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Somalia Weekly Update Week-40 Ending 08 th October 2017

Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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Page 1: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Somalia Weekly Update

Week-40Ending 08th October 2017

Page 2: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Part -I

AFP-Surveillance

Page 3: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Somalia conducted POSE and annual program review

Objectives for the review meeting• Review progress of implementing planned activities in 2017,

recommendation from external surveillance review and the TAG.

• Identify gaps in AFP surveillance, identify zonal specific challenges and come up with clear and doable recommendations

• Review Somalia outbreak response preparedness plan and discuss the risk of outbreak following importation and come up with clear action points to respond to outbreak if it happens. Develop and finalize zonal outbreak preparedness plans.

• Review performance of EPI improvement activities in Somalia Review preparedness of national level Measles campaign (Nov./ Dec. 2017)

• Set 2018 EPI/POL program priorities

Somalia conducted polio outbreak simulation exercise (POSE) from 3-5 October in Hargeisa with 84 participants fromMOH, UNICEF (RO, CO & Zonal Office), WHO (RO, CO, Zones and Regions), CDC, BMGF, Core Group and KEMRIlaboratory. The 3 days exercise was led by Dr. Tariq from EMRO. After the completion of the POSE, workshop continuedwith the annual EPI/POL with all participants remaining behind for the meeting and will ran between 7th and 10th

October.

Page 4: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Week-40 Somalia Weekly EPI/POL Update

Epidemiological Curve January 1, 2014 – October 08, 2017

Graph no. 1

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Pending Lab Pending ERG Discarded Compatable WPV aVDPV

Page 5: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

- 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017.- In addition 836 contact samples (3 contacts for each case) and 93 community samples were collected from 17 districts and all are discarded.

Week-40 Somalia Weekly EPI/POL Update

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

W37

2016

W38

2016

W39

2016

W40

2016

W41

2016

W42

2016

W43

2016

W44

2016

W45

2016

W46

2016

W47

2016

W48

2016

W49

2016

W50

2016

W51

2016

W52

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

W12

2017

W13

2017

W14

2017

W15

2017

W16

2017

W17

2017

W18

2017

W19

2017

W20

2017

W21

2017

W22

2017

W23

2017

W24

2017

W25

2017

W26

2017

W27

2017

W28

2017

W29

2017

W30

2017

W31

2017

W32

2017

W33

2017

W34

2017

W35

2017

W36

2017

W37

2017

W38

2017

W39

Gra

nd

To

tal

BANADIR 1 1 2 1 2 1 30 1 1 1 2 1 3 1 2 1 1 1 1 1 2 1 1 2 2 2 27

GALGADUD 2 1 1 25 1 1 1 1 1 1 1 2 1 1 1 1 1 2 1 1 2 1 1 22

M. SHABELLE 1 1 1 1 1 19 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 2 1 19

L. SHABELLE 1 1 1 1 2 1 24 1 1 1 1 1 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 22

HIRAN 1 1 15 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 18

BARI 1 1 1 1 2 1 1 24 1 2 1 1 1 2 1 1 1 1 1 2 1 1 1 1 19

NUGAL 2 1 1 1 11 2 1 1 1 1 1 1 8

MUDUG 1 1 2 1 1 14 1 2 1 1 1 1 1 1 1 1 11

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

GALBEED 1 1 1 1 1 1 1 1 19 1 3 1 1 1 1 1 1 1 1 2 1 2 17

SANAQ 1 2 1 7 1 1 1 1 1 5

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

SAHIL 1 1 8 1 1 1 1 1 1 1 1 8

SOOL 1 5 1 2 1 1 1 1 1 8

LOWER JUBA 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 1 23

BAY 2 1 2 19 3 1 3 1 1 1 1 1 1 1 1 2 17

GEDO 2 1 1 1 21 1 2 1 1 1 1 1 1 1 1 1 1 2 2 1 18

MIDDLE JUBA 1 1 1 1 11 1 1 1 1 2 1 2 9

BAKOOL 1 1 1 9 1 1 1 1 1 1 1 7

Total Somalia 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 6 9 5 7 10 4 5 280

Page 6: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

REGION2016 2017

Pending Discarded VDPV Total Discarded Pending Total

BANADIR 0 30 0 30 27 27

GALGADUD 0 25 0 25 21 1 22

HIRAN 0 15 0 15 17 1 18

L. SHABELLE 0 24 0 24 20 2 22

M. SHABELLE 0 19 0 19 18 1 19

BARI 0 24 0 24 19 19

MUDUG 0 14 0 14 10 1 11

NUGAL 0 11 0 11 7 1 8

AWDAL 0 18 0 18 14 1 15

GALBEED 0 19 0 19 15 2 17

SAHIL 0 8 0 8 7 1 8

SANAQ 0 7 0 7 5 5

SOOL 0 5 0 5 8 8

TOGDHER 0 10 1 11 7 7

BAKOOL 0 9 0 9 7 7

BAY 0 19 0 19 15 2 17

GEDO 0 21 0 21 17 1 18

LOWER JUBA 0 26 0 26 22 1 23

MIDDLE JUBA 0 11 0 11 9 9

Grand Total 0 315 1 316 265 15 280

Classification of AFP cases by status (2016 & 2017)

12In process (lab)

0Pending ITD

265Discarded

0 WPV

15Pending

0 Compatible

0VDPV

280 AFP Cases Reported in 2017

Week-40 Somalia Weekly EPI/POL Update

Tab

le n

o.-

2

Chart no. 1

3Pending ERG

Page 7: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Surveillance Indicators by Zone and Region 2017

Week-40 Somalia Weekly EPI/POL Update

Graph no. 2

Graph no. 3

Map no. 1 Map no. 2

4.9

11.1

5.56.6

5.9

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

7.8

5.5 5.8 5.9

-

2.0

4.0

6.0

8.0

10.0

In-accessible PartiallyAcceessible

Accessible Somalia

Annualized NP-AFP rate by accessibility status

Page 8: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

All of the 115 districts in Somalia have

reported at least 1 AFP case since the

beginning of 2017.

The NP-AFP rate for all the 112 districts is

>2/100,000 U-15 Population.

112 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 accessible from south while Bossaso

is fully accessible district in Puntland.

Week-40 Somalia Weekly EPI/POL Update

Map no. 3 Map no. 4

Page 9: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

Week-40 Somalia Weekly EPI/POL Update

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 35 zero dose

AFP cases reported in 2017 were

reported from access compromised

districts. Map no. 5 Map no.6

Page 10: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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 the zones for the same period.

Week-40 Somalia Weekly EPI/POL Update

39 19 31 23

112

32 3255

114

459

145

52 48

85

334

94

45 4256

237

95

3650

63

244

108

38

6074

280

0

50

100

150

200

250

300

350

400

450

500

CENTRAL Puntland Somaliland SOUTH SOMALIA

2012 2013 2014 2015 2016 2017

Page 11: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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 103 36 8 312 36 20

Puntland 36 8 5 107 15 6

Somaliland 56 6 7 171 13 3

South 70 18 3 206 28 6

Somalia 265 68 23 796 92 35

Week-40 Somalia Weekly EPI/POL Update

Table no.-3

17.5%

11.5%

7.8%

6.4%

11.1%

14.0% 13.9%

5.6%5.4%

7.6%

12.5%

1.8%

12.9%

13.6%

4.3%

2.9%

12.8%

11.6%

8.7%

4.4%

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

Page 12: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

Week-40 Somalia Weekly EPI/POL Update

94% (n=263/280) of AFP cases reported in 2017 are notified within 7 days of onset. 17 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), Bay (2) and Galbeed (1)}.

Graph no.7

10837 58

60

263

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

CENTRAL NE NW SOUTH SOMALIA

Notification within 7 days, Zonal

27 22 18 22 19

18

11 8 15

16

8

4

8 7 7

15

15

15

8

263

0%

20%

40%

60%

80%

100%

CENTRAL NE NW SOUTH SOMALIA

Notification within 7 days, Regional

Page 13: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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 108 4.9 108 100% 99% 100% 5 103 103 100% 36 17% 8 8%

Puntland 38 11.1 37 97% 100% 97% 2 36 36 100% 8 11% 5 14%

Somaliland 60 5.5 60 100% 98% 97% 4 56 56 100% 6 5% 7 13%

South 74 6.6 72 97% 99% 81% 4 70 70 100% 18 13% 3 4%

Total 280 5.9 277 99% 99% 94% 15 265 265 100% 68 13% 23 9%

Summary of AFP surveillance key indicators by Zone, 2017

Surveillance indicators at national and sub-national level perform above global standard; however, notification within 7 days in south zone particularly in L. Juba regions is low. 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 Hiran Region 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; Which are also pending for ERG.

Week-40 Somalia Weekly EPI/POL Update

Table no.-4

Page 14: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Week-40 Somalia Weekly EPI/POL Update

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

follow-up

CENTRAL

BANADIR 27 3.3 100% 100% 100% 100% 24% 7% 1

GALGADUD 22 11.0 100% 100% 100% 100% 17% 5% 0

HIRAN 18 10.3 100% 94% 100% 100% 3% 0% 0

LOWER SHABELLE 22 3.1 100% 100% 100% 100% 23% 25% 0

MIDDLE SHABELLE 19 6.8 100% 100% 100% 100% 17% 0% 0

PUNTLAND

BARI 19 14.0 95% 100% 95% 100% 5% 16% 0

MUDUG 11 7.9 100% 100% 100% 100% 15% 20% 0

NUGAL 8 11.8 100% 100% 100% 100% 21% 0% 1

SOMALILAND

AWDAL 15 8.2 100% 100% 100% 100% 0% 14% 1GALBEED 17 4.1 100% 100% 94% 100% 0% 7% 0SAHIL 8 12.5 100% 100% 100% 100% 0% 29% 0SANAQ 5 4.4 100% 100% 80% 100% 10% 0% 0SOOL 8 8.9 100% 100% 100% 100% 19% 25% 3TOGDHER 7 3.0 100% 86% 100% 100% 14% 0% 0

SOUTH

BAKOOL 7 5.1 100% 100% 100% 100% 7% 0% 0BAY 17 4.2 100% 100% 88% 100% 0% 0% 0GEDO 18 7.7 100% 94% 83% 100% 9% 18% 1LOWER JUBA 23 10.2 91% 100% 65% 100% 27% 0% 0MIDDLE JUBA 9 7.4 100% 100% 89% 100% 11% 0% 0

SOMALIA 280 5.9 99% 99% 94% 100% 13% 9% 7

Page 15: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Region District Site Name

Epidemiological week 2017

38 39 40 41 42 43 44 45 46 47 48 49 50 51 52

Banadir Waberi Twenty one October NP-EV1

Banadir Shangani Urobo

Banadir Hamerewoini Kawma NP-EV1

Week-40 Somalia Weekly EPI/POL Update

Summary Laboratory status of Environmental samples

1 Not scheduled 6 Sabin 11 WPV1+cVDPV2

2 Pending 7 NPENT + Sabin 12 Sent for sequencing

3 Negative 8 cVDPV2 13 Scheduled but not collected

4 NEV 9 WPV1 14 Sabin 2

5 NPENT 10 WPV3 15 Sabin + NPEV + NEV

Page 16: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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 108 324 312 3 93% 99% 312 12 36 12% 20 6%

Puntland 38 114 107 3 98% 97% 107 7 15 14% 6 6%

Somaliland 60 180 171 3 94% 98% 171 9 13 8% 3 2%

South 74 218 206 3 94% 97% 206 12 28 14% 3 3%

Somalia 280 836 796 3 94% 98% 796 40 92 12% 32 4%

Note: One specimen is collected for each contact

Week-40 Somalia Weekly EPI/POL Update

Table no.-5

Summary of AFP surveillance key indicators for Contacts, 2017

Page 17: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

ZoneNumber of VPVs

Number of cases reported

# of cases Notified by

VPV

Proportion of cases reported

by VPV

CENTRAL 190 108 82 76%

PUNTLAND 105 38 17 45%

SOMALILAND 81 60 20 33%

SOUTH 159 74 33 45%

Somalia 535 280 152 54%

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

Week-40 Somalia Weekly EPI/POL Update

Table no.-6

82

1720

33152

15

1431 20

80

117 9

2148

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Central Puntland Somaliland South Somalia

Pro

p. c

ases

no

tife

d b

y

Source of AFP cases notification

VPV HFs Other

Page 18: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

Of the total 280 AFP

cases reported in 2017,

43% (n=121) and 36%

(n=102) are from Urban

and Rural population

respectively. Nomadic

communities account for

only 21% (n=57).

91% (n=256) of cases are

aged less than 5 years.

45% (n=127) AFP cases

are female.

Week-40 Somalia Weekly EPI/POL Update

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

31 97 9180

70 57

51

150

144

87117

102

65281

181 112 129 121

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2012 2013 2014 2015 2016 2017

Distribution of AFP cases by Life style 2012-2017

Nomadic Rural Urban

56 221 167 115

164127

92 324 252 166

152153

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2012 2013 2014 2015 2016 2017

Distribution AFP cases by sex2012-2017

Female Male

129

129

348249 283 256

19

83

7232 33 24

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2012 2013 2014 2015 2016 2017

Distribution of AFP cases by Age group2012-2017

<5 Yrs ≥ 5 Yrs

Page 19: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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 36 29 81% 7.8 35 100% 100% 89% 25% 0%

Partially accessible

23 1,670,705 71 32 53% 5.5 66 97% 99% 90% 4% 8%

Accessible 75 3.907,440 173 91 52% 5.8 164 99% 99% 96% 13% 10%

National 115 6,179,427 277 152 54% 5.9 265 99% 99% 94% 13% 9%

VPVs continue to support AFP surveillance and have reported 79% (n=27/34) of cases from inaccessible and 48% (n=31/64) 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.

Week-40 Somalia Weekly EPI/POL Update

Table n

o.-7

Page 20: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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% 57 37 65% 54 85% 96% 98% 93% 11% 7%

Rural 25.9% 102 65 64% 99 88% 100% 99% 94% 15% 9%

Urban 45.3% 121 50 41% 112 94% 99% 99% 94% 12% 9%

National 100% 280 152 54% 265 90% 99% 99% 94% 13% 9%

AFP surveillance indicators by Life Style of Population 2017

Week-40 Somalia Weekly EPI/POL Update

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

Page 21: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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 108 63 58%

Somaliland 60 42 70%

South Zone 74 63 85%

Puntland 38 19 50%

Somalia 280 187 67%

Of the total 280 cases, 67% (n=187) were validated by the RPOs. There were 35 zero OPV dose AFP cases reported in 2017, 94% (n=33/35) were investigated.

Week-40 Somalia Weekly EPI/POL Update

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 14 13 93%

Puntland 1 1 100%

Somaliland 0 0 0

South 20 19 95%

Somalia 35 33 94%Table no.-9

Page 22: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Tracking lab results of AFP cases

Total AFP cases

280

Total AFP cases with stool specimens

Total AFP cases without stool

specimens

280 0

With lab results

En route In the lab

265 0 15

cVSPV2 SL EV -ve

0 23 41 201

64

201

15

Tracking AFP with stool specimens

cVDPV2

Other viruses

neg st

in lab

en route

Week-40 Somalia Weekly EPI/POL Update

Page 23: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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 560 530 30 477 90% 68 13% 23 9%

Contacts 836 796 40 716 90% 92 12% 32 4%

Total 1396 1326 70 1193 90% 160 12% 55 5%

Lab performance indicators for AFP surveillance in Somalia, 2017

Week-40 Somalia Weekly EPI/POL Update

Table no.-10

Page 24: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Median and average number of days from onset of paralysis up to final lab result - 2017

Date of Notification

Second stool collected

Specimen reached to Lab

Primary Culture result

Date of onset ITD result

Median: 20 daysAverage: 22 days

Date second stool

collected

Date final ITD results

Median: 3 daysAverage: 3.53 days

Median: 2 daysAverage: 1.89 days

1 day

Week-40 Somalia Weekly EPI/POL Update

Chart no. 2

Median: 3 daysAverage: 3.8 days

Median: 11 daysAverage: 11.7 days

Page 25: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Village polio volunteers weekly house to house visit and AFP cases notified , 08 October 2017

Week-40 Somalia Weekly Polio Update

Central

January Feberuary March April May June July Aug Sept

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 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 AFP cases

notified

No. of HH visited

No. of AFP cases

notified

No. of HH visited

No. of AFP

cases notified

Central31757 6 31780 6 39997 11 35672 12 37438 10 46730 10 38112 6 46205 10 37,881 11

South33599 5 32985 3 41237 5 34252 4 33505 4 43001 1 32761 6 41701 3 33,641 2

Puntland 15237 3 15591 1 18903 3 15193 1 15291 2 14887 1 15175 1 19043 1 15,393 4

Somaliland36646 6 36882 4 45971 0 35634 3 35446 2 41710 1 33807 1 43648 2 34,710 1

Total 117239 20 117238 14 146108 19 120751 20 121680 18 146328 13 119855 14 120535 16 151687 18

Page 26: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Routine Immunization Services, status of Cold Chain & Vaccine stocks in AFP Surveillance Sites as of 02 October. 2017

Week-40 Somalia Weekly Polio Update

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%

Lower 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%

Page 27: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Part -II

Fever and rash Surveillance

Page 28: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

- 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. - 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.

Week-40 Somalia Weekly Polio Update

Epi-curve on suspected measles cases by week, Somalia (Week 20, 2015-Week 40, 2017)

2017(n=16,314)

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

436

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

330

277 29

0

352

0

100

200

300

400

500

600

700

800

2015

W1

3

2015

W1

4

2015

W1

5

2015

W1

6

2015

W1

7

2015

W1

8

2015

W1

9

2015

W2

0

2015

W2

1

2015

W2

2

2015

W2

3

2015

W2

4

2015

W2

5

2015

W2

6

2015

W2

7

2015

W2

8

2015

W2

9

2015

W3

0

2015

W3

1

2015

W3

2

2015

W3

3

2015

W3

4

2015

W3

5

2015

W3

6

2015

W3

7

2015

W3

8

2015

W3

9

2015

W4

0

2015

W4

1

2015

W4

2

2015

W4

3

2015

W4

4

2015

W4

5

2015

W4

6

2015

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

2016

W3

8

2016

W3

9

2016

W4

0

2016

W4

1

2016

W4

2

2016

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

1

2016

W5

2

2017

W0

1

2017

W0

2

2017

W0

3

2017

W0

4

2017

W0

5

2017

W0

6

2017

W0

7

2017

W0

8

2017

W0

9

2017

W1

0

2017

W1

1

2017

W1

2

2017

W1

3

2017

W1

4

2017

W1

5

2017

W1

6

2017

W1

7

2017

W1

8

2017

W1

9

2017

W2

0

2017

W2

1

2017

W2

2

2017

W2

3

2017

W2

4

2017

W2

5

2017

W2

6

2017

W2

7

2017

W2

8

2017

W2

9

2017

W3

0

2017

W3

1

2017

W3

2

2017

W3

3

2017

W3

4

2017

W3

5

2017

W3

6

2017

W3

7

2017

W3

8

2017

W3

9

Page 29: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Fever & Rush cases reported by AFP surveillance System, 08 October 2017

Week-40 Somalia Weekly Polio Update

RegionTotal 2016

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 W34 W35 W36 W37 W38 W39

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 54 46 41 31 44 200 968

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 56 39 26 50 35 38 1531

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 37 32 56 61 49 64 1635

N/East Zone 584 5 11 13 7 10 21 20 20 33 42 16 46 77 48 88 82 64 76 106 136 173 188 215 183 154 185 161 157 187 162 166 156 167 147 117 123 142 128 302 4134

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 1 2 1 4 5 2 713

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 0 4 0 2 1 1 563

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 6 3 0 6 5 8 235

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 4 1 6 0 4 0 596

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 0 0 0 0 0 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 7 26 10 13 6 17 2149

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 18 36 17 25 21 28 4354

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 21 8 19 22 16 7 564

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 13 8 7 4 10 4 1265

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 8 6 9 7 5 8 554

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 76 62 58 69 68 75 4665

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 29 30 34 56 49 40 1612

Central Zone 4017 123 122 138 120 163 135 186 258 170 183 184 205 369 218 297 341 349 342 299 370 329 359 346 284 240 265 263 237 204 221 162 149 201 147 114 127 158 148 134 8660

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 0 0 0 0 2 0 49

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 4 0 4 2 0 2 52

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 0 0 2 8 8 24 107

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 6 7 12 9 3 4 448

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 8 3 5 8 10 13 256

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 18 10 23 27 23 43 912

Grand Total 5657 196 210 229 214 311 255 408 375 399 372 428 432 670 491 699 657 685 663 696 703 720 686 693 584 560 538 554 463 488 444 400 325 436 330 277 290 352 320 507 18060

Page 30: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

Week-40 Somalia Weekly Polio Update

Map no.7 Map no.8

Data source: from the Polio surveillance system and CSR.

Region

Fever & rash cases (2014)

Fever & rash cases (2015)

Fever & rash cases (2016)

Fever & rash cases (2017)

Nugal 1110 82 112 968

Bari 1284 226 202 1531

Mudug 542 561 270 1635

Galbeed 121 212 45 713

Sahil 30 60 226 563

Sanag 115 114 16 235

Sool 187 86 24 596

Awdal 1 15 56 98

Togdher 407 864 223 2149

M. Shab. 285 500 206 564

Hiran 63 663 107 1265

Galgadud 299 229 261 554

Banadir 2594 1974 2226 4665

L. Shab. 1978 1611 1217 1612

M. Juba 177 48 51 49

Bakool 3 26 37 52

Gedo 126 8 104 107

Bay 309 145 9 448

L.Juba 648 74 265 256

Total 10,279 7,498 5,657 18,060

Map no.9

Page 31: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Fever & Rush cases reported by AFP surveillance System 08 October 2017

Week -40 Somalia Weekly Polio Update

<1yr, 3247, 18%

1_4 yrs, 8871, 49%

5_9yrs, 3029, 17%

Yrs10+, 2913, 16%

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

8660

4134 4354

912

18060

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

20000

Central North East North West South Total Somalia

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

Page 32: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

Week-40 Somalia Weekly Polio Update

• Number of fever and rash cases reported has shown decline in recent months compared to the previous month; However, it is still very high/4 times higher than cases reported during the same period in 2015 or 2016.

Mea

sles

Cam

pai

gn(2

1-2

5 M

ay)

Mea

sles

Cam

pai

gn

(24

-28

Ap

ril)

Mea

sles

Cam

pai

gn(2

1-2

5 M

ay)

Mea

sles

Cam

pai

gn(2

4-2

8 M

ay)

161 133 115 97 14062 43 39 19 33 12 1539 30 48 70 119 83

24 27 27 11 40 036 71

214282

491

925

667 634510

302

0

200

400

600

800

1000

Puntland

2015 2016 2017

161 142269

202 243

93 72 47 29 47 29 1514 36 82 10433 35 16 9 42

9637 8

265

459

861 909823

503

275

132 9928

0

200

400

600

800

1000

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

Somaliland

2015 2016 2017

455 443 441 348545 450 514

328 281388 383 401367 315 401

265 324 307 278 271 310142

350

30

503742

1111 12051340

1494

925

659547

134

0

500

1000

1500

2000

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

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

8264

83

43

0

50

100

150

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

South

2015 2016 2017

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Part -IIIPopulation Immunity

Page 34: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Supplemental Immunization Activities

Page 35: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Maps showing accessibility and security/ risk level, Somalia

Week-40 Somalia Weekly EPI/POL Update

Map no.11Map no.10

Page 36: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

Week-40 Somalia Weekly EPI/POL Update

Page 37: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

2017 SIA Calendar, Implementation status and coverage Summary

Week-40 Somalia Weekly EPI/POL Update

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

All accessible areas of Central zone

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

389,159

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

136,929 P.L: 07-10 Sept 2017 122,321 89.3% No IM No LQAS Received

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

409,002

73,447 C. Z: 29 Aug-01 Sept. 2017

b-OPV

66,285 90% No IM No LQAS Received

32,803 S.Z: 29- Aug-01 Sept. 2017 32,238 98.3% No IM No LQAS Received

185,844

116,908 SL: 11- 14 Sept. 2017

22-Oct-17 NIDs R-3

All accessible areas of Central zone

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.

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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

Week-40 Somalia Weekly EPI/POL Update

ZONE/REGION

NID-1 NID-2 HtR-1

# U -5 Targeted

# U-5 Reached

IM coverage

# U -5 Targeted

# U-5 reached

IM coverage

# U -5 Targete

d

# U-5 reached

IM coverag

e

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% 73447 64160

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 Total 2,441,996 2,377,070 96% 1,926,340 1,846,090 95% 252,230 238,049 92%

Page 39: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Week-40 Somalia Weekly EPI/POL Update

Transit Points Vaccination Activities as of October 08, 2017

Table no.-16

A total of 1,711,386 < 10 years individuals were vaccinated week 39,2017. Among them,78,851 (5%) were vaccinated for the first time.

Zones

January February March April May June July August September

Nu

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Zero

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ero

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ated

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% Z

ero

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ated

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do

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% Z

ero

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ated

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do

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% Z

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Zero

do

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% Z

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ses

CENTRAL 77816 12082 15.5% 109859 7779 7.1% 144262 7777 5.4% 110748 3902 3.5% 102455 2583 2.5% 130637 1742 1.3% 102700 786 0.8% 127897 632 0.5% 104615 418 0.4%

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% 27849 76 0.3% 22146 66 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% 19626 614 3.1% 15714 476 3.0%

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% 35148 1173 3.3% 28224 888 3.1%

SOMALIA 154137 24881 16.1% 188233 22910 12.2% 229530 11000 4.8% 176517 5520 3.1% 168555 4262 2.5% 216910 3680 1.7% 171711 2255 1.3% 210520 2495 1.2% 170699 1848 1.1%

Page 40: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Performance of Permanent Vaccination sites in inaccessible areas of S/C zone and distribution as of Oct. 08, 2017

Week-40 Somalia Weekly EPI/POL Update

Since the first weeks of 2017, a total of 114,486 <10 years children were reached through the newly established permanent vaccination sites in fully inaccessible area in South and Central zones. 49% (n=56,187) 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 33,051 11,928 36%Sablale 33,636 11,322 34%

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 114,486 56,187 49%

Page 41: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Immunity Profile of NP-AFP cases (6-59 Months) and Contacts 2013-2017

In 2017, 35 zero-dose NP-AFP cases were reported; 19 from South, 14 from Central and 1 from Puntland. One case is out of the age group 6-59 months. 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. About 30% of the total cases and contacts are under immunized.

Week-40 Somalia Weekly EPI/POL Update

Graph no.-21 Graph no.-19

709

26569 110 118 102

439

164 102

123 144155

344

180

144

134 189147

409

630

126

448 492 396

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2013 2014 2012 2015 2016 2017

Immunization Profile of contacts (all-2017)

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

Graph no.-20

179

7638 37 34

100

34

29 3847

80

5044 56

52

84

182 127 143118

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

14

1 0

19

34

15 14

5

13

47

17

3

14

18

52

5518

31

14

118

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

Central Puntland Somaliland South Somalia

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

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

Page 42: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

Week-40 Somalia Weekly EPI/POL Update

Graph no.-22 Graph no.-23

Graph no.-24 Graph no.-25

Page 43: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Routine Immunization

Page 44: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

45

%

41

%

37

% 39

%

37

%

45

%

66

%

65

%

48

%

60

%

24

%

30

%

22

%

26

%

23

%

33

%

41

%

34

%

34

%

32

%

45

%

51

%

49

%

43

%

49

%

41

%

51

%

57

%

43

%

58

%

33

%

43

%

37

%

36

%

31

%

44

%

54

%

45

%

43

%

41

%

73

%

81

%

72

%

62

%

71

%

57

%

71

% 73

%

52

%

73

%

54

%

57

%

43

%

43

%

46

%

58

%

66

%

57

%

50

%

57

%

64

%

81

%

76

%

63

%

74

%

51

%

64

%

64

%

86

%

69

%

39

%

49

%

40

%

49

%

40

%

46

%

58

%

52

%

61

%

53

%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

BCG P-1 P-3 Measles OPV-3 BCG P-1 P-3 Measles OPV-3 BCG P-1 P-3 Measles OPV-3 BCG P-1 P-3 Measles OPV-3

PUNTLAND SOMALILAND SOUTH CENTERAL SOMALIA

2014 2015 2016 2017 six monthGraph no.-26

Trend of routine EPI coverage by zone, 2014-2017

(N.B. 2017 is annualized from 6 months data )

Source: HMIS/DHIS-2 data 2016 and 2017.

Page 45: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

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

Week-40 Somalia Weekly EPI/POL Update

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

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

Page 46: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Part -IVVaccines and Cold Chain

Management

Page 47: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Vaccines and Cold Chain Management

Week-40 Somalia Weekly EPI/POL Update

USSC (Country Office)

• bOPV for October campaign shipped to South Central and Somaliland while Puntland

still pending due to tax exaptation from Government.

• Received 684,000 doses BCG

• Dispatch of Q4 RI vaccines started and will be finalized next week

• Participated in the Measles planning meeting in collaboration with WHO and UNICEF

in Nairobi

Page 48: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Part -VCommunication

Page 49: Week-40 - HumanitarianResponse · - 3 new AFP cases were reported this week making the total 280 AFP cases reported in 2017. - In addition 836 contact samples (3 contacts for each

Communication for Development

• Updating of communication and social mobilization in outbreak

preparedness and response plan in preparation of the

forthcoming POSE (polio outbreak simulation exercise).

Week-40 Somalia Weekly EPI/POL Update

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the end