Epidemiological Highlights - origin.searo.who.intorigin.searo.who.int/entity/bangladesh/ewarsw72019.pdfEpidemiological Highlights Week 7, 2019 5 | Diphtheria No new diphtheria case-patient

Epidemiological Highlights Week 7, 2019

1 |

Epidemiological Highlights

Week 7, 2019


2 |

Highlights:

Varicella cases showing increasing trend

Acute respiratory infection (ARI), varicella & diarrhoeal diseases are the diseases with highest proportional morbidity in last week

No notable changes in trends of other diseases and syndromes


3 |

EWARS Reporting Updates

Total 170/ 212 (80%) health facilities registered in EWARS

This week 144/170 health facilities submitted weekly reports form in EWARS which is higher than previous week (1 in week 5)

Completeness and Timeliness for this week is 842%

Total 75 alerts were triggered this week which is lower than previous week (91 last weeks).

All alerts were reviewed and verified by EWARS team.


4 |

Varicella

This week we received 9 232 varicella cases via weekly report form which in more than previous week (7 285 in week 6, 6 090 in week 5 & 5 376 cases in week 4).

A total 114 Facilities reported Varicella cases in EWARS which is less than previous week (110 facilities in week 6).

No complicated varicella case report this week.


5 |

Diphtheria

No new diphtheria case-patient was reported this week which might be a reporting delay in EWARS.

Total case-patients reported = 8 442 – Confirmed case = 293

– Probable case = 2 719

– Suspected case = 5 430

The last confirmed case was reported on 31 December 2018 (Epi week 1 2019).

Total number of deaths reported till now is 45. Last death was reported on 15 January 2019.

No death reported from host community


6 |

Measles

14 new suspected case reported via weekly reporting this week less than previous week (29 cases in week 6).

A total of 133 cases were reported in first 7 weeks of 2019 out of which only 60 reported with case report form.

All cases reported with cases report form were being traced by WHO-IVD team.

WHO is supporting ministry of health (MoH) in routine measles surveillance in FDMN population

BangladeshRohingya Emergency Response

Ministry of Health and FamilyWelfare Bangladesh Printed: 02:49 Wednesday, 20 February 2019 UTC

Early Warning, Alert and Response System (EWARS)Epidemiological Bulletin W7 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

W7 2019

Table 1 | Coverage

# %

918,936 - Estimated total Rohingya population

904,056 98% Total population under surveillance

212 - Total number of health facilities

170 80% Number of EWARS reporting sites

Table 2 | Early warning performance indicators

W7 Cumulative (2019)

144 1007 Number of weekly reports received

84% 76% Completeness

84% 74% Timeliness

Table 3 Alert performance indicators


75 693 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 W7 2019

1 W7 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 W7 2019

1

2

3

4

56

7 8

91011

1213 14 15 16

1718 19

20

21

22

2324

25

26

1 Camp 142 Camp 183 Camp 134 Camp 165 Camp 1W6 Camp 1E7 Camp 8W8 Camp 8E9 Camp 710 Camp 611 Camp 512 Camp 4 Ext13 Camp 414 Camp 315 Camp 2W16 Camp 2E17 Camp 918 Camp 20 Ext19 Camp 2020 Camp 1921 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 (W7 2019) Map 2 | Completeness by camp

Completeness 0 25% 50% 75% 100%

Early Warning | Ukhia (Northern Group)

3 W7 2019

Camp 1E 6 4 80% 80%

Camp 1W 5 3 75% 75%

Camp 2E 1 1 100% 100%

Camp 2W 6 3 60% 60%

Camp 3 8 6 86% 86%

Camp 4 7 5 100% 100%

Camp 4 Ext 1 1 100% 100%

Camp 5 7 6 100% 100%

Camp 6 3 3 100% 100%

Camp 7 8 4 67% 67%

Camp 8E 11 5 63% 63%

Camp 8W 9 6 75% 75%

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 W7 2019

Camp 10 5 5 100% 100%

Camp 11 11 9 90% 90%

Camp 12 6 4 80% 80%

Camp 13 16 10 100% 100%

Camp 14 7 3 60% 60%

Camp 15 10 7 88% 88%

Camp 16 8 6 75% 75%

Camp 17 6 6 100% 100%

Camp 18 9 8 100% 100%

Camp 19 3 2 100% 100%

Camp 20 4 3 75% 75%

Camp 20 Ext 1 1 100% 100%

Camp 9 10 7 75% 75%

1

2

3

4

56 7

8

9

10

1112

13

1 Camp 142 Camp 183 Camp 134 Camp 165 Camp 96 Camp 20 Ext7 Camp 208 Camp 199 Camp 1710 Camp 1511 Camp 1212 Camp 1113 Camp 10

Teknaf Reporting Performance

# healthfacilities



Completeness 0 25% 50% 75% 100%

Early Warning | Teknaf

5 W7 2019

Camp 21Chakmarkul

5 3 75% 75%

Camp 22Unchiprang

7 4 100% 100%

Camp 23Shamlapur

4 2 100% 100%

Camp 24 Leda 2 2 100% 100%

Camp 25 AliKhali

2 2 100% 100%

Camp 26Nayapara

5 3 75% 75%

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 0 0% 0%

FRNDS 15 13 87% 87%

GK 9 9 100% 100%

HMBDF 2 2 100% 100%

IOM 18 17 94% 94%

IRC 8 8 100% 100%

MSF 11 9 82% 82%

MoH 0 0 0% 0%

Hope 2 1 50% 50%

Table 7 | Performance by partner (W7 2019)

Partner Performance Reporting

# sites # reportsreceived Completeness Timeliness

MTI 6 6 100% 100%

PHD 8 8 100% 100%

Prottyashi 2 2 100% 100%

PWJ 1 0 0% 0%

RHU 2 2 100% 100%

RI 9 9 100% 100%

RTMI 9 9 100% 100%

SCI 10 9 90% 90%

TdH 2 1 50% 50%

Early Warning | Partner performance

6 W7 2019

Northerngroup W7 Cumulative (2019)

# alerts % verif. # alerts % verif.

Northerngroup W7 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 W7 2019

Camp 1E 1 100% 12 100%

Camp 1W 0 0% 6 100%

Camp 2E 0 0% 4 100%

Camp 2W 2 100% 17 100%

Camp 3 2 100% 26 100%

Camp 4 3 100% 33 97%

Camp 4 Ext 0 0% 2 100%

Camp 5 1 100% 56 100%

Camp 6 0 0% 22 100%

Camp 7 0 0% 7 100%

Camp 8E 2 100% 13 100%

Camp 8W 1 100% 43 100%

KutupalongRC

7 100% 39 100%

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 W7 Cumulative (2019)




Alert | Ukhia (Southern Group)

8 W7 2019

Camp 10 3 100% 21 100%

Camp 11 1 100% 20 100%

Camp 12 5 100% 20 100%

Camp 13 11 100% 64 100%

Camp 14 3 100% 18 100%

Camp 15 5 100% 38 100%

Camp 16 2 100% 26 100%

Camp 17 0 0% 30 100%

Camp 18 3 100% 19 100%

Camp 19 1 100% 4 100%

Camp 20 0 0% 11 100%

Camp 20 Ext 1 100% 3 100%

Camp 9 3 100% 21 100%

1

2

3

4

56 7

8

9

10

1112

13

1 Camp 142 Camp 183 Camp 134 Camp 165 Camp 96 Camp 20 Ext7 Camp 208 Camp 199 Camp 1710 Camp 1511 Camp 1212 Camp 1113 Camp 10

Teknaf W7 Cumulative (2019)




Alert | Teknaf

9 W7 2019

Camp 21Chakmarkul

7 100% 28 100%

Camp 22Unchiprang

0 0% 18 100%

Camp 23Shamlapur

1 100% 7 100%

Camp 24 Leda 2 100% 9 100%

Camp 25 AliKhali

1 100% 7 100%

Camp 26Nayapara

2 100% 12 100%

Camp 27Jadimura

0 0% 4 100%

Nayapara RC 5 100% 26 100%

12

3

4

5

6

78


Event W7 Cumulative (2019)


Indicator-based surveillance

Malaria 0 0% 0 0%

Measles 10 100% 101 99%

Bloody Diarr. 0 0% 0 0%

AFP 0 0% 1 100%

Meningitis 0 0% 0 0%

Haem. fever(susp.)

0 0% 3 100%

NNT 0 0% 1 100%

Unexp. fever 4 100% 28 100%

AWD 4 100% 37 100%

ARI 7 100% 72 100%

AJS 1 100% 4 100%

Varicella (Susp.) 21 100% 258 100%

Event-based surveillance

EBS total 26 100% 184 100%

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 W7 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: 02:49 Wednesday, 20 February 2019 UTC

Early Warning, Alert and Response System (EWARS)Annex W7 2019

Figure 1 | Proportional morbidity (W7 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 W7 2019

# cases % morbidity # cases % morbidity

AWD 3,457 4.5% 24,788 4.5%

Bloody diarr. 356 0.5% 2,519 0.5%

Other diarr. 1,483 1.9% 13,803 2.5%

Susp. Varicella 9,232 11.9% 34,145 6.1%

ARI 11,705 15.1% 82,921 14.9%

Measles/Rub. 14 0.0% 133 0.0%

AFP 0 0.0% 3 0.0%

Susp. menin. 0 0.0% 0 0.0%

AJS 9 0.0% 49 0.0%

Susp. HF 0 0.0% 9 0.0%

Neo. tetanus 0 0.0% 1 0.0%

Adult tetanus 0 0.0% 0 0.0%

Malaria (conf.) 0 0.0% 3 0.0%

Malaria (susp.) 0 0.0% 26 0.0%

Dengue (conf.) 0 0.0% 0 0.0%

Dengue (susp.) 0 0.0% 0 0.0%

Unexpl. fever 2,726 3.5% 22,341 4.0%

Sev. Malnut. 56 0.1% 593 0.1%

Inj./Wounds 1,326 1.7% 11,159 2.0%

Other 47,171 60.8% 362,396 65.3%

Total 74,910 100% 555,371 100%

Proportional morbidity

1 W7 2019

*

*

Figure 2 | Trend in proportional morbidity for key diseases (W7)

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 W7 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

W05

201

9

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

*

*

Acute Respiratory Infection | Trend

3 W7 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 - W7 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 (W7 2019)

4 W7 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 (W7 2019) Figure | % sex Figure | % age

Male Female >=5 < 5

Measles | Trend

5 W7 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 - W7 2019)


Measles | Maps and Alert Management

Map 2 | Map of cases by camp (W7 2019)

6 W7 2019



Alert threshold1 case. Source: IEDCR

10Alerts

100%Verified

0Low Risk

0Moderate

Risk

0High Risk

0Very High

Risk


Male Female >= 5 < 5

Acute Jaundice Syndrome | Trend

7 W7 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 - W7 2019)

8 W7 2019



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

1Alerts

100%Verified

0Low Risk

0Moderate

Risk

0High Risk

0Very High

Risk


Female Male < 5 >= 5

Acute Watery Diarrhoea | Trends

9 W7 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 W7 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

W05

201

9

0

1

2

3

4

5

6

7



Dengue | Maps and Alert Management


12 W7 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 W7 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

W05

201

9

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000

10,000


a. Ukhia | Number of cases c. Teknaf | Number of cases

Varicella (Susp.) | Maps


14 W7 2019


Figure | % sex Figure | % age


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

Documents

Epidemiological Highlights - origin.searo.who.intorigin.searo.who.int/entity/bangladesh/ewarsw72019.pdfEpidemiological Highlights Week 7, 2019 5 | Diphtheria No new diphtheria case-patient