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Northern Sindh

S
Hub W#155, 2011

E
EPIDEMIOL
LOGICAL BULLETIN
B
: FLOOD RE
ESPONSE IN
I NORTHE
ERN SINDH
H
DEW
WS Highlights:

Priiority dise
eases
Und
der surveillance
in the fllood affec
cted areas
s
Acute Flaccid
d Paralysis (AFP
P)
Acute Jaundiice Syndrome (A
AJS)
Acute Respirratory Infections
(Upper and Low
wer) (ARI)
Acute Wateryy Diarrhoea/ (AW
WD)
Suspected Cholera
C
Acute Bloodyy Diarrhoea (BD))
Other Acute Diarrhoea (AD)
er (VHF)
Suspected Hemorrhagic Feve
M
(Mal)
Suspected Malaria
Suspected Measles
M
(Ms)
Suspected Meningitis
M
(Mg)
Skin diseases and others

Between 08 Apr to 14 Apr 20


011 (epidemiological week no. 15,, 2011), all 9 disttricts of Northern Sindh
providedsurvveillancedatatotheDEWSsystem,Sitrep15missingfromEssentialmeedicinesandLogistics.
Outof619DEWSSurveillance,dataprovidedby448(72%),mainlyyfromGovt.healtthfacilities;EDOH,PPHI,
privatehealthfacilitiesandhealthclusterpartners.
Teachinghosspitalsandsomep
A total of 20
04,413 consultatio
ons were reported
d through DEWS of
o which (21%) AR
RI (URI = 16% and
d LRI =
5%),followed
dby(13%)skindisseases,(10%)susp
pectedMalaria,and(9%)wereAcuteeDiarrhea.
th
WHO Northeern Sindh respond
ded first outbreakk of Acute Waterry Diarrhea (AWD) on 14 April 20011, at
Village Sawan Chandio, Deh Abji,
A
UCAbran Taluka Naushera Feeroze. 6 AWD cases were diagnoseed and
reported fro
om DHQ Nausherra Feroze, on daated 1442011, WHO responded
d immediately, 3 were
dehydrated, allwerefromsam
mefamily,2stool samplesweretakkenandshippedttoNIH,Islamabad,,WHO
DK) supplied to DHQ
D
through EDOH, Health hygien
ne kits and Aquq tabs distributed tto this
medicine (DD
family,Hypotthesesdeveloped..All6watersampleswerealsocolleectedandsenttoN
NIH.
Figure:1:Wee
eklyreportingtren
ndofweek#48(2
2010)toweek#1
15(2011)

54%

59%

48%
311%
19%

22%

23%

36%

W2

35%

36%

37%

W3

W4

W5

64%
%

60%

67%

67%

67%

72%

48%

25%

8%

W48 W49 W50 W51 W52 W


W1

W6

W7

W8

W9 W10 W1
11 W12 W13 W14 W15

Figure:2:Northern
nSindhDistrictsresponseinDEWSr
reporting(Week1
12to15,2011)
W12

120%
100%

W13

98%
%
95% 95%95%

955% 95%95%95%

85%
84% 82%82%

9
92%

84%
%
81% 80%

80%

70%

W15

73%

55%

60%

50%
40%

36%
33%

40%

32%28%
30%

27%

WHONortthernSindhresponded1stoutbreakkofAWDon
th
14 April2011,atUCAbranTaluka,Naushe
eraFeroze.

92%
888%
91% 87%

W14

88%
84
4% 84%86%

20%

9%

0%

Figurre:3:DEWSdiiseasesreporrted
du
uringthewee
ek#15(2011
1)

Sukkkur

Shikarpur

Larkana

Kambe
er

Kashmore

Jaaccobabad

Ghotki

Khairpur

N..Feroz

Figure:4:DEW
WSdiseasesrep
portedduringthe
eweek#15(20
011)
AD,9%

LRTI,5%

URTI,16%

UF,4%

AL,10%
MA

SCB,13%

OTH,40%

DISEASES
D
AD
AFP
AJS
AWD
BD
EYE
HF
LRTI
MAL
MG
MS
OTH
SCB
SNB
UF
URTI

GTTK
14%
%
0%
%
0%
%
0%
%
25%
%
10%
%
0%
%
15%
%
9%
%
0%
%
0%
%
10%
%
6%
%
0%
%
5%
%
10%
%

JCB
6%
0%
0%
200%
4%
20%
0%
6%
5%
0%
0%
13%
10%
0%
8%
5%

KMR
17%
0%
47%
0%
16%
9%
0%
21%
17%
0%
0%
16%
19%
20%
16%
14%

KSM
M
1%
%
0%
%
0%
%
0%
%
1%
%
1%
%
0%
%
1%
%
2%
%
0%
%
0%
%
1%
%
2%
%
0%
%
3%
%
1%
%

KHP
12%
0%
29%
0%
14%
11%
0%
10%
15%
0%
0%
8%
12%
5%
24%
12%

Weekly Epidemiological Bulletin Data


D
source; Distrrict health office, PPHI,
P
Teaching hoospitals and privatte partners.
For
F Correspondennce: ghyder.shaikhh@gmail.com
WHO Northern Sindh Hub Sukkur: Tel
T : +92-071-59332871, Fax : +92-071-5932871

LRK
14%
0%
3%
0%
22%
11%
0%
18%
13%
100%
0%
12%
20%
0%
15%
14%

NFZZ
12%
%
0%
5%
0%
4%
12%
%
0%
11%
%
24%
%
0%
0%
14%
%
7%
25%
%
1%
12%
%

SKP
12%
0%
16%
0%
7%
14%
0%
11%
8%
0%
0%
14%
10%
30%
8%
15%

SUK
11%
0%
0%
0%
6%
12%
0%
6%
6%
0%
0%
12%
15%
20%
22%
16%

Pagee 1

Northern Sindh
Hub W#15, 2011

EPIDEMIOLOGICAL BULLETIN: FLOOD RESPONSE IN NORTHERN SINDH

Alerts Highlights:

Atotalof24alertswerereceivedandrespondedbyalldistrictsduringweekNo.15Outof24reportedalerts;Measles(9),Pertussis(4),(3)eachforTetanusand
Death,AWD(2)and(1) caseeachforSnakebite,viralencephalitisandDengue,whileno anycaseofPolioreportedatNorthernSindhHubduringweek15
(2011).

Districtwise
AlertsofWeek15

Ghotki

Jacobabad

Kambar

Kashmore

Khairpur

Larkana

NFeroze

Shikarpur

Sukkur

Figure:5:AlertsreportedatSukkurHUBduringweek#14&15(2011)
43%

38%

Week#14

22%
0%

0%

AFP

9%

4%

4%

Dengue

13%

0%

CPox

Death

Alert

No.of
cases

District

Age/Sex

8-Apr-11

AD

Jacobabad

>5M

9-Apr-11

Pertussis

Ghotki

<5F

9-Apr-11

Measles

Ghotki

<5F

9-Apr-11

Measles

Khairpur

<5F

9-Apr-11

Measles

Sukkur

9-Apr-11

Measles

Jacobabad

<5M
<5F,>5
F

10-Apr-11

Measles

Kashmore

<5M

11-Apr-11

Tetanus

Ghotki

<5F

11-Apr-11

Measles

Ghotki

<5M

11-Apr-11

Measles

Jacobabad

>5M

12-Apr-11
12-Apr-11

Pertussis
Pertussis

1
1

Sukkur
Sukkur

<5M
<5F

12-Apr-11

Measles

Sukkur

<5M

13-Apr-11

Snake bite

13-Apr-11
13-Apr-11
13-Apr-11

Death
Death
Death
Viral
Encephlitis

1
1
1

14-Apr-11

Dengue

9%

Qambar
Shahdadkot
Shikarpur
Shikarpur
Shikarpur

MS

Ghotki

Naushahro
Feroze

<5M

Naushahro
Feroze

All
groups

>5F

14-Apr-11

Pertussis

Sukkur

<5F

14-Apr-11

Tetanus

Larkana

>5F

14-Apr-11

Measles

Shikarpur

<5M

14-Apr-11

Tetanus

<5M

40%

AllARI,36%

30%

Mal+UF+
HF,24%
Skin
Dis.,23%
All
Diarrhea,17
%

20%

10%

0%
W7

W8

W9

W10 W11 W12 W13 W14 W15

4%

0%

S.bite

CausativeAgent

Acute Diarrhoea
Pertussis
Suspected Measles
Suspected Measles
Suspected Measles
Suspected Measles
Suspected Measles
Tetanus
Suspected Measles
Suspected Measles
Suspected pertussis
Suspected pertussis
Suspected Measles
Snake bit

PatientisadmittedinCMCLarkana,TIGreceivedbypatientprovidedbyWHO,onseton1242011,reportedbySODEWSLarkana

50%

W6

HIV

Actiontaken/Notes

60%

W5

V.E

A32yearsoldmalediagnosedandreportedsuspectedcaseofAcuteDiarrhoea,reportedbySODEWSJacobabad.
1suspectedcase,collectedspecimenandsenttoNIH,gaveerythromycintocaseandcontacts,uponfieldinvestigationfoundmany
unimmunizedchildrenandoutreachvaccinationscheduledforcommunity.
suspectedcaseofmeaslesfoundintheweeklyDEWSdataofRHCjarwaruponfieldinvestigationthreeyearsagebabyboynamedKanwalS/O
Srichandwithpostmeaslescasewithoutanyrashnosamplewascollectednoanyothercasefoundduringactivesearch
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
1suspectedcase,childwasinvestigated,norashandnofever,babywassickbutnotaccordingtoMeaslescasedefinition.
3suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
SuspectedcaseofTetanuswasadmitedinMCHcentrenotifiedbypediatricianhospitalinvestigationcompleted.TIGwasgivenpatient.
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.
1suspectedcase,uponfieldinvestigationfoundfalsereoprtedcase.
1suspectedcase,uponfieldinvestigationfoundthatitwasacasedefinitionproblem,vaccinationscheduledforcommunity.
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,patientisadmittedatMuhammadiMedicalCenterSukkur,reportedby
SODEWSSukkur.

Shahdadkot

Figure:6:ProportionatePrioritydiseasesreportedatSukkurHUB

W4

TET

A60yearslady,reporteddeathduetoRenalFailure,on13042011.
A7monthsoldbaby,reporteddeathduetoAnaemia,on13042011.
A12yearslady,reporteddeathduetoaroadaccident,on13042011.
A7yearsoldgirl,sufferingfromViralEncephlitis,herthreeothersistershaveexpiredduringlastsixmonthswithsimilarcomplaints.Reported
bySODEWSGhotki.
1suspectedcase,admittedtodaywithnegativeantidengueIGM,negativeMPtest,platelets24000,fromAghaKhanlab,nowcaseisreferredto
Sukkurhospital.CrossnotifiedbySODEWSKhairpur.BloodsampletakenatRanipur,on07042011.
6AWDcasesatDHQN/Feroze,ondated1442011,respondedImmediately,3weredehydrated,allwerefromsamefamily,2stoolsamples
weretakenandshippedtoNIH,Islamabad,WHOmedicine(DDK)suppliedtoDHQthroughEDOH,HealthhygienekitandAquqtabs:distributed
tothisfamily,Hypothesesdeveloped.Watersampleswerealsocollected.
1suspectedcase,specimennotcollectedaspatienthadtakenantibiotic,uponfieldinvestigationfoundmanyunimmunizedchildrenandhealth
educationforcommunitycompleted.
PatientisadmittedinCMCLarkana,TIGreceivedbypatientprovidedbyWHO,onseton0842011,reportedbySODEWSLarkana
1suspectedcase,gavevitaminA,collectedspecimenandsenttoNIH,uponfieldinvestigationnomorecasesfoundandoutreachvaccination
scheduledforcommunity.

W3

Pert

0%

>5F
<5M
>5F

AWD

W2

AWD

4%

4%

0%

CasecommunicatedwithEDOH,ASVadministrated,patientarenowimproving,reportedbySODEWSLarkana.

14-Apr-11

W1

0%

>5M

Qambar

MG

0%

Week#15

13%

9%

8%
0%

Dateofalert

14-Apr-11

17%

Renal Failure
Anaemia
Anaemia
Viral Encephlitis
Negative anti dengue
IGM
AWD
Suspected pertussis
Tetanus
Suspected Measles
Tetanus

Figure:7:ProportionatePrioritydiseasesreportedatSukkurHUB

Week#
W1
W2
W3
W4
W5
W6
W7
W8
W9
W10
W11
W12
W13
W14
W15

AllDiarrhoea
5684(11%)
6842(11%)
7072(11%)
7453(10%)
6998(10%)
8812(10%)
7940(10%)
13638(12%)
8668(11%)
14030(12%)
15327(13%)
15746(14%)
16710(15%)
17042(16%)
19700(17%)

AllARI
23466(45%)
29266(45%)
30103(46%)
34281(46%)
32765(48%)
40753(46%)
34716(46%)
52439(45%)
35746(46%)
50801(42%)
48096(41%)
43955(39%)
40881(38%)
39458(37%)
41933(36%)

Weekly Epidemiological Bulletin Data source; District health office, PPHI, Teaching hospitals and private partners.
For Correspondence: ghyder.shaikh@gmail.com
WHO Northern Sindh Hub Sukkur: Tel : +92-071-5932871, Fax : +92-071-5932871

Mal+UF+HF
12041(23%)
13945(22%)
13852(21%)
16243(22%)
13557(20%)
19195(22%)
15576(20%)
26324(23%)
17308(22%)
28632(24%)
29115(25%)
27614(25%)
26054(24%)
25957(24%)
27952(24%)

SkinDis.
10525(20%)
14283(22%)
14088(22%)
17298(23%)
14847(22%)
20076(23%)
17750(22%)
24181(21%)
15564(20%)
26448(22%)
25693(22%)
25259(22%)
24202(22%)
24491(23%)
27012(23%)

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