. 52% (n=55,899) of the children are vaccinated for the first time.

Number of U-10 Children vaccinated by Newly Established permanent vaccination sites in inaccessible areas of South and Central zones of Somalia.

ZONE REGION

DISTRICT Number of vaccinated kids

Number of Zero doses vaccinated

Proportion of Zero doses (%)

CENTRAL

GALGADUD

Elbur 2,928 2,315 79%Galhareri Data not received Elgaras 7,273 6,305 87%

L.ShabelleAwdegle 29,243 11,755 40%

Sablale 29,660 11,207 38%

South

L. Jubba

Hagar 5,397 3,226 60%

Jamame East 4,137 3,950 95%

Jamame West 3,071 2,857 93%

Kismayo 11,379 2,705 24%

M. JubbaBuale 7,800 6,714 86%

Sakaw 5,814 4,865 84%

TOTAL 106,702 55,899 52%

Immunity Profile of NP-AFP cases (6-59 Months)

▪ In 2017, 32 zero-dose NP-AFP cases were reported; 18 from South, 13 from Central and 1 from Puntland. One of the cases is out of the 6-59 months age group▪ Review of five years data reveals, the proportion of zero dose AFP cases is declining progressively, however, there are significant proportion of children at risk due to

under vaccination.


Graph no.-20 Graph no.-19

13

1 0

17

31

12 12

5

10

39

13

3

12

14

42

46

13

30

13

102

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%


Immunity Profile of NP-AFP cases 6-59 Months by Zone, 2017

0 dose 1-3 doses 4-6 doses 7+ doses

7673

38 37 31

63

3329 37

39

61

50 43 56

42

69

182 127 143102

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2013 2014 2015 2016 2017

Immunity Profile of NP-AFP Cases 6-59 Months, 2013-2017

0 dose 1-3 doses 4-6 doses 7+ doses

Immunity profile of 6-59 months age NP-AFP cases by Zone 2012-2017




Routine Immunization

Source: HMIS data 2016 and 2017.

33%

44%

58%

46%

41%

54%

66%

58%

34%

45%

57%

52%

34%

43%

50%

61%

32%

41%

57%53%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2014 2015 2016 2017 six month

BCG Penta1 Penta3 Measles OPV 3

Routine Immunization coverage in Somalia 2014-17

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Pent1 24215 48781 73263 98229 124707 152394 181148 207148 235011 266781 299618 331481

Penta3 27543 48616 70816 91732 113674 136589 160723 181282 203464 229673 256554 283080

Measles 18379 39266 60502 81562 103608 127044 150435 174056 193371 209302 230710 249465

Target 7.50% 15.00% 22.50% 30.00% 37.50% 45.00% 52.50% 60.00% 67.50% 75.00% 82.50% 90.00%

Penat1% 5% 11% 16% 22% 28% 34% 40% 46% 52% 59% 66% 73%

Penta3% 6% 11% 16% 20% 25% 30% 36% 40% 45% 51% 57% 63%

measles% 4% 9% 13% 18% 23% 28% 33% 39% 43% 46% 51% 55%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

0

50000

100000

150000

200000

250000

300000

350000

Immuinzation monitoring chart, Somalia2016

Pent1 Penta3 Measles Target

Penat1% Penta3% measles%


N.BThe graph shows that the data is from Jan-June, 2017

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec

Sum of Pent1 31154 62595 89585 116079143067150888

Sum of Penta3 27701 55745 79984 103221126247134438

Sum of Measles 26476 57585 84740 117956150345158934

Sum of Montly target on surval% 8% 17% 25% 33% 42% 50% 58% 67% 75% 83% 92% 100%

Sum of P-1% 8% 16% 23% 30% 37% 39%

Sum of penta-3% 7% 14% 21% 27% 32% 35%

Sum of Measless% 7% 15% 22% 30% 39% 41%

0%

20%

40%

60%

80%

100%

120%

0

20000

40000

60000

80000

100000

120000

140000

160000

180000

Immunization monitoring chart, Somalia-2017

Part -IVVaccines and Cold Chain

Management

Vaccines and Cold Chain Management

USSC (Country Office)

• IRC CCEOP application comments addressed and to be shared with GAVI

by 21st Aug deadline

• All pending routine vaccines to zones have been shipped

• Quarterly cold chain equipment inventory updated for all zones

• Plans are underway to conduct the cold chain cascaded trainings before

September end and funds have been allocated to all zones


Part -VCommunication

Communication for Development

• Sensitization activities underway in South Central Zone in

preparation of the August HtR campaign.

• Updating of communication and social mobilization in outbreak

preparedness and response plan in preparation of the

forthcoming POSE (polio outbreak simulation exercise).


the end

week-34 - humanitarianresponse · weekly afp cases reported by provinces, 2016-2017 somalia. (cases...

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