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Epidemiological week 16 of 2013 [15 – 21 April 2013]
National Summary
Completeness & Timeliness of Reporting This week, 105 (93.8%) of the districts submitted their weekly reports as opposed to 49 (43.8%) for the corresponding week of 2012. The mean intra-district completeness this week is 65% [median 65%]; compared to the mean intra-district completeness of 88.3% [median 96%] for the corresponding week of 2012. Only 39 (37%) of the districts that reported this week attained an intra-district completeness of at least 80% as opposed to 38 (77.6%) for the corresponding week of 2012. A total of 7districts including Abim, Bududa, Busia, Kaabong, Kumi, Namutumba, & Tororo never submitted reports this week. Timeliness for weekly reporting is 95 (84.8%) for the reporting week; representing a drastic improvement from 35 (31.3%) for the corresponding week of 2012. Disease Outbreaks Suspect VHF: The suspect case was reported to MoH by the DHO Kasese on 26-04-2013 but tested negative for Ebola/Marburg by PCR (details annex 2). Cholera: Suspect cholera cases have emerged in Buliisa & Kasese districts. Consequently, the cumulative number of districts affected by cholera this year rises to nine (9) with a cumulative total of 416 cases and 13 deaths (details annex 2). Rubella: Rubella outbreaks have been confirmed in Kibaale and Kamwenge districts in the sub-counties of Mpeefu and Kekubo respectively. The confirmed cases are 2-11 years of age (details annex 2). Nodding Syndrome (NS): A total of 2,413 nodding syndrome (NS) cases have been registered in the outpatient departments (this includes
258 NS admissions) in designated treatment centres in the six districts of Kitgum, Pader, Lamwo, Amuru, and Gulu & Lira since March 2012. During the same period, 3,050 epilepsy cases were registered in OPD with 66 admissions (details annex 2). Human Influenza Surveillance: The National Influenza Centre in UVRI maintains sentinel surveillance sites for ILI/SARI countrywide (details annex 2). As of 13th Apr. 2013; a total of 402 human specimens had been analyzed with 17 isolates [A(H3) – 4; Influenza B – 9; Type A[not sub-typed] – 2; & Influenza A(H1N1)pdm09 – 2] (details annex 2). Makerere University Walter Reed Project is implementing a complementary Influenza surveillance program. By the end of the 15th epidemiological week of 2013 a total of 310 human samples were analyzed with 15 isolates [A(H3) – 4; Influenza B – 7; Type A[not sub-typed] – 2; & Influenza A(H1N1)pdm09 – 2]. During the same period, a total of 557 non-human samples were analyzed with no influenza isolates (details annex 2). Districts and international ports of entry have been urged to look out for cases of the severe acute respiratory infection (SARI) particularly among international travellers. This follows the emergence of cases of the novel Coronavirus (nCoV) Respiratory infections (17 confirmed cases with 11 deaths among nationals & international travellers from the Middle East) http://www.who.int/csr/don/2013_03_26/en/index.html and due to the more recent emergence of Influenza A (H7N9) cases from eight (8) provinces in China. To date, a total of 121 patients have been laboratory confirmed with influenza A(H7N9); including 23 deaths in China. At this time, there is no evidence of sustained human-to-human transmission; WHO does not advise special screening at points of entry, nor does it recommend that any travel or trade restrictions http://www.who.int/csr/don/2013_04_25/en/index.html
Indicator Epidemiological week 16
2013 2012 Median
2008-2012 % of Districts reporting
93.8 43.8
% HU reporting 65 88.3 % Timely District reports
84.8 31.3
AFP 2(0) 0(0) Animal bites 328(0) 168(0) Cholera 17(0) 17(0) Dysentery 1214(0) 468(0) Guinea Worm 0(0) 0(0) Malaria 187,331
(37) 91,860
(23)
Measles 68(0) 150(0) Meningitis 8(1) 2(0) NNT 2(0) 0(0) Plague 0(0) 0(0) Typhoid 1304(0) 232(0) S/Sickness 0(0) 0(0) Human Influenza 0(0) 0(0) Nodding Syndrome 0(0) 0(0) Yellow Fever 0(0) 0(0) Viral Hemorrhagic Fever
0(0) 0(0)
Highlights of the Week
Weekly Incidence for Selected Priority Diseases in the Country This week; we present a concise profile of the four top priority diseases [including Malaria; Typhoid Fever; Dysentery; & Animal bites] reported during the 16th Epidemiological week of 2013. Malaria: Is the commonest cause of morbidity and mortality in the country; thus this week, 187,331 cases including 37 deaths were reported from the 105 districts that submitted weekly reports for the current epidemiological week. This translates into a weekly incidence rate of 58.9 cases per 10,000 populations as opposed to the weekly incidence rate of 28.9 cases per 10,000 for the corresponding week during 2012. The top 10 districts [Namayingo, Serere, Butaleja, Katakwi, Butambala, Lyantonde, Kiruhura, Bukwo, Kaberamaido, & Otuke] had a malaria incidence of 136-269 cases per 10,000 during the current reporting period. The figure below shows the .number of malaria cases reported by week for 2012 & 2013.
Typhoid Fever: A total of 1304 (4.1 cases per 100,000) suspect typhoid cases were reported from 72 districts. The top 10 districts [Mityana, Lyantonde, Kween, Kapchorwa, Kanungu, Isingiro, Namayingo, Mbale, Kiboga, & Nakaseke] reported 28-112 cases each this week. The figure below shows the number of Typhoid fever cases reported by week for 2012 & 2013. These trends are being investigated.
Dysentery (Bloody diarrhea): A total of 1214 cases (3.8 cases per 100,000) of bloody diarrhea were reported from 96 districts during the current week. The top 10 districts [Namayingo, Nebbi, Mbale, Nakapiripirit, Kisoro, Gulu, Hoima, Yumbe, Kapchorwa, & Moyo] reported 30-63 cases each this week. The figure below shows the number of bloody diarrhea cases reported by week for 2012 & 2013.
Animal bites (Suspect human rabies): A total of 328 cases (1 cases per 100,000) including one (1) death of suspect rabies were reported from 69 districts during the current week. The top 10 districts [Wakiso, Oyam, Nebbi, Amuria, Mbale, Mityana, Bukwo, Kaberamaido, Kibaale, & Masindi] reported 11-40 cases each this week. The figure below shows the number of suspect rabies cases reported by week for 2012 & 2013.
For comments please contact: The Epidemiological Surveillance Division- M.O.H
P.O BOX 7272 Kampala, Tel: 0414-340874/0414-345108 email: [email protected] or [email protected]
Editorial: Dr. Joseph F. Wamala, Dr. Robert Musoke, Mr. M. Mugagga, Dr. Charles Okot, Dr. Immaculate Nabukenya, Mr. Luswa Lukwago, Dr. James Sekajugo, Dr. Francis Adatu, Dr. Issa Makumbi Founders:Dr. Jimmy Kamugisha (RIP), Dr. J. Wanyana, Dr. M. Lamunu, Dr. C. Mugero Dr. N. Ndayimirigye Mr. L. Luswa Dr. N. Bakyaita, Mr. M. Mugagga
4
Annex 1: Summary of District Reports for Epidemiological week 16 of 2013 [15 – 21 April 2013] (Numbers in brackets indicate deaths) D
istr
ict
% o
f H/U
re
port
ing
Tim
ely
AFP
Ani
mal
bite
(S
uspe
cted
R
abie
s)
Cho
lera
Dys
ente
ry
Gui
nea
Wor
m
Mal
aria
Mea
sles
Men
ingi
tis
NN
T
Plag
ue
Typ
hoid
Fe
ver
Slee
ping
Si
ckne
ss
New
Oth
ers
Koboko 100 T 0 1 0 10 0 2098 0 0 0 0 0 () , 0 ,
Moyo 100 T 0 3 0 30 0 3118 0 0 0 0 15 () , 0 ,
Bukwo 100 T 0 11 0 43 0 1045 0 0 0 0 0 0
Kabale 100 T 0 8 0 0 0 243 0 0 0 0 0 0
Kapchorwa 100 T 0 4 0 32 0 432 0 0 0 0 23 0 Bruce 19, ,
Lamwo 100 T 0 4 0 9 0 388 0 0 0 0 1 0 CP 4, ,
Butambala 100 T 0 3 0 2 0 1824 0 0 0 0 4 () , 0 ,
Buvuma 100 T 0 3 0 16 0 706 2 0 0 0 3 () , 0 ,
Sheema 100 T 0 2 0 0 0 2218 0 0 0 0 2 0
Katakwi 100 L 0 1 0 4 0 3137 0 0 0 0 0 0
Ngora 100 T 0 1 0 7 0 1558 0 0 0 0 0 0 AEFI , ,
Kibuku 100 T 0 0 0 4 0 2262 0 0 0 0 0 0
Otuke 100 T 0 0 0 2 0 1093 0 0 0 0 0 0
Rubirizi 100 T 0 0 0 0 0 959 0 0 0 0 4 0
Kisoro 97 T 0 2 0 46 0 961 0 0 0 0 22 () , 0 ,
Pallisa 97 T 0 2 0 15 0 2873(3) 0 0 0 0 0 0
Amuria 96 T 0 12 0 8 0 4578(2) 0 0 0 0 4 0 CP 3, ,
Bulambuli 95 T 0 0 0 13 0 1567 0 0 0 0 2 0
Nakapiripirit 94 T 0 6 0 50 0 1768 0 0 0 0 2 0
Kyegegwa 93 T 0 5 0 0 0 1643 1 0 0 0 3 () , 0 ,
Napak 92 T 0 8 0 21 0 1446(1) 0 0 0 0 3 0
Kayunga 92 T 0 3 0 17 0 3491(2) 0 0 0 0 6 () , 0 ,
Butaleja 92 L 1 2 0 9 0 4264(1) 0 0 0 0 0 0 CP 2, ,
Amolatar 92 T 0 1 0 5 0 1124 0 0 0 0 1 0
Yumbe 91 T 0 3 0 33 0 2067 0 0 0 0 16 () , 0 ,
Manafwa 91 T 0 1 0 15 0 3019 0 0 0 0 25 0
5
Dis
tric
t
% o
f H/U
re
port
ing
Tim
ely
AFP
Ani
mal
bite
(S
uspe
cted
R
abie
s)
Cho
lera
Dys
ente
ry
Gui
nea
Wor
m
Mal
aria
Mea
sles
Men
ingi
tis
NN
T
Plag
ue
Typ
hoid
Fe
ver
Slee
ping
Si
ckne
ss
New
Oth
ers
Mbale 85 L 0 12 0 50 0 4984(1) 0 6(1) 2 0 68 0
Rukungiri 85 T 0 2 0 1 0 3435 0 0 0 0 0 0
Nebbi 84 L 0 13 8 51 0 3503(5) 0 0 0 0 23 0
Namayingo 84 T 0 3 0 63 0 5673 0 0 0 0 36 0
Buikwe 84 T 0 1 0 21 0 3099 7 0 0 0 27 () , 0 ,
Kaberamaido 82 T 0 11 0 21 0 2522 0 0 0 0 3 0 Bruce 1, CP 17,
Serere 82 T 0 3 0 18 0 2952 0 0 0 0 0 0 CP 7, ,
Kiruhura 82 T 0 1 0 4 0 4793 0 0 0 0 6 () , 0 ,
Kole 82 T 0 0 0 1 0 380 0 0 0 0 0 0 CP 1, ,
Kitgum 81 L 0 2 0 12 0 798(3) 0 0 0 0 0 0
Mpigi 81 T 0 1 0 2 0 1934 0 0 0 0 18 () , 0 ,
Dokolo 81 T 0 0 0 4 0 1142 0 0 0 0 2 () , 0 ,
Amudat 80 T 0 0 0 12 0 303 0 0 0 0 0 0 CP 1, ,
Sironko 79 T 0 1 0 13 0 2441 0 0 0 0 0 0
Kampala 76 T 0 0 0 13 0 6438 6 0 0 0 25 0 CP 4, ,
Maracha 75 T 0 0 0 13 0 1742 0 0 0 0 0 () , 0 ,
Lwengo 70 T 0 1 0 4 0 695 1 0 0 0 27 () , 0 ,
Buliisa 70 T 0 0 5 10 0 541 3 0 0 0 9 () , 0 ,
Kyenjojo 69 T 0 10 0 5 0 1182 0 0 0 0 3 () , 0 ,
Alebtong 69 T 0 0 0 2 0 633(1) 0 0 0 0 0 0
Bukomansimbi 69 T 0 0 0 0 0 491 1 0 0 0 9 () , 0 ,
Ssembabule 68 T 0 2 0 12 0 1860 0 0 0 0 31 () , 0 ,
Masindi 67 T 0 11 0 14 0 1271 0 0 0 0 4 () , 0 ,
Gomba 67 T 0 0 0 5 0 1409(2) 0 0 0 0 0 () , 0 ,
Ntoroko 67 T 0 0 0 8 0 306 2 0 0 0 0 () , 0 ,
Mukono 65 T 0 5 0 11 0 2726(2) 1 0 0 0 8 () , 0 ,
Kalungu 65 T 0 3 0 0 0 715(2) 0 0 0 0 18 () , 0 ,
6
Dis
tric
t
% o
f H/U
re
port
ing
Tim
ely
AFP
Ani
mal
bite
(S
uspe
cted
R
abie
s)
Cho
lera
Dys
ente
ry
Gui
nea
Wor
m
Mal
aria
Mea
sles
Men
ingi
tis
NN
T
Plag
ue
Typ
hoid
Fe
ver
Slee
ping
Si
ckne
ss
New
Oth
ers
Masaka 65 T 0 0 0 1 0 1446(1) 0 0 0 0 6 () , 0 ,
Agago 64 L 0 1 0 12 0 968 0 0 0 0 0 0 CP 8, ,
Kalangala 64 T 0 1 0 10 0 416 0 0 0 0 9 () , 0 ,
Moroto 64 L 0 1 0 24 0 630 0 0 0 0 0 0
Bushenyi 63 T 0 7 0 2 0 1306 0 0 0 0 18 () , 0 ,
Isingiro 62 T 0 8 0 13 0 2957 0 0 0 0 69 () , 0 ,
Soroti 61 T 0 4 0 9 0 3093 1 0 0 0 7 () , 0 ,
Mbarara 60 T 0 2 0 7 0 2105 0 0 0 0 42 () , 0 ,
Kamuli 60 T 0 1 0 4 0 4312 0 0 0 0 3 () , 0 ,
Nakaseke 59 T 0 8 0 11 0 1389 0 0 0 0 28 () , 0 ,
Bundibugyo 57 T 0 0 0 27 0 2187 0 1 0 0 14 () , 0 ,
Luweero 56 T 0 3 0 5 0 3169 3 0 0 0 55 () , 0 ,
Kween 56 T 0 2 0 9 0 594 0 0 0 0 21 0 Bruce 6, ,
Lira 56 T 0 1 0 4 0 1274 0 0 0 0 2 () , 0 ,
Gulu 55 T 0 3 0 41 0 1359 0 0 0 0 21 () , 0 ,
Nakasongola 55 T 0 3 0 26 0 1422 3 0 0 0 6 () , 0 ,
Kaliro 55 T 0 1 0 6 0 1037(1) 0 0 0 0 0 () , 0 ,
Bukedea 55 T 0 0 0 6 0 966 0 0 0 0 6 0
Kiboga 54 T 0 0 0 0 0 335 0 0 0 0 30 () , 0 ,
Mityana 53 T 0 12 0 6 0 2227 0 0 0 0 112 () , 0 ,
Mayuge 53 T 0 0 0 17 0 2893 1 0 0 0 4 () , 0 ,
Ibanda 51 T 0 0 0 3 0 2758 0 0 0 0 2 () , 0 ,
Rakai 49 T 0 2 0 12 0 4043 2 0 0 0 38 () , 0 ,
Wakiso 48 T 1 40 0 26 0 5965 6 0 0 0 88 () , 0 ,
Kanungu 48 T 0 4 0 2 0 1357 0 0 0 0 53 () , 0 ,
Ntungamo 47 T 0 9 0 2 0 2750 0 0 0 0 9 () , 0 ,
Jinja 47 T 0 6 0 14 0 3254 7 0 0 0 27 () , 0 ,
7
Dis
tric
t
% o
f H/U
re
port
ing
Tim
ely
AFP
Ani
mal
bite
(S
uspe
cted
R
abie
s)
Cho
lera
Dys
ente
ry
Gui
nea
Wor
m
Mal
aria
Mea
sles
Men
ingi
tis
NN
T
Plag
ue
Typ
hoid
Fe
ver
Slee
ping
Si
ckne
ss
New
Oth
ers
Kotido 47 L 0 1 0 25 0 698(2) 0 0 0 0 15 0
Kamwenge 46 T 0 2 0 1 0 2151 0 0 0 0 6 () , 0 ,
Luuka 46 T 0 0 0 0 0 1192 0 0 0 0 0 () , 0 ,
Kibaale 45 T 0 11 0 3 0 1386 6 0 0 0 56 () , 0 ,
Buyende 45 T 0 4 0 1 0 726 0 0 0 0 0 () , 0 ,
Lyantonde 44 T 0 0 0 0 0 1411 0 0 0 0 24 () , 0 ,
Kiryandongo 43 T 0 0 0 8 0 532 0 0 0 0 5 () , 0 ,
Kyankwanzi 42 T 0 0 0 1 0 330 0 0 0 0 7 () , 0 ,
Hoima 41 T 0 1 3 34 0 1309 2 0 0 0 19 () , 0 ,
Adjumani 38 T 0 5 0 15 0 1927 0 0 0 0 0 0 CP 2, ,
Apac 38 L 0 0 0 0 0 596 0 0 0 0 0 0
Buhweju 38 T 0 0 0 0 0 583 0 0 0 0 0 () , 0 ,
Kabarole 36 T 0 0 0 1 0 2544 8 0 0 0 11 () , 0 ,
Mubende 33 T 0 0 0 4 0 1663(1) 4 0 0 0 17 () , 0 ,
Oyam 27 T 0 14 0 10 0 335 0 1 0 0 2 () , 0 ,
Mitooma 26 T 0 0 0 0 0 907 0 0 0 0 0 () , 0 ,
Pader 26 T 0 0 0 2 0 314 0 0 0 0 0 0
Iganga 23 T 0 2 0 0 0 2652(7) 1 0 0 0 1 () , 0 ,
Zombo 20 T 0 0 0 8 0 145 0 0 0 0 0 () , 0 ,
Amuru 15 T 0 0 0 0 0 100 0 0 0 0 0 () , 0 ,
Nwoya 10 T 0 0 0 33 0 545 0 0 0 0 0 0
Arua 9 L 0 1 0 0 0 774 0 0 0 0 0 0
Budaka 5 T 0 0 0 1 0 84 0 0 0 0 9 () , 0 ,
Bugiri 5 T 0 0 0 0 0 97 0 0 0 0 5 () , 0 ,
Kasese 4 T 0 0 1 7 0 268 0 0 0 0 4 () , 0 ,
Abim NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR
8
Dis
tric
t
% o
f H/U
re
port
ing
Tim
ely
AFP
Ani
mal
bite
(S
uspe
cted
R
abie
s)
Cho
lera
Dys
ente
ry
Gui
nea
Wor
m
Mal
aria
Mea
sles
Men
ingi
tis
NN
T
Plag
ue
Typ
hoid
Fe
ver
Slee
ping
Si
ckne
ss
New
Oth
ers
Bududa NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR
Busia NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR
Kaabong NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR
Kumi NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR
Namutumba NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR
Tororo NR NR NR NR NR NR NR NR NR NR NR NR NR NR NR National 65 84.8 2(0) 328(0) 17(0) 1214(0) 0(0) 187331(37) 68(0) 8(1) 2(0) 0(0) 1304(0) 0(0)
HU= Health Units, NR = Not reported, CP = Chicken Pox, KZ = Kalazar, Sch = Schistosomiasis, MP= Malaria in pregnancy; Nodding Syndrome
Color codes for Completeness of reporting: Dark Yellow; (0-79%); & Light Brown (80-100%)
9
Annex 2: Summary of Epidemics and Response Activities initiated by Epidemiological week 16 of 2013 [15 – 12 April 2013] Condition Affected
districts New cases
(deaths) 15th to 21th
April 2013 [16th Epi-
week]
Cumulative Cases
Cumulative Deaths
Comments and Actions
Suspect VHF
Kasese 1 1 0 1. A suspect VHF case has been reported to the MoH by the DHO Kasese. The report came in on 26-04-2013 with the suspect case being an adult male who was involved in 2 burials (in DRC) at the end of March 2013. He later developed the initial symptoms (fever, abdominal complaints, muscle aches) in mid April 2013 after which he developed bleeding tendencies by 21-Apr-2013. He was managed at Kitholu HCIII which referred him to Bwera hospital and eventually to Kagando hospital where he is currently isolated.
2. A laboratory sample was obtained and tested negative for Ebola and Marburg by PCR. Serological testing (IgM & Antigen detection) is underway & results will be communicated.
Rubella (confirmed)
Kibaale 3 3 0 1. Following reports of suspect measles cases in Mpeefu sub-county, Kibaale district; five blood samples were collected on 18th April 2013 & submitted for testing in the UVRI/EPI laboratory where three (60%) of the samples tested positive for Rubella.
2. The cases are aged 5-11 years with a median of 6 years. Rubella is teratogenic in the first trimester of pregnancy but there is no cause for alarm since the current cases have been reported in children.
3. Districts have been urged to line-list all the subsequent cases to allow monitoring of epidemiological trends.
Rubella (confirmed)
Kamwenge 5 5 0 1. Following reports of suspect measles cases by Kekubo sub-county, Kamwenge district; five blood samples were submitted on 23-April-2013 for testing in the UVRI/EPI laboratory where five (100%) of the samples tested positive for Rubella.
2. The cases are aged 2-10 years with a median of 4 years. Rubella is teratogenic in the first trimester of pregnancy but there is no cause for alarm since the current cases have been reported in children.
3. Districts have been urged to line-list all the subsequent cases to allow monitoring of epidemiological trends.
Cholera (suspect)
Buliisa 5 5 0 1. The district has been requested to provide a verification report.
Cholera (suspect)
Kasese 1 1 0 1. The district has been requested to provide a verification report.
Cholera (suspect)
Hoima 3 56 3 (CFR 5.4%)
2. The outbreak is on the decline with one case currently admitted in the treatment centre at Runga landing site. The outbreak started on 12_04_2013 with cases originating from Runga village/landing site, Kapaapi Parish, Kigorobya sub-county.
10
Condition Affected districts
New cases (deaths)
15th to 21th
April 2013 [16th Epi-
week]
Cumulative Cases
Cumulative Deaths
Comments and Actions
3. A tent with cholera beds has been erected at the landing site with support from World Vision Uganda. Other partners like URCS are supporting active case finding with health education at the landing site; and provision of Jerry cans for safe water storage.
4. There are adequate case management supplies available in the district. However the district lacks water purification tablets, chlorine for disinfection in the treatment centre, gum boots and mobilets at the treatment site.
Cholera (suspect)
Nebbi 8(0) 117 3 (CFR 2.6%)
1. The initial cases were reported from Angum village, Nyakagei Parish, Panyimur sub-county on the shores of Lake Albert starting 16th January 2013. Cases were subsequently reported from Akworo sub-county; which together with Panyimur sub-county recorded the bulk of the cholera cases reported during the outbreak.
2. Intense behavioural change campaign (sensitisations and inspection of public places and domestic areas to enforce sanitation and hygiene standards) launched with the stewardship of the district taskforce. Consequently; only sporadic cases have been reported from Parombo, Erussi, and Nyaravur sub-counties in the recent weeks.
3. NMS delivered cholera case management supplies but intravenous fluids were lacking in the consignment.
Cholera (confirmed)
Ntoroko 0 43 0 1. The outbreak was controlled in early February 2013 following the discharge of last case on 10th February 2013.
2. The outbreak started on 27th December 2013 with cases being reported from Kanara Town Council. Most of the subsequent cases were reported from Kanara TC except for two (2) cases that were reported from Kanara sub-county. The onset of the outbreak followed torrential rains that caused flooding; submerging pit latrines & leaving the local population to resort to open defecation with the risk of contaminating unprotected water sources. The floods were reported in Bweramure, Batungama, Rwebisengo & Rwangara (Kanala).
3. Five samples have been sent to Bundibugyo hospital laboratory with Vibrio Cholerae being isolated from one of the samples. The cholera treatment centre was set up at Ntoroko HCIII.
4. Community education and sanitation/hygiene inspections were intensified during the outbreak.
Cholera (confirmed)
Arua 1 141 4 (CFR 2.8%)
1. The outbreak is nearly controlled with no cases currently on admission [most recent case discharged on 23-April-2013]. Initial cases were reported from Aiivu sub-county and Oli division starting 12-02-2013. Eventually cases were reported from Katini, Omugo, & Bileafe sub-counties.
2. Vibrio Cholerae was confirmed from two (2) specimens collected from Oli division at the onset of the outbreak.
11
Condition Affected districts
New cases (deaths)
15th to 21th
April 2013 [16th Epi-
week]
Cumulative Cases
Cumulative Deaths
Comments and Actions
3. The outbreak intensified in March 2013 but following sustained interventions; the outbreak is now nearly controlled.
4. The district taskforce met only twice but the DHT has been meeting weekly to coordinate upstream interventions for improving sanitation, personal and food hygiene, and drinking treated water in both the affected and at-risk sub-counties.
5. The NMS delivered case management supplies to the district with adequate stocks reported till now.
Cholera (confirmed)
Maracha 0 15 01 (CFR 6.7%)
1. The outbreak is controlled with no new cases reported in the district in the last four (5) weeks.
2. The initial cases were reported from Nyadri sub-county in Late February 2013. The outbreak was imported from Arua by a family that attended a funeral in Aiivu sub-county, Arua district where a cholera outbreak was already ongoing at the time.
3. Cholera cases were reported from Nyadri and Yivu sub-counties; and following intense surveillance and health education to the initial clusters; the outbreak is now under control.
4. No supplies were delivered for case management. Cholera (confirmed)
Yumbe 0 12 0 1. The outbreak has been controlled hence no new cases have been reported in the last five (5) weeks; the last case was discharged on 16_03_2013.
2. The initial cases were reported from Lodonga HC III on 24th February 2013. On 27th February 2013, two (2) specimens we sent to the Arua RRH where Vibrio Cholerae was isolated.
3. Two (2) cholera treatment centres (Yumbe hospital and Lodonga HC III) were established and the District Disaster Task Force was reactivated to coordinate the investigations and response to control the outbreak.
4. The initial cases in the district originated from Atu river village, Lobule sub-county in Koboko and travelled to Yumbe for a marriage feast where they fell sick and were subsequently admitted in Lodonga HCIII. The affected sub counties included: Lodonga, Drajini, Kuru, Yumbe Town Council and Apo.
5. Effective control interventions were initiated with no fatal cases being registered and NMS delivered drug supplies for case management.
Cholera (confirmed)
Koboko 0 26 2 (CFR
1. The outbreak has been controlled hence no new cases have been reported in the last four (4) weeks.
12
Condition Affected districts
New cases (deaths)
15th to 21th
April 2013 [16th Epi-
week]
Cumulative Cases
Cumulative Deaths
Comments and Actions
6.25%) 2. The initial cases were reported on 26th February 2013 among family members who travelled to Aiivu sub-county, in Arua for a traditional function. Cases were initially reported from Lobule (where the majority of the cases occurred. Suspect cases were subsequently reported from Midia; and Kuluba sub-counties among relatives who attended a family function but laboratory tests indicated food poisoning.
3. Vibrio Cholerae was isolated in Arua RRH laboratory from specimens collected from cases in Lobule sub-county.
4. Effective control interventions were initiated and the outbreak is now reported to be under control.
Nodding Syndrome
Kitgum 15 OPD - 452 IPD – 112
1. Nodding syndrome census finalised in Feb. 2013 and the data analysis is underway. 2. The data presented here is derived from cases seen at NS treatment centre – Kitgum hosp. &
outreaches. Data last updated Oct. 2012 (district still compiling updated data). Lamwo OPD - 347
IPD – 38 1. Nodding syndrome census finalised in Feb. 2013 and the data analysis is underway.
2. The data presented here is derived from patients seen at NS treatment centres – Padibe HCIV & the 12 outreaches conducted monthly to Palabek Kal; Palabek Gem; Palabek Ogili & Lokung sub-counties.
3. Aerial spraying along rivers Pager & Aswa finalised in November/December 2013. 4. Food received from OPM was distributed to the affected families this week [3/02/13].
Pader OPD – 1,210 IPD – 108
15 1. Nodding syndrome census finalised in Feb. 2013 and the data analysis is underway. 2. The data presented here is derived from patients seen at NS treatment centres – Atanga
HCIII & outreaches. Gulu 330 1 1. There was one death in the index case from Aromowanglobo; after he missed a scheduled
refill visit and fitted while alone at home. 2. A total of 15 HCW trained in NS case management; & they subsequently conducted
verification in Omel & Cwero Parishes in Paicho sub-county; & Paibona parish in Awac sub-county.
3. NS treatment centres set up in Odek HCIII; Aromowanglobo HCII; Cwero HCII; & Labworomo HCIII.
4. Food donations from WVU have been distributed to affected families. & Additional funds have been provided by WVU to train more HCW on NS case management.
Lira 13 1. A total of 13 NS cases registered but only three are attending care at Aromo HC while the
13
Condition Affected districts
New cases (deaths)
15th to 21th
April 2013 [16th Epi-
week]
Cumulative Cases
Cumulative Deaths
Comments and Actions
rest are attending care in Aromowanglobo in Gulu. No admissions to date. Amuru 61 1. No new cases recorded; cases are getting care from the treatment centre in Atiak HCIV and
at the four (4) outreach sites [Ogomraa Community School; Okidi HCII; Pacilo HCII; & Gunya Community School].
2. A total of 10 HCW trained in NS case management. 3. Mass treatment for onchocerciasis with ivermectin conducted in October 2012.
Epilepsy Kitgum OPD – 1,003 IPD – 25
Data derived from cases seen at NS treatment centre – Kitgum hosp. & outreaches. Data last updated Oct. 2012 (district still compiling updated data).
Lamwo OPD – 122 IPD – 0
The data presented here is derived from patients seen at the NS treatment centres – Padibe HCIV & the 12 outreaches conducted monthly to Palabek Kal; Palabek Gem; Palabek Ogili & Lokung sub-counties.
Pader OPD – 1,251 IPD – 41
The data presented here is derived from patients seen at NS treatment centres – Atanga HCIII & outreaches.
Gulu 268 Data derived from Nodding Syndrome treatment centres. Lira 344 Current data derived from cases seeking care from the treatment centre in Aromo HC Amuru 62 Data derived from Nodding Syndrome treatment centres.
Human Influenza (confirmed) Human Influenza (confirmed)
32 0 1. The National Influenza Centre in UVRI maintains sentinel surveillance sites for ILI at (Entebbe hospital, Kampala [Kawala HC, Kisenyi HC, Kitebi HC], and Lobule HC [Koboko district]); and SARI at (Entebbe hospital, Tororo hospital, Fort Portal hospital, Mbarara hospital, Arua hospital, Koboko HCIV).
2. As of 21st Apr. 2013; a total of 402 specimens had been analyzed by the 13th epidemiological week of 2013 with 17 isolates [A(H3) – 4; Influenza B – 9; Type A[not sub-typed] – 2; & Influenza A(H1N1)pdm09 – 2].
3. Makerere University Walter Reed Project is implementing a complementary Influenza surveillance program.
4. The human influenza surveillance sites are located in Gulu RRH, Jinja RRH, & Mulago NRH. 5. The non-human component collects samples on a regular basis from potential Influenza
reservoirs like the waterfowl from the Western Rift Valley Lakes, Lake Victoria shores, and the wetlands in Eastern Uganda. Non-human samples are also obtained from other potential reservoirs in Eastern, West Nile, Central, Northern, & Western Uganda.
6. By the end of the 15th epidemiological week of 2013 a total of 310 human samples had been analyzed with 15 isolates [A(H3) – 4; Influenza B – 7; Type A[not sub-typed] – 2; & Influenza
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Condition Affected districts
New cases (deaths)
15th to 21th
April 2013 [16th Epi-
week]
Cumulative Cases
Cumulative Deaths
Comments and Actions
A(H1N1)pdm09 – 2]. 7. During the same period, a total of 557 non-human samples had been analysed with no
influenza isolates.
8. While there is low seasonal influenza activity in most parts of the country; districts and international ports of entry have been urged to look out for cases of the severe acute respiratory infection (SARI) particularly among international travellers.
9. Districts and international ports of entry have been urged to look out for cases of the severe acute respiratory infection (SARI) particularly among international travellers. This heightened surveillance for SARI cases is crucial following the emergence of cases of the novel Coronavirus Respiratory infections (17 confirmed cases with 11 deaths among nationals & international travellers from the Middle East) http://www.who.int/csr/don/2013_03_26/en/index.html and due to the more recent emergence of Influenza A (H7N9) cases from five (5) provinces in China. To date, there are a total of 121 laboratory confirmed human cases with avian influenza A(H7N9) virus including 23 fatalities in China reported from eight (8) Provinces: Anhui 4 (1), Fujian 1 (0), Henan 4 (0), Hunan 1 (0), Jiangsu 26 (4), Jiangxi 3 (0), Shandong 1 (0) and Zhejiang 45 (6) and two Municipalities: Beijing 1 (0) and Shanghai 34 (12), and one case with no fatalities reported from the Taipei CDC. . At this time, there is no evidence of sustained human-to-human transmission; WHO does not advise special screening at points of entry, nor does it recommend that any travel or trade restrictions http://www.who.int/csr/don/2013_04_25/en/index.html
MDR-TB 114 1. A total of 114 MDR-TB cases were confirmed in 2012 [but this doesn’t include data from July to August] Since 2008; a total of 351 MDR cases have been reported with 30 cases being reported in 2008; 50 cases in 2009; 86 cases in 2010; 71 cases in 2011; & 114 cases in 2012.
2. During 2012, MDR-TB cases were reported from Kampala; Kamuli, Wakiso, Iganga, & Mubende; Pader, Gulu, Alebtong, Buikwe, Napak, Mukono, Ibanda, Kabarole, Amuria, Mpigi, Luwero & Abim.
3. The NTLP worked with NMS to supply MDR-TB drugs to Mulago, Kitgum, & Mbarara.
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For comments please contact: The Epidemiological Surveillance Division- M.O.H
P.O BOX 7272 Kampala, Tel: 0414-340874/0414-345108 email: [email protected] or [email protected]
Editorial: Editorial: Dr. Joseph F. Wamala, Dr. Robert Musoke, Mr. M. Mugagga, Dr. Charles Okot, Dr. Immaculate Nabukenya, Mr. Luswa Lukwago, Dr. James Sekajugo, Dr. Francis Adatu, Dr. Issa Makumbi Founders:Dr. Jimmy Kamugisha (RIP), Dr. J. Wanyana, Dr. M. Lamunu, Dr. C. Mugero Dr. N. Ndayimirigye Mr. L. Luswa Dr. N. Bakyaita, Mr. M. Mugagga
