Epidemiological Highlightsorigin.searo.who.int/entity/bangladesh/ewarsw132020.pdf · 2020-04-02 · Epidemiological Highlights Week 13, 2020 3| EWARS Reporting Updates Total 139/166

Epidemiological HighlightsWeek 13, 2020

1 |

Epidemiological Highlights

Week 13 (23 – 29 March 2020)


2 |

Highlights:

▪ Surveillance strategy has been shared with Epidemiology Working Group forreview and will be finalized upon receiving their feedback by next week.

▪ Rapid Investigation Team training completed and camp wise allocation ofinvestigation team members done.

▪ Adaptation of go.data for COVID-19 is being planed for rolling-out.

▪ IEDCR Field Laboratory based on Cox’s Bazar Medical College started COVID-19PCR testing science April 01, 2020.

▪ Acute Respiratory Infection (25.4%), Diarrheal Diseases (5.7%) & UnexplainedFever (1.9%) are the diseases with highest proportional morbidity in week 13.Injury/wounds shows increasing trend (2.1%) over last couple of months.


3 |

EWARS Reporting Updates

▪ Total 139/166 (84%) health facilities registered in EWARS

▪ Only 111/139 weekly reports received in week 13.

▪ Completeness and Timeliness for this week is 72%.

▪ In 2020 cumulative completeness and timeliness of reporting is 91% and82% respectively

▪ Total 23 alerts were triggered in week 13. All alerts were reviewed andverified (20 under monitoring and 3 discarded) by WHO EWARS teamwhich is less than as of previous week (45).


4 |

Diphtheria

12 suspected diphtheria case reported in go.data in week 13

A total of 9 075 case-patients were reported since 2017 to till date

• Confirmed = 327

• Probable = 2785

• Suspected = 5975

Total Case reported in 2020 = 123

• Confirmed = 5

• Probable = 7

• Suspected = 111

Last confirmed case was reported in Week 9 (01 March 2020)

Total deaths reported is 46. Last death was reported on 25 October 2019


5 |

Diphtheria

0

2

4

6

8

10

12

14

16

18

20

36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13

Nu

mb

er

of

rep

ort

ed

ca

se

Epidemiological week

Diphtheria case patient reported in EWARS from Epi week 36-13, 2020

Confirm Probable Suspected


6 |

Measles

▪ Total 12 suspected measles cases were reported throughaggregated weekly reporting in EWARS in week 13

▪ In last seven weeks number of cases showed a decreasingtrend

▪ 2,400 (56%) individual case report forms (CRF) werereceived out of total 4,293 cases reported throughaggregated weekly report in EWARS in 2020


7 |

Measles

0

100

200

300

400

500

600

700

36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13

Nu

mb

er

of

rep

ort

ed

ca

se

Epidemiological week

Total number of Measles case reported in EWARS from week 36-13, 2020


8 |

Diarrhoeal Disease

▪ A total 1 966 cases of diarrhoeal diseases reported in EWARS inweek 13

▪ Among which 1,181 cases (3.4%) reported as acute waterydiarrhoea (AWD), 630 (1.8%) and 155 (0.5%) cases as otherdiarrhea and bloody diarrhea respectively.

▪ Diarrhoeal diseases are the second highest contributor ofproportional morbidity after acute respiratory infection (ARI).


9 |

Community-based surveillance

▪ In week 13 total of 5 deaths were recorded. 3 were due to causesclassified as “Others” , 1 still birth and 1 injury related death.

▪ There was NO mortality alert raised for women of reproductive age(12-49 years).

▪ 1 death was reported from health facility, 1 from community and 3from home

▪ We would like to urge donor agencies to inform their partners to reportall mortalities into EWARS using the “Community-based mortalitysurveillance” form.


10 |

Community-based surveillance

1

2

1

1

ACUTE MALNUTRITION

INFECTIOUS DISEASE

INJURY

MATERNAL DEATH

NEONATAL (<28 DAYS OLD)

OTHER

STILL BIRTH (BORN DEAD)

FEMALE MALE

BangladeshRohingya Emergency Response

Ministry of Health and FamilyWelfare Bangladesh Printed: 14:45 Tuesday, 31 March 2020 UTC

Early Warning, Alert and Response System (EWARS)Epidemiological Bulletin W13 2020

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

W13 2020

Table 1 | Coverage

# %

854,704 - Estimated total Rohingya population

854,704 100% Total population under surveillance

166 - Total number of health facilities

139 84% Number of EWARS reporting sites

Table 2 | Early warning performance indicators

W13 Cumulative (2020)

111 1778 Number of weekly reports received

72% 91% Completeness

72% 82% Timeliness

Table 3 Alert performance indicators


23 980 Total alerts raised

100% 100% % verified

0% 0% % auto-discarded

0% 0% % undergoing risk assessment

0% 0% % completed risk assessment

Source: UNHCR. Bangladesh: Joint Goverment of Bangladesh- UNHCR Population Factsheet. 31 December 2019.

Highlights W13 2020

1 W13 2020

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 W13 2020

1

2

3

4

5

6

7

8

9

10

11

12

13

14

1516

17

18

19

20

21

22 23

24

25

26

1 Camp 122 Camp 1E3 Camp 144 Camp 1W5 Camp 76 Camp 47 Camp 58 Camp 2E9 Camp 8E10 Camp 1111 Kutupalong RC12 Camp 613 Camp 2W14 Camp 1015 Camp 8W16 Camp 1717 Camp 2018 Camp 1919 Camp 1520 Camp 20 Ext21 Camp 4 Ext22 Camp 1823 Camp 924 Camp 325 Camp 1626 Camp 13

1

2

3

4

5

6

7

8

1 Nayapara RC2 Camp 27 Jadimura3 Camp 24 Leda4 Camp 21 Chakmarkul5 Camp 25 Ali Khali6 Camp 23 Shamlapur7 Camp 26 Nayapara8 Camp 22 Unchiprang

Northerngroup Reporting Performance

# healthfacilities

# reportsreceived Completeness Timeliness

Table 4 | Performance by camp (W13 2020) Map 2 | Completeness by camp

Completeness 0 25% 50% 75% 100%

Early Warning | Ukhia (Northern Group)

3 W13 2020

Camp 1E 5 3 60% 60%

Camp 1W 3 2 67% 67%

Camp 2E 1 0 0% 0%

Camp 2W 2 2 100% 100%

Camp 3 6 4 67% 67%

Camp 4 6 4 60% 60%

Camp 4 Ext 1 1 100% 100%

Camp 5 5 4 80% 80%

Camp 6 3 2 67% 67%

Camp 7 5 4 100% 100%

Camp 8E 7 6 100% 100%

Camp 8W 8 6 86% 86%

KutupalongRC

0 2 0% 100%

12

3

4

5

6

7

8

9

10

11

1213

1 Camp 1E2 Camp 1W3 Camp 74 Camp 45 Camp 56 Camp 2E7 Camp 8E8 Kutupalong RC9 Camp 610 Camp 2W11 Camp 8W12 Camp 4 Ext13 Camp 3

Southerngroup Reporting Performance

# healthfacilities



Completeness 0 25% 50% 75% 100%

Early Warning | Ukhia (Southern Group)

4 W13 2020

Camp 10 4 3 75% 75%

Camp 11 10 9 90% 90%

Camp 12 7 7 100% 100%

Camp 13 12 8 78% 78%

Camp 14 8 4 50% 50%

Camp 15 10 7 75% 75%

Camp 16 5 5 100% 100%

Camp 17 5 0 0% 0%

Camp 18 5 3 60% 60%

Camp 19 5 5 100% 100%

Camp 20 3 2 67% 67%

Camp 20 Ext 1 1 100% 100%

Camp 9 6 3 75% 75%

1

2

3

4

5

6

7

8

9 10 11

12

13

1 Camp 122 Camp 143 Camp 114 Camp 105 Camp 176 Camp 207 Camp 198 Camp 159 Camp 20 Ext10 Camp 1811 Camp 912 Camp 1613 Camp 13

Teknaf Reporting Performance

# healthfacilities



Completeness 0 25% 50% 75% 100%

Early Warning | Teknaf

5 W13 2020

Camp 21Chakmarkul

4 2 33% 33%

Camp 22Unchiprang

5 2 67% 67%

Camp 23Shamlapur

4 3 100% 100%

Camp 24 Leda 1 1 100% 100%

Camp 25 AliKhali

3 1 33% 33%

Camp 26Nayapara

1 1 100% 100%

Camp 27Jadimura

1 0 0% 0%

Nayapara RC 0 2 0% 100%

1

2

3

4

5

6

7

8


Partner Performance Reporting

# sites # reportsreceived Completeness Timeliness

BDRCS 4 6 150% 150%

BRAC 11 11 100% 100%

CARE 4 4 100% 100%

FHM 1 0 0% 0%

FRNDS 12 12 100% 100%

GK 9 9 100% 100%

HMBDF 1 1 100% 100%

IOM 15 13 87% 87%

IRC 2 1 50% 50%

MSF 9 4 44% 44%

MoH 0 1 0% 0%

Hope 2 2 100% 100%

Medair 1 1 100% 100%

Table 7 | Performance by partner (W13 2020)

Partner Performance Reporting

# sites # reportsreceived Completeness Timeliness

FH/MTI 4 4 100% 100%

PHD 9 9 100% 100%

PWJ 1 1 100% 100%

RHU 0 0

RI 3 3 100% 100%

RTMI 7 1 14% 14%

SCI 9 0 0% 0%

TdH 1 1 100% 100%

Early Warning | Partner performance

6 W13 2020

Northerngroup W13 Cumulative (2020)

# alerts % verif. # alerts % verif.

Table 8 | Performance by camp Map 5 | Number of alerts by camp

# of alerts 0 2 5 10

Alert | Ukhia (Northern Group)

7 W13 2020

Camp 1E 0 0% 29 100%

Camp 1W 0 0% 8 100%

Camp 2E 0 0% 22 100%

Camp 2W 2 100% 20 100%

Camp 3 2 100% 74 100%

Camp 4 3 100% 70 100%

Camp 4 Ext 1 100% 10 100%

Camp 5 0 0% 50 98%

Camp 6 0 0% 9 100%

Camp 7 0 0% 7 100%

Camp 8E 0 0% 16 100%

Camp 8W 0 0% 48 100%

KutupalongRC

0 0% 6 100%

12

3

4

5

6

7

8

9

10

11

1213

1 Camp 1E2 Camp 1W3 Camp 74 Camp 45 Camp 56 Camp 2E7 Camp 8E8 Kutupalong RC9 Camp 610 Camp 2W11 Camp 8W12 Camp 4 Ext13 Camp 3

Southerngroup W13 Cumulative (2020)




Alert | Ukhia (Southern Group)

8 W13 2020

Camp 10 1 100% 27 100%

Camp 11 1 100% 38 100%

Camp 12 1 100% 59 100%

Camp 13 0 0% 34 100%

Camp 14 2 100% 39 100%

Camp 15 1 100% 52 100%

Camp 16 1 100% 54 100%

Camp 17 0 0% 29 100%

Camp 18 0 0% 32 100%

Camp 19 1 100% 39 100%

Camp 20 1 100% 31 100%

Camp 20 Ext 0 0% 4 100%

Camp 9 3 100% 41 100%

1

2

3

4

5

6

7

8

9 10 11

12

13

1 Camp 122 Camp 143 Camp 114 Camp 105 Camp 176 Camp 207 Camp 198 Camp 159 Camp 20 Ext10 Camp 1811 Camp 912 Camp 1613 Camp 13

Teknaf W13 Cumulative (2020)




Alert | Teknaf

9 W13 2020

Camp 21Chakmarkul

1 100% 25 100%

Camp 22Unchiprang

0 0% 3 100%

Camp 23Shamlapur

0 0% 10 100%

Camp 24 Leda 0 0% 14 100%

Camp 25 AliKhali

0 0% 7 100%

Camp 26Nayapara

1 100% 41 100%

Camp 27Jadimura

0 0% 10 100%

Nayapara RC 1 100% 7 100%

1

2

3

4

5

6

7

8


Event W13 Cumulative (2020)


Indicator-based surveillance

Malaria 0 0% 0 0%

Measles 9 100% 587 100%

Bloody Diarr. 0 0% 0 0%

AFP 0 0% 5 100%

Meningitis 0 0% 10 100%

Haem. fever(susp.)

0 0% 7 100%

NNT 0 0% 1 100%

Unexp. fever 0 0% 52 100%

AWD 0 0% 48 100%

ARI 5 100% 53 100%

AJS 1 100% 36 100%

Varicella (Susp.) 0 0% 7 100%

Event-based surveillance

EBS total 0 0% 62 98%

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 W13 2020

For more help and support, please contact:

Dr. Shownam Barua Medical Officer - Civil Surgeon Office (MO-CS) Ministry of Health and Family Welfare Cox's Bazar, Bangladesh

Telephone: +88 01723350483

Md. Sabbir Hossain Surveillance & Outbreak Officer World Health Organization Cox's Bazar, Bangladesh

Telephone: +88 017 1355 9987

Email: [email protected] 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: 14:44 Tuesday, 31 March 2020 UTC

Early Warning, Alert and Response System (EWARS)Annex W13 2020

Figure 1 | Proportional morbidity (W13 2020)

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 W13 2020

# cases % morbidity # cases % morbidity

AWD 1,181 3.4% 36,750 4.3%

Bloody diarr. 155 0.5% 5,472 0.6%

Other diarr. 630 1.8% 17,349 2.0%

Susp. Varicella 79 0.2% 985 0.1%

ARI 8,738 25.4% 205,795 24.1%

Measles/Rub. 12 0.0% 4,293 0.5%

AFP 0 0.0% 5 0.0%

Susp. menin. 0 0.0% 29 0.0%

AJS 6 0.0% 317 0.0%

Susp. HF 0 0.0% 12 0.0%

Neo. tetanus 0 0.0% 1 0.0%

Adult tetanus 1 0.0% 1 0.0%

Malaria (conf.) 0 0.0% 6 0.0%

Malaria (susp.) 0 0.0% 144 0.0%

Dengue (conf.) 0 0.0% 2 0.0%

Dengue (susp.) 2 0.0% 4 0.0%

Unexpl. fever 664 1.9% 16,913 2.0%

Sev. Malnut. 10 0.0% 479 0.1%

Inj./Wounds 705 2.1% 20,366 2.4%

Other 22,161 64.5% 545,831 63.8%

Total 33,695 100% 855,107 100%

Proportional morbidity

1 W13 2020

*

*

Figure 2 | Trend in proportional morbidity for key diseases (W13)

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 W13 2020

% m

orbi

dity

W01

201

9

W05

201

9

W09

201

9

W14

201

9

W18

201

9

W22

201

9

W27

201

9

W31

201

9

W35

201

9

W40

201

9

W44

201

9

W48

201

9

W01

202

0

W05

202

0

W09

202

0

W14

202

0

0.0%

20.0%

40.0%

60.0%

80.0%

100.0%

*

*

Acute Respiratory Infection | Trend

3 W13 2020

Total ARI cases - Cox's Bazar

W26

201

7

W39

201

7

W01

201

8

W13

201

8

W26

201

8

W40

201

8

W01

201

9

W14

201

9

W27

201

9

W40

201

9

W01

202

0

W14

202

0

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 - W13 2020)

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 (W13 2020)

4 W13 2020

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 (W13 2020) Figure | % sex Figure | % age

Male Female >=5 < 5

Measles | Trend

5 W13 2020

Total suspected measles/rubella cases - Cox's Bazar

W26

201

7

W39

201

7

W01

201

8

W13

201

8

W26

201

8

W40

201

8

W01

201

9

W14

201

9

W27

201

9

W40

201

9

W01

202

0

W14

202

0

0

50

100

150

200

250

300

350

400

450

500

550

600

650

700

Figure 4 | Trend in number of suspected cases over time (W38 2017 - W13 2020)


Measles | Maps and Alert Management

Map 2 | Map of cases by camp (W13 2020)

6 W13 2020



Alert threshold1 case. Source: IEDCR

9Alerts

100%Verified

0Low Risk

0Moderate

Risk

0High Risk

0Very High

Risk


Male Female >= 5 < 5

Acute Jaundice Syndrome | Trend

7 W13 2020

Total suspected AJS cases - Bangladesh

W26

201

7

W39

201

7

W01

201

8

W13

201

8

W26

201

8

W40

201

8

W01

201

9

W14

201

9

W27

201

9

W40

201

9

W01

202

0

W14

202

0

0

20

40

60

80

100

120

140

160



Acute Jaundice Syndrome | Maps and Alert Management

Map 3 | Map of cases by camp (W37 2017 - W13 2020)

8 W13 2020



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



Acute Watery Diarrhoea | Trends

9 W13 2020

Total AWD cases - Bangladesh

W26

201

7

W39

201

7

W01

201

8

W13

201

8

W26

201

8

W40

201

8

W01

201

9

W14

201

9

W27

201

9

W40

201

9

W01

202

0

W14

202

0

0

500

1,000

1,500

2,000

2,500

3,000

3,500

4,000

4,500

5,000

5,500

6,000


Dengue | Trends

11 W13 2020

Total Dengue Cases - Suspected - Bangladesh Total Dengue Cases - Confirmed - Bangladesh

W01

201

8

W09

201

8

W18

201

8

W26

201

8

W35

201

8

W44

201

8

W01

201

9

W09

201

9

W18

201

9

W27

201

9

W35

201

9

W44

201

9

W01

202

0

W09

202

0

0

1

2

3

4

5

6

7

8

9



Dengue | Maps and Alert Management


12 W13 2020



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 W13 2020

Total Varicella Cases - Suspected - Bangladesh

W01

201

8

W09

201

8

W18

201

8

W26

201

8

W35

201

8

W44

201

8

W01

201

9

W09

201

9

W18

201

9

W27

201

9

W35

201

9

W44

201

9

W01

202

0

W09

202

0

0

1,000

2,000

3,000

4,000

5,000

6,000

7,000

8,000

9,000


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

Varicella (Susp.) | Maps


14 W13 2020


Figure | % sex Figure | % age


For more help and support, please contact:

Dr. Shownam Barua Medical Officer - Civil Surgeon Office (MO-CS) Ministry of Health and Family Welfare Cox's Bazar, Bangladesh

Telephone: +88 01723350483

Md. Sabbir Hossain Surveillance & Outbreak Officer World Health Organization Cox's Bazar, Bangladesh

Telephone: +88 017 1355 9987

Email: [email protected] 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

Epidemiological Highlightsorigin.searo.who.int/entity/bangladesh/ewarsw132020.pdf · 2020-04-02 · Epidemiological Highlights Week 13, 2020 3| EWARS Reporting Updates Total 139/166

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