presentation on field work careysburg district, montserrado county by john s. yarngrorble. dso
TRANSCRIPT
Presentation on Field WorkCareysburg District, Montserrado
county
By John S. Yarngrorble. DSO
Outline
• Introduction• Expanded Surveillance Report• Measles Outbreak Investigation Report
Introduction
• Careysburg District• One of the 7 districts in Montserrado county• Population- 65850 – since 2008 national census• Male- 29012 estimated, Female- 25644 estimated, Under 5 :
11,194• Zone: one ( 1700)
• Field work for 6 weeks after workshop 2• Project 1: Weekly and expanded surveillance reporting
(Week 31 to 42)• Project 2: Disease outbreak investigation
EXPANDED SURVEILLANCE REPORT: Epi Weeks 31-42,2015, Careysburg District
Expanded Weekly Surveillance Report for EPI Week 31 To 42, 2015
Summary: • Total IMRD= 83
AWD 16 (Bensonville Hospital-5, Careysburg Clinic-3, Kingsville Clinic-8), 53 dysentery( Bensonville Hospital-23, Kingsville Clinic-11, Harrisburg Clinic-13, Crozierville Clinic-3, Slemp-3)cases, 8 suspected
measles and 6 suspected EVD cases
• The EVD and measles samples were collected, all tested negative.
• 1 out of 10 reporting facilities was often silent
• The DHT continues to work with reporting health facilities as active and passive surveillance continue.
Timeliness and completeness of Reports from Reporting Health Facilities in Careysburg District, Epi week 31 to 42, 2015
No. Health Facilities % Cumulative timeliness
% Cumulative completeness
1. Bensonville Hospital 100 100
2. Kingsville Clinic 75 91
3. Careysburg Clinic 83 91
4. Crozierville Clinic 66 66
5. Harrisburg Clinic 83 91
6. White Plains Clinic 100 100
7. Camp Sandee Ware 25 25
8. Slemp Medical Clinic 75 91
9. Exclusive Executive Clinic 66 83
10. Faith Medical Clinic 66 75
T L NR>8%0 0n Time
>50-80% On Time
<50% On Time
Cumulative Completeness
Cumulative TimelinessLegend
Timeliness and completeness of facility Surveillance Weekly reporting, Careysburg District, EPI wks 31-42, 2015
Benso
nville
Hospita
l
Kingsville
Clinic
Careysb
urg Clin
ic
Crozie
rville
Clinic
Harrisb
urg Clin
ic
White
Plains C
linic
Camp Sa
ndee W
are
Slemp M
edica
l Clin
ic
Exclu
sive E
xecu
tive Clin
ic
Faith
Med
ical C
linic
0
20
40
60
80
100
120
TimelinessCompleteness
Reporting Facilities
Perc
enta
ge
• 40% of facilities achieved national target for timeliness and 70% for completeness
Comments on Reporting Quality:
• Defaulting facilities complained about long distance to district office to submit report.
• Public health action: • DHT held meeting with defaulting facilities for
improvement
Disease Reports Summary of Notifiable Diseases for EPI week 31 to 42, 2015 for
Careysburg District Legend: S= SuspectedDisease Cumulative: Week 31 – 42, 2015
Cases Deaths Case Fatality Rate
Acute Flaccid Paralysis (AFP) 0
0 0%
Yellow Fever 0 0 0%Lassa Fever 0 0 0%Neonatal Tetanus 0 0 0%Cholera (S) 0 0 0%Acute Watery Diarrhea 16 0 0%Meningitis 0 0 0%Measles (S) 9 0 0%Dysentery 53 0 0%Human Rabies (S) 0 0 0%Suspected VHF/EVD 6 0 0%Neonatal Death 0 9 100%Maternal Death 1 5 0%
Trend of AWD and Dysentery cases, Careysburg District, EPI wks 31-42,2015
wk 31 Wk 32 Wk 33 Wk 34 Wk 35 Wk 36 Wk 37 Wk 38 Wk 39 Wk 40 Wk 41 Wk 420123456789
10
AWD CasesDysenteryCases
Epi Weeks
Num
ber o
f cas
es
• All cases received case management, no deaths• No samples taken for lab analysis• Public Health action: Surveillance kept on all reported
cases
MEASLES OUTBREAK INVESTIGATION:EPI WEEK 40, 2015
Background- Measles• Highly contagious viral illness• Common and often fatal in developing areas• Paramyxovirus (RNA) • Preventable by vaccine• Features– Incubation period 10-12 days– Fever, rash– Cough, coryza or conjunctivitis
Background- Outbreak investigation
• Rapid rise in suspected cases during Epi week 40, 2015 following long standing zero reporting
• Objectives – To confirm the outbreak– To describe the outbreak( in person, place and time)– To determine the cause of the outbreak– To control the outbreak
Methods• Surveillance data reviewed• Blood specimens collected for laboratory
analysis• Active case search• Line listing• Reviewed vaccination record• Interviewed community leaders and parents
of affected children• Public health action
Results• Surveillance reports Showed a sharp rise in
suspected measles cases ,zero reporting since Epi wk 1,2015
• Blood samples collected from 6 of 8 cases(results negative)
• 8 cases line-listed; all from Binda Ballah Town, 6 females and 2 males; all aged under 5 years
• About 70% vaccination coverage in affected community
Reasons Contributing to the Outbreak
• Rejection of measles vaccine on account of fear of EVD
• Low immunization coverage
29th sept
30th sept
1st Oct 2nd Oct 3rd oct 4th Oct 5th Oct 6th Oct0
0.5
1
1.5
2
2.5
3
3.5
Epicurve of suspected measles outbreak, Caryesburg District, 30th Sept to Oct 5th 2015
suspected measles cases
Date of onset
num
ber o
f cas
es
Outbreak Control (Public Health Action)
• All cases received case management. • Massive measles immunization, October 3-5,2015• Public health education done• Media education• Fliers with symptoms and signs• Early reporting• No new cases reported so far
Discussion• Suspected measles outbreak in Careysburg
District from September 30- October 3, 2015• Children affected aged 1-5yrs at Binda Ballah
Town• Contributing cause of outbreak: Low
immunization coverage• Mass immunization was effective in
controlling the suspected outbreak
Acknowledgement
• Ministry of Health• CDC• WHO• Emory University• AFENET• MCHT • FETP mentors (Stephen, Dr Maame)
Thank you