FETPProjectReport

ByOsantoe J.Korboi,CSO/Montserrado Coumty

Background• MontserradoCountyborderedbyBomi,Margibi andBongCounties:– 7healthdistricts:CentralMonrovia,Bushrod,SomaliaDrive,Commonwealth,St.Paul,Careysburg,Todee

– TotalPopulation=2,056,511– Under-fivepopulation=349,607

• FETPtraining(6weeksafterworkshop2)– Weeklysurveillancereports– Expandedsurveillancereport(Epi weeks31-42)– Measlesoutbreakinvestigation

ExpandedSurveillanceReportMontserradoCounty,Liberia, EPI

Week 31-422015

1. Summary2. Reportingquality3. Diseasereports

Summaryofsurveillancereport(Epi week31-42)

• IMRD:• 232suspectedMeaslescases(2death),• 292Acutewaterydiarrhea(AWD),• 342suspectedEVD(85death),• 4suspectedNeonataltetanus(2death),• 5suspectedMeningitis,• 33suspectedHumanrabies,• 28suspectedBloodydiarrhea,• 1suspectedYellowfever,• 4AFP

Summary

• Nosilentdistricts• EVD– Alltested,noneconfirmed

• Publichealthactions– IDSRtrainings– MeaslesOutbreakinvestigationsandmassimmunizations

– AFPcaseinvestigation

Timelinessandcompletenessofdistrictreports,MontserradoCounty,LiberiaEpiWk31-42,2015:

Graphshowingcumulativetimelinessandcompletenessofdistrictreports,MontserradoCounty

Liberia,EpiWk31to42,2015

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120%

Districts

Timeliness

Complteness

Commentonreportingquality

• DSOscomplainedofdelayingettingreportsfromhealthfacilities.

• ActionTaken:DSOswereverballywarnedtoimprovetheirreportingmechanism,adhereto6pmdeadlineSundays.

Diseasereport,MontserradoCountyDisease Cumulative:Week31– 42,2015

Cases Deaths Case Fatality RateCFR

Acute Flaccid Paralysis(AFP)

4 0 0%

Suspected Yellow Fever 1 0 0%Suspected Lassa Fever 0 0 0%Neonatal Tetanus 4 2 50%Suspected Cholera 0 0 0%AcuteWatery Diarrhea 300 0 0%SuspectedMeningitis 5 0 0%SuspectedMeasles 232 2 0.9%Bloody Diarrhea 28 0 0%Suspected Human Rabies 34 0 0%Suspected VHF/EVD 342 85 25%NeonatalDeathMaternal Death

Publichealthaction

• WaterandSanitationhealtheducation• Chlorinationofwells• Minimeaslesimmunizationcampaigns• IPCtrainingforhealthfacilitiesstaff• IDSRtrainingforsupervisorsandsurveillancefocalpersons.

• Safeburial,swapandbloodsamplecollectionforsuspectedEVDareongoing.

• Suspectedcases,nolabconfirmation• Alltreatedclinicallyanddischarged

PublicHealthAction:• OutbreakinvestigationinCentralMonrovia,

SomaliaDriveandCareysburgdistrictsWK33-36(55cases3confirmed).Miniimmunizationcampaignimplementedinaffectedcommunities

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wk31 wk32wk33wk34 wk35 wk36 wk37 wk38 wk39 wk40 wk41 wk42

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rofCases

Epiweeks

ThetrendofSuspectedmeaslescasesanddeathsinMontserradoCountyLiberia,EpiWk31to422015

Cases

Death

2nd ProjectMeaslesoutbreakinvestigation;Central

MonroviaDistrictZone900

September21-26,2015

Introduction• Measles - air-borneinfectioncausedbyavirus,usuallyaffectschildren

• Symptoms:fever,rashwithrunningnose,redeyesorcough.

• Transmission:coughing,sneezing,andcontactwithsalivaandnasalsecretionperson.

• Complications:pneumonia,ottitismedia,blindness,death

• Prevention:Immunization• Treatment:Supportivedueitsvirusnature

Introduction…….cont’d• Epiweek33;receivedRumorofmeaslesoutbreakinzone900

• Teamwasconstitutedtoinvestigate• Objectives– Toconfirmtheoutbreak– Todeterminethecause,– Todescribebyperson,placeandtime,– Totakepublichealthactionsforcontrol

Method…..cont’d

• Todeterminethecause:– Interviewedcommunitymembers,– Reviewedvaccinationcards

• Todescribetheoutbreak:– Activecasesearch,linelistedsuspectedcases– Analyed byproportions

• Toconfirmtheoutbreak:– collected5bloodsamplesforanalysis

• Tocontroltheoutbreak– Isolated15Suspectedcaseswithfeverandrash– Immunizedtargetpopulationunderfiveatrisk

Results• FromEpiwk31,gradualriseinsuspectedmeaslescases,fromCentralMonroviaDistrict

• Isolated15casesline-listed– 6maleand9female,allagedunder5years.– Only3outof15hadwerevaccinatedinrecentcampaign

– 5Bloodsamplescollected,oneconfirmed• LackofGOLhealthfacilityinZone900• Miniimmunizationwasconducted– Target:4561childrenunder5,Oldroadcommunity– 3375childrenwereimmunized(74%coverage)

Result……cont’d

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wk31 wk32 wk33 wk34 wk35 wk36 wk37 wk38 wk39 wk40

Dateofonset(Epi Weeks)

EpicurveofmeaslesinCentralMonroviaDistrictMontserradoCounty,LiberiaWk31-40,2015

Cases

Discussion• ThemeaslesoutbreakinZone900Oldroadwascausedby– lowimmunizationcoverage,– lackofpublichealthfacility– fearofmotherstocarrytheirchildrenforvaccinationNIDSMarch2015

– mothersignorantaboutroutineimmunizationforchildren.

Recommendations

• ThattheMinistryofHealthbuildapublichealthfacility inzone900Oldtoenhancewiderroutineimmunizationcoverageofchildrenunderfiveyears.

• ThatcommunitysensitizationonroutineimmunizationforchildrenunderfivebeimplementedbyCentralMonroviaDistrictHealthTeam

Acknowledgement

• DPC/MOH• FETP• MentorSteveAtasige• MentorDr.Amo-AddaeMaame

THANKYOU

MAYGODBLESSUSALL