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Somalia Weekly Update
Week-31Ending 05 Aug 2018
Summary highlight
➢No new cVDPV2 isolates from environmental samples. The date of collection of most recent positive environmental sample was on 17th May 2018
➢No new cVDPV3 isolate from environmental samples. The date of collection of most recent positive environmental sample for cVDPV3 in Somalia was on 19th April 2018
➢In total, 10 cVDPV2 and seven (7) cVDPV3 viruses have been
isolated from environmental samples in 2018 compared to
two (2) VDPV2s and 0 VDPV3 in 2017
➢There are four (4) environmental sites in Somalia, all of which
are located in Banadir region (Mogadishu)
➢ Five(5) community samples with PV type 2 referred to the CDC for sequencing on 30th July 2018. Samples collected from Dollo on 10 and 11 July 2018 (which is during mOV2 campaign in South) all have OPV doses >9 and confirmed that they took mOPV2 vaccine on 9th June 2019.
➢ One (1) AFP case from Galgadud region with date of on set of paralysis on July 08 has PV-2 and sent for sequencing to CDC. The last OPV for this case was on May 08 and has 5 OPV doses and no IPV
➢No new confirmed cVDPV from human samples this week. The last case was reported from Dolo.
➢The total number of cVDPV cases remains four (4) [two (2) cVDPV3, one (1) cVDPV2 and one (1) with both cVDPV2 and cVDPV3. The dates of onset of the most recent cVDPV2 is on 26 May and cVDPV3 is on 23 May 2018
VDPVs from environmental samples
VDPVs from human samples
2
cVDPV2/3 (n=1)
Summary Environmental Samples and Lab Classification
District
Epidemiological Week-2017 Epidemiological Week-2018
Name of
Sites
Date of
Establishment
383940414243444546474849505152 1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930313233
J. 04
J. 11
J. 18
J. 25
F.01
F.08
F.15
F.22
M.01
M.08
M.15
M.22
M.29
Ap.
05
Ap.
12
Ap.
19
Ap.
26
May
03
May
10
May
17
May
24
May
31
June 7
June
14
June
21
June
28
July
05
July
12
July
19
July
26
Aug
02
Waberi 21October 19 Sept. 2017 Bo
th
No
sam
ple
co
llect
ed
du
e t
o f
loo
din
g o
f se
wag
e
vDP
V2
ShanganiUrobo 20 Sept. 2017
Hamerewoini
Kawma21 Sept. 2017
HodanEgyptianHospital
23 Nov. 2017
Legend 9
1 Not scheduled 5 NPENT 10 Sent for sequencing
2 Pending 6 Sabin 11 Scheduled but not collected
3 Negative 7 NPENT + Sabin 12 Sabin 2
4 NEV 8 cVDPV2 13 Sabin + NPEV + NEV
cVDPV3
2nd round mOPV2 campaign in Central and South of Somalia synchronized with Kenya & Ethiopia
- After successful completion of the first round mOPV2 synchronized campaign, the second round started on August 4 and will continue till August 7 targeting approximately 700,000 U-5 children living in 37 districts
- Trained intra-campaign independent monitors are deployed for each DFA and are sharing their daily coverage data using ODK from the field
- Daily data analysis on Admin data and IM data collected by independent monitors are being analyzed daily and feedback shared for corrective measures in real time
Second round Day-1 and Day ICIM preliminary coverage data by district. Data is from daily data collected through ODK which represents less than 30% of the targeted DFA areas
Province District
Number of
HHs
Visited
% of HHs
Correctly
Marked
Number of 0-
11 Children
Seen
% of 0-11
Children
Vaccinated
Number of 0-
11 Children
Vaccinated
Number of
12-59
Children
Seen
Number of
12-59
Children
Vaccinated
% of 12-59
Children
Vaccinated
% of Total
Children
Vaccinate
d
Sum of
Missed
Children
Sum of
suspected
AFP cases
reported
% HHs
Aware
about the
Campaign
BAY BDB 1481 98% 1248 1242 100% 2420 2381 98% 99% 45 0 96%
BAY BDL 160 96% 127 127 100% 277 277 100% 100% 0 0 99%
BAY DNS 81 100% 65 63 97% 186 166 89% 91% 22 0 100%
BAY Total 1722 98% 1440 1432 99% 2883 2824 98% 98% 67 0 97%
BKL HUD 201 89% 153 147 96% 443 420 95% 95% 29 0 82%
BKL Total 201 89% 153 147 96% 443 420 95% 95% 29 0 82%
GDD ABD 80 100% 41 41 100% 172 164 95% 96% 8 0 78%
GDD ADD 160 100% 96 91 95% 286 284 99% 98% 7 0 100%
GDD BLB 120 100% 113 113 100% 265 265 100% 100% 0 0 98%
GDD DSB 122 98% 111 100 90% 228 197 86% 88% 42 0 98%
GDD GUR 200 99% 136 132 97% 363 350 96% 97% 17 0 100%
GDD Total 682 99% 497 477 96% 1314 1260 96% 96% 74 0 97%
GDO BDB 41 100% 8 8 100% 72 72 100% 100% 0 0 100%
GDO BLH 30 100% 8 8 100% 59 59 100% 100% 0 0 90%
GDO BRD 85 99% 134 134 100% 218 217 100% 100% 1 0 99%
GDO DLO 150 100% 156 156 100% 327 317 97% 98% 10 0 100%
GDO ELW 40 100% 25 25 100% 81 81 100% 100% 0 0 100%
GDO LUQ 72 100% 54 54 100% 105 105 100% 100% 0 0 100%
GDO Total 418 100% 385 385 100% 862 851 99% 99% 11 0 99%
HRN BLT 194 98% 154 154 100% 359 359 100% 100% 0 0 98%
HRN Total 194 98% 154 154 100% 359 359 100% 100% 0 0 98%
LJB AFM 80 100% 80 80 100% 172 172 100% 100% 0 0 100%
LJB KIS 233 98% 238 217 91% 569 522 92% 92% 68 0 77%
LJB Total 313 98% 318 297 93% 741 694 94% 94% 68 0 83%
Grand Total 3530 98% 2947 2892 98% 6602 6408 97% 97% 249 0 95%
Province District
Number of
HHs
Visited
% of HHs
Correctly
Marked
Number of
0-11
Children
Seen
Number of
0-11
Children
Vaccinated
% of 0-11
Children
Vaccinated
Number of
12-59
Children
Seen
Number of
12-59
Children
Vaccinated
% of 12-59
Children
Vaccinated
% of Total
Children
Vaccinated
Sum of
Missed
Children
Sum of
suspected
AFP cases
reported
% HHs
Aware
about the
Campaign
BAY BDB 1529 98% 1406 1400 100% 2721 2690 99% 99% 37 0 96%
BAY BDL 161 98% 129 129 100% 276 276 100% 100% 0 0 100%
BAY DNS 260 100% 195 194 99% 622 562 90% 93% 61 0 100%
BAY Total 1950 99% 1730 1723 100% 3619 3528 97% 98% 98 0 97%
BKL HUD 203 93% 131 126 96% 406 378 93% 94% 33 0 91%
BKL Total 203 93% 131 126 96% 406 378 93% 94% 33 0 91%
GDD ABD 80 100% 31 31 100% 149 143 96% 97% 6 0 81%
GDD ADD 160 100% 102 101 99% 300 294 98% 98% 7 0 98%
GDD BLB 130 100% 115 115 100% 271 271 100% 100% 0 0 99%
GDD DSB 240 98% 199 189 95% 476 449 94% 95% 37 0 96%
GDD GLS 40 100% 17 11 65% 115 111 97% 92% 10 0 98%
GDD GUR 240 100% 158 155 98% 485 466 96% 97% 22 0 100%
GDD Total 890 99% 622 602 97% 1796 1734 97% 97% 82 0 97%
GDO BDB 41 100% 15 15 100% 81 81 100% 100% 0 0 100%
GDO BLH 81 89% 67 62 93% 131 126 96% 95% 10 0 96%
GDO BRD 151 98% 191 191 100% 441 428 97% 98% 13 0 93%
GDO DLO 270 100% 247 240 97% 624 574 92% 93% 57 0 98%
GDO ELW 40 100% 23 23 100% 73 72 99% 99% 1 0 100%
GDO LUQ 122 100% 71 71 100% 189 187 99% 99% 2 0 100%
GDO Total 705 98% 614 602 98% 1539 1468 95% 96% 83 0 97%
HRN BLT 240 100% 197 197 100% 433 429 99% 99% 4 0 100%
HRN MTB 81 99% 29 29 100% 155 150 97% 97% 5 0 99%
HRN Total 321 100% 226 226 100% 588 579 98% 99% 9 0 100%
LJB AFM 138 99% 181 181 100% 298 297 100% 100% 1 0 100%
LJB KIS 320 98% 264 258 98% 820 798 97% 97% 28 0 92%
LJB Total 458 98% 445 439 99% 1118 1095 98% 98% 29 0 94%
Grand Total 4527 98% 3768 3718 99% 9066 8782 97% 97% 334 0 96%
IM Coverage by age group and level of awarness of HHS about the campaignDay-1 Day-2
IM coverage1st round Synchronized mOPV2 Campaign Round 1
County/ Province Sub-County/ District 0 - 59mths SeenTotal Vaccinated
FM% IM
Coverage
Lower Juba Afmadow 1,171 1,168 100%
Lower Juba Badade 266 266 100%Lower Juba Kismayo 6112 5955 97%
Bay Baidoa
Bay Qansadhere 1,646 1,644 100%
Bay Burhakaba 6,663 6,548 98%
Bay Berdale 2,088 2,053 98%
Bay Dinsor 1,738 1,612 93%
Bakool Elberde 1,171 1,168 100%
Bakool Rabdure 1,124 1,124 100%
Bakool Huddor 1,739 1,694 97%
Bakool Tieglow 252 247 98%
Bakool Wajid 1,646 1,644 100%
Gedo Luuq 538 509 95%
Gedo Dolo 488 488 100%
Gedo Gedweine 194 188 97%
Gedo Beled-xawo 552 539 98%
Gedo Elwak 238 237 100%
Gedo Garbaharre 530 530 100%
Gedo Bardera 1,075 1,075 100%
Gedo Burdubo 693 693 100%
Galgudud Dusamareb 252 237 94%
Galgudud Guriel 814 1177 95%
Galgudud Adado 693 693 100%
Galgudud Galinsor 586 655 89%
Galgudud Abudwaq 711 718 99%
Galgudud Balanbale 448 390 100%
Galgudud Elbur 451 402 89%
Galgudud Galhareri 343 303 88%
Galgudud Elgaras 343 303 88%
Galgudud Harardere 393 354 90%
Galgudud Hobyo 409 372 91%
Hiran Mataban 862 862 100%
Hiran Mahas 901 901 100%
Hiran Beletwein 2,763 2,763 100%
Hiran Bulo Burte 645 645 100%
Hiran Jalalaqsi 865 865 100%
National - Somalia 90,091 83,562 93%
NIDs round 1 of bOPV campaign conducted targeting all <5 in Somaliland, South Zone and two Regions in Central Zone (Hiran and Galgadud)
➢SomalilandCampaign date: 30 April-03 May 2018Target: 638,062Reached: 627,805 (98%)Missed: 2,206IM coverage: 97%
➢South zoneCampaign date: 08-11 May 2018Target: 467,553Reached: 457,167 (98%)Missed: 1,049IM coverage: 95%
➢Central zone(Hiran and Galgaduud)Campaign date: 05-09 May 2018Target: 213,865Reached: 199,516 (93%)IM Coverage: 97%Missed: 579
➢PuntlandCampaign date: 10-13 July 2018Target: 484,523Reached: 479,348 (99%)Missed: 5175IM Coverage: 99%
➢National Level:Target: 1,804,003Reached: 1,763,836 (97%)Missed: 8999IM coverage: 97%
Response activities SIA summaries
Three rounds of mOPV2 campaigns conducted targeting all <5 (Benadir, Middle and Lower Shabelle)
➢ 1st Round (10-13 Dec. 2017)
• Target: 726,699
• Reached: 702,667 (97%)
• Missed: 24,032
• IM coverage: 97%
• LQAS= 98% FM
➢ 2nd Round ( 29 Jan-01 Feb 2018)
• Target: 741,313
• Reached: 715,172 (96%)
• Missed: 26,141
• IM coverage: 93%
• LQAS= 98% FM
➢ IPV
• Target: 299,424
• Reached: 270,484 (90%)
➢ 3rd Round (05-08 May 2018)
• Target: 790,837
• Reached: 763,471 (97%)
• Missed: 27,366
• IM coverage: 98% FM
• LQAS= 98% FM
➢ 1st Round Synchronized campaign (09-12 July 2018)
• Target: 697,773
• Reached: 666,057 (97%)
• Missed: 31,716
• IM coverage: 99% FM
• LQAS= Of the total 27 Lots, 22 passed, 4 were satisfactory, 1 was incomplete and 0 lots failed
SIA Activity Calendar Apr – Dec. 2018Activity Target area Date Status
NID 1 bOPV Somaliland and Puntland 30 Apr- 03 May 2018 Campaign completed
NID 1 bOPVSouth and Central Except Banadir, Lower and Middle Shabelle
5-8 May 2018 Campaign completed
Third response round mOPV2Campaign
Banadir, Lowe Shabelle and Middle Shabelle 5-8 May 2018 Campaign completed
Synchronized mOPV2 Campaign (withKenya and Ethiopia), Round 1
South and Central regions without Banadir, Lower and Middle Shablle regions synchronized with Kenya response campaign
9 - 12 Jul 2018 Campaign completed
Small scale bOPV Response Banadir, Lower and Middle Shablle regions 23-Jul 2018 Campaign completed
SynchronizedmOPV2 Campaign (with Kenya and Ethiopia), Round 2
South and Central regions with out Banadir, Lower and Middle Shabelle regions synchronized with Kenya response campaign
4-8 Aug. 2018 On going
Upcoming Campaigns
NID 1 bOPV synchronized with Kenya and Ethiopia
All 19 regions in Somalia (Target: 2,499,010 Children) 3-6 September 2018 Planned
NID 2 bOPV synchronized
with Kenya and EthiopiaAll 19 regions in Somalia (Target: 2,499,010 Children) 1-4 Oct 2018 Planned
Part I
AFP Surveillance
Week-31 Somalia Weekly EPI/POL Update
Epidemiological Curve 01 January 2014 – 05 Aug 2018
Graph no. 1
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Pending Lab Pending ERG Discarded Compatable WPV aVDPV cVDPV2 cVDPV3
Weekly AFP cases reported by Provinces, 2016-2018 Somalia. (cases are distributed across weeks based on date of onset of paralysis).
- Eight (8) new AFP cases were reported last week bringing the total AFP cases reported in 2018 to 201 from 19 regions, compared to 220 AFP cases from 19 regions at the same time point in 2017.
Week-31 Somalia Weekly EPI/POL Update
Tab
le n
o.-
1
Silent (not reporting) for > 8 weeks
Reported AFP cases
Community Samples collected in silent regions
Community Samples collected but regions not silent
PROVINCE
To
tal 2
016
2017
W31
2017
W32
2017
W33
2017
W34
2017
W35
2017
W36
2017
W37
2017
W38
2017
W39
2017
W40
2017
W41
2017
W42
2017
W43
2017
W44
2017
W45
2017
W46
2017
W47
2017
W48
2017
W49
2017
W50
2017
W51
2017
W52
To
tal 2
017
2018
W01
2018
W02
2018
W03
2018
W04
2018
W05
2018
W06
2018
W07
2018
W08
2018
W09
2018
W10
2018
W11
2018
W12
2018
W13
2018
W14
2018
W15
2018
W16
2018
W17
2018
W18
2018
W19
2018
W20
2018
W21
2018
W22
2018
W23
2018
W24
2018
W25
2018
W26
2018
W27
2018
W28
2018
W29
2018
W30
To
tal 2
018
BANADIR 30 2 2 1 2 1 1 1 33 2 1 1 1 1 1 1 1 1 1 2 2 2 2 19
GALGADUD 25 1 2 1 1 1 1 1 1 1 27 1 2 1 1 1 1 1 1 1 1 1 1 13
M. SHABELLE 19 1 1 2 1 1 1 1 1 1 24 1 1 1 1 1 1 3 1 1 1 1 1 14
L. SHABELLE 24 1 1 1 1 1 1 1 2 1 1 2 1 1 1 31 1 2 1 1 2 2 1 1 1 1 1 1 1 16
HIRAN 15 1 1 1 1 1 1 1 1 1 21 1 1 1 1 1 1 1 7
BARI 24 1 1 1 1 1 1 1 1 1 24 3 2 1 1 2 1 2 1 1 1 15
NUGAL 11 1 1 1 1 10 1 1 1 1 1 1 1 7
MUDUG 14 1 1 1 12 1 1 1 2 1 1 1 1 1 1 11
TOGDHER 11 1 1 1 9 1 1 1 1 1 1 1 7
GALBEED 19 2 1 2 1 2 20 1 1 1 1 1 2 1 1 1 1 11
SANAQ 7 1 1 6 1 1 1 1 4
AWDAL 18 1 1 1 17 1 2 1 1 1 1 1 1 1 1 1 12
SAHIL 8 1 1 8 1 1 1 3
SOOL 5 1 2 1 11 1 1 1 3
LOWER JUBA 26 1 1 1 1 1 1 1 1 29 2 1 2 1 1 1 1 1 1 1 1 1 1 1 1 17
BAY 19 1 1 1 2 2 2 1 22 1 4 1 1 1 1 1 1 1 1 1 14
GEDO 21 2 1 1 1 20 1 1 1 1 1 1 1 3 2 1 13
MIDDLE JUBA 11 2 1 1 11 1 1 1 1 1 1 1 1 8
BAKOOL 9 1 1 1 1 1 10 1 1 1 1 1 1 1 7
Total Somalia 316 7 7 6 9 5 7 10 4 5 7 3 2 8 11 4 7 2 5 3 6 2 5 345 6 4 8 7 4 9 13 7 12 5 5 7 6 4 9 5 8 5 8 8 3 7 6 2 4 11 7 8 6 7 201
Classification of AFP cases by status (2017 & 2018)
Week-31 Somalia Weekly EPI/POL Update
Tab
le n
o.-
2
Chart no. 1
ZONE PROVINCE
2017 2018
Discarded
Pending
TotalDiscard
edVDPV
Pending
Total
CENTRAL
BANADIR 33 0 33 13 0 6 19
GALGADUD 27 0 27 12 0 1 13
HIRAN 21 0 21 7 1 7
L. SHABELLE 30 0 31 13 0 3 16
M. SHABELLE 24 0 24 11 1 3 14
Puntland
BARI 24 0 24 15 0 15
MUDUG 11 0 12 9 0 2 11
NUGAL 10 0 10 6 0 1 7
Somaliland
AWDAL 16 0 17 11 0 1 12
GALBEED 20 0 20 10 0 1 11
SAHIL 8 0 8 2 0 1 3
SANAQ 6 0 6 3 0 1 4
SOOL 11 0 11 3 0 3
TOGDHER 9 0 9 4 0 3 7
SOUTH
BAKOOL 10 0 10 6 0 1 7
BAY 22 0 22 12 0 2 14
GEDO 20 0 20 9 1 4 13
LOWER JUBA 29 0 29 12 0 5 17
MIDDLE JUBA 11 0 11 7 0 1 8
Grand Total 345 0 345 165 3 36 201
36In process (lab)
0Pending ITD
165Discarded
0 WPV
36Pending
0 Compatible
2cVDPV2
201 AFP cases reported in 2018
0Pending ERG
2cVDPV3
Note: The total number of cVDPV cases remains 4 (two (2) cVDPV3, one (1) cVDPV2 and one (1) had both cVDPV2 and cVDPV3).
Surveillance Indicators by Zone and Region 2018
Week-31 Somalia Weekly EPI/POL Update
Graph no. 2
Graph no. 3
Map no. 1 Map no. 2
3.9
12.0
4.6
6.65.5
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
Central Puntland Somaliland South Total Somalia
Annualized NP-AFP Rate by Zone, 2018
7.3
5.1 5.3 5.5
-
2.0
4.0
6.0
8.0
10.0
In-accessible PartiallyAcceessible
Accessible Somalia
Annualized NP-AFP rate by accessibility status, 2018
Surveillance Indicators (NP-AFP rate and Stool adequacy) by district, 2018
▪ 104/115 districts reported at least 1 AFP case
since the first week of 2018
▪ Of the 104 districts reporting AFP cases in 2018,
101 have annualized NP-AFP rate above 2 per
100,000. In addition, 100 districts have stool
adequacy rate of above 80%
▪ The remaining 11 districts have not reported any
AFP case in 2018; However, no district in Somalia
has been silent for more than 52 consecutive
weeks
▪ 12% (n=2/17) inaccessible districts and 15%
(n=11/75) of accessible districts did not report
AFP cases in 2018. All the 17 partially accessible
districts have reported at least 1 AFP case
Week-31 Somalia Weekly EPI/POL Update
Map no. 4Map no. 3
Distribution of NP-AFP cases and zero-dose cases vs accessibility of districts
Week-31 Somalia Weekly EPI/POL Update
▪ AFP cases were reported from all
zones, regions, and accessible and
inaccessible parts of the country
▪ Geo-code information was collected
from 65.4% of AFP cases reported in
2018
▪ Of the 23 zero-dose AFP cases
reported in 2018, 12 were reported
from inaccessible districts, eight (8)
from partially- accessible districts and
two (3) from accessible districts (from
Warshakh in M Shabelle and 1 from
Jariban in Mudug regionMap no. 5 Map no.6
Number of NP-AFP cases reported across years during the same period (2013-2018) by zone
▪ Central, Somaliland and South zones have reported lower number of AFP cases compared to the number reported in 2017 during the same period. ▪ A total of 319 additional community samples were collected from healthy children. Majority of these samples were collected from access compromised and silent districts of
Central and south zones.
Week-31 Somalia Weekly EPI/POL Update
22 2239
73
344
115
43 39
69
270
77
40 3643
196
77
2842
51
198
83
31
5063
227
69
3340
59
201
0
50
100
150
200
250
300
350
400
CENTRAL PUNTLAND SOMALILAND SOUTH SOMALIA
2013 2014 2015 2016 2017 2018
Early case detection within 7 days from onset of paralysis at zonal and region levels-2018
Week-31 Somalia Weekly EPI/POL Update
95% (n=193/201) cases reported in 2018 were notified within 7 days of onset of paralysis. Eight AFP cases [three (3) from Bay, two (2) from Lower Jubba, one (1) from Middle Jubba, one (1) from Middle Shabelle and one (1) from Sanaaq regions had delayed notification].
19 13 7 16
13
15 11 7 12 11 3
3
3 7 7
11
13
15 7
193
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
BA
NA
DIR
GA
LGA
DU
D
HIR
AN
L. S
HA
BEL
LE
M.
SHA
BEL
LE
BA
RI
MU
DU
G
NU
GA
L
AW
DA
L
GA
LBEE
D
SAH
IL
SAN
AQ
SOO
L
TOG
DH
ER
BA
KO
OL
BA
Y
GED
O
L. J
UB
A
M.
JUB
A
CENTRAL PUNTLAND SOMALILAND SOUTH TOTAL
Notification within 7 days, Regional
68 33 39 53 193
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
CENTRAL PUNTLAND SOMALILAND SOUTH SOMALIA
Notification within 7 days, Zonal
ZONE
# A
FP c
ases
NP
-AFP
Rat
e
# C
ases
wit
h
Ad
eq
uat
e Sp
ecim
en % Stool Adequacy
% Inv. within 48
hours
% Notification
within 7 days
Cas
es
pe
nd
ing
lab
res
ult
s
Cas
es w
ith
lab
. re
sult
.
Cas
es w
ith
sto
ol i
n g
oo
d
con
d.
% C
ases
wit
h s
too
l in
go
od
co
nd
.
#o
f sa
mp
les
wit
h N
P-E
V
Iso
late
d
% S
amp
les
wit
h N
P E
V
Iso
late
d
# c
ases
wit
h S
abin
like
vir
us
Iso
lati
on
% o
f ca
ses
wit
h
S L
Vir
us
Iso
lati
on
Central 69 4.1 68 99% 99% 99% 13 56 56 100% 8 7% 5 9%
Puntland 33 12.9 33 100% 100% 100% 3 30 30 100% 3 5% 4 13%
Somaliland 40 4.9 40 100% 100% 98% 7 33 33 100% 3 5% 1 3%
South 59 6.8 57 97% 100% 90% 13 46 46 100% 7 8% 0 0%
Total 201 5.6 198 99% 100% 96% 36 165 165 100% 21 6% 10 6%
Summary of AFP surveillance key indicators by Zone, 2018
Week-31 Somalia Weekly EPI/POL Update
Table no.-4
Week-31 Somalia Weekly EPI/POL Update
Summary of AFP surveillance key indicators by Province, 2018
ZONE PROVINCE Regional U15 Pop.Expected # of AFP
cases as of this Week
Number of AFP cases reported
NP-AFP Rate(Target
2/100000)
% Stool Adq. (Target >80%)
% inv. within 48 hrs.
(Target >80%)
% Notif. within 7 days(Target >80%)
% Stool condition
(Target >80%)
% Samples with EV isolated
(Target >7)
% cases with SL isolated
(Target >10)
# Cases with late 60 days followup
CENTRAL
BANADIR 1110807 13 19 3.1 100% 100% 100% 100% 0% 23% 0
GALGADUD 267828 3 13 8.4 100% 100% 100% 100% 8% 8% 0
HIRAN 233838 3 7 5.2 100% 100% 100% 100% 7% 0% 0
LOWER SHABELLE 948112 11 16 2.9 100% 100% 100% 100% 15% 8% 0
MIDDLE SHABELLE 375400 4 14 6.5 93% 93% 93% 100% 5% 0% 0
PUNTLAND
BARI 182218 2 15 13.8 100% 100% 100% 100% 7% 13% 2
MUDUG 186490 2 11 10.6 100% 100% 100% 100% 0% 11% 1
NUGAL 90921 1 7 13.8 100% 100% 100% 100% 8% 17% 0
SOMALILAND
AWDAL 244900 3 12 8.8 100% 100% 100% 100% 0% 9% 1GALBEED 550148 6 11 3.6 100% 100% 100% 100% 5% 0% 0SAHIL 85949 1 3 6.3 100% 100% 100% 100% 0% 0% 0SANAQ 150975 2 4 4.8 100% 100% 75% 100% 33% 0% 0SOOL 120412 1 3 4.5 100% 100% 100% 100% 0% 0% 0TOGDHER 317058 4 7 4.0 100% 100% 100% 100% 0% 0% 0
SOUTH
BAKOOL 183178 2 7 6.6 100% 100% 100% 100% 0% 0% 0BAY 540491 6 14 4.5 93% 100% 79% 100% 17% 0% 0GEDO 312710 3 13 7.2 92% 100% 100% 100% 17% 0% 0LOWER JUBA 300735 3 17 9.8 100% 100% 88% 100% 0% 0% 0MIDDLE JUBA 162640 2 8 8.5 100% 100% 88% 100% 0% 0% 0
SOMALIA 636,4810 71 201 5.6 99% 100% 96% 100% 6% 6% 4
ZONE# AFP Cases
# CONTACTS
# Contactsamples with
Lab result
Average contacts per
cases
% contacts < 5 age
% Contact collected
within 7 daysof AFP
notified
% Contact with stool in
Good Condition
# Contactpending lab
results
# Specimens with NPEV
isolated
% Specimens with NPEV
Isolated
# Contacts with Sabin
virus isolated
% contacts with Sabin like virus Isolated
Central 69 208 144 3 100% 100% 100% 64 10 7% 10 7%
Puntland 33 99 83 3 100% 100% 100% 16 9 11% 6 7%
Somaliland 40 120 99 3 100% 100% 100% 21 5 5% 5 5%
South 59 177 133 3 100% 100% 100% 44 13 10% 6 5%
Somalia 201 604 459 3 100% 100% 100% 145 37 8% 27 6%
Week-31 Somalia Weekly EPI/POL Update
Table no.-5
Summary of key AFP surveillance indicators for contacts, 2018
Summary of Community Samples collected in 2018 from silent districts, Egyptian hospital and inaccessible districtsZone Pending Negative NPENT PV 3 Sabin PV 1 Sabin & PV3 Sabin PV 1 Sabin VPV3 SL2 Grand Total
PUNLAND 52 157 9 1 3 1 223
SOMALILAND 5 51 8 1 1 66
CENTRAL 10 24 1 35
SOUTH 31 28 2 2 5 68
Grand Total 98 260 20 1 1 3 2 7 392
Of the total 381 community samples collected from healthy children in 2018, 48% were collected from accessible and the rest 52% were from access-compromised areas
ZoneNumber of
VPVsNumber of
cases reported # of cases Notified
by VPVProportion of cases
reported by VPV
CENTRAL 190 69 31 45%
PUNTLAND 105 33 15 45%
SOMALILAND 81 40 15 38%
SOUTH 159 59 21 36%
Total Somalia 535 201 82 41%
Distribution of AFP cases by source of case notification, 2018
Key: 1. VPVs: Village polio volunteers2. HFs: MCH, Hospitals and Private clinics3. Others: community members, district field assistants, traditional healers
Week-31 Somalia Weekly EPI/POL Update
Table no.-6
31 1515 21 82
29 12 22
16
79
9 63
2240
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Central Puntland Somaliland South Somalia
Pro
p. c
ases
no
tife
d b
y
Source of AFP cases notification by Zone 2018
VPV HFs Other
1 1 4 5 0 6 414
138
3120
2025 24
33
78
63
4172 53
389
14
17
4
612
410
37
16
4
7 8
9
0
50
100
150
200
250
300
2012 2013 2014 2015 2016 2017 2018
NOTIFIED BY HEALTH FACILITIES
HEALTH POST HOSPITAL MCH
PRIVATE CLINIC PRIVATE PHARMACY
2 3 2 0 0 0 00 118 24 17
7 509
22 8
3
0 00
12
109
111143
184
82
0
50
100
150
200
250
2012 2013 2014 2015 2016 2017 2018
NOTIFIED BY COMMUNITY AND VOLUNTEERS
CHW COMMUNITY HOUSEHOLD VOLUNTEERS
0 2 0 0 0 1 012
77
40
14 8 8 64
26
5
43 6
2
28
74
75
3631 28
20
21
49
4
1
1 0
0
12
17
10
7
5 7
7
0
50
100
150
200
250
300
2012 2013 2014 2015 2016 2017 2018
NOTIFIED BY VACCINATORS AND TRADITIONAL HEALERS
CAMPAIGNS DISTRICT FIELD ASST DPO
NID VACCINATOR TRADITIONAL HEALER
AFP cases by specific sources notification, 2012-2018
Week-31 Somalia Weekly EPI/POL Update
Distribution of AFP cases by lifestyle, age group and sex, 2018
▪ Of the 201 AFP cases
reported in 2018, 44%
(n=88) and 38% (n=76)
came from urban and
rural populations
respectively. Nomadic
communities account for
only 18% (n=37).
▪ 73% (n=147) of cases are
aged less than 5 years.
▪ 52% (n=104) AFP cases
are female.
Week-31 Somalia Weekly EPI/POL Update
Graph no.-10 Graph no.- 11 Graph no.-12
31 97 9180
70 69 37
51
150
144
87117
124 76
65281
181 112 129 152 88
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2012 2013 2014 2015 2016 2017 2018
Distribution of AFP cases by Life style per zone-2012-2018
Nomadic Rural Urban
56 221 167 115
164156
104
92 324 252 166
152189
96
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2012 2013 2014 2015 2016 2017 2018
Distribution AFP cases by Sex2012-2018
Female Male
129
129
348249 283
293
147
19
83
7232 33
52
54
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2012 2013 2014 2015 2016 2017 2018
Distribution of AFP cases by Age group2012-2018
<5 Yrs ≥ 5 Yrs
AFP surveillance indicators by district accessibility status, 2018
Despite accessibility challenges, majority of indicators are above global standards
Week-31 Somalia Weekly EPI/POL Update
Table n
o.-7
Accessibility# of
districts
U-15 Pop in this area
# of AFP cases
Reported
# of Cases
reported by VPVs
% of Cases
reported by VPVs
NP AFP rate
Number of cases with lab
result
% of Stool adequacy
% inv. Within 48
hrs.
% of Notif. within 7
days
% Specimen
s with NPEV
% cases with Sabin like virus
Inaccessible 17 619,320 26 15 58% 7.5 20 100% 100% 96% 10% 0%
Partially accessible
23 1,720,826 51 17 33% 5.3 45 96% 100% 90% 6% 2%
Accessible 75 4,024,663 124 50 40% 5.5 100 99% 101% 98% 6% 9%
National 115 6,364,810 201 82 41% 5.6 165 99% 100% 96% 6% 6%
Accessibility% of <15 populati
on in the area
# of AFP cases
Reported
# of Cases
reported by VPVs
% of Cases
reported by VPVs
NP AFP rate
Number of cases with lab
result
% of cases
with lab result
within 14 days
% of Stool
adequacy
% inv.Within 48 hrs.
% of Notifie
d within 7 days
%Specim
ens with NPEV
% cases with
Sabin like virus
Nomadic 28.80% 37 17 46% 3.6 29 69% 95% 100% 92% 0% 3%
Rural 25.90% 76 39 51% 8.3 65 80% 100% 100% 99% 8% 5%
Urban 45.30% 88 26 30% 5.5 71 83% 99% 99% 95% 7% 8%
National 100% 201 82 41% 5.7 165 79% 99% 100% 96% 6% 6%
AFP surveillance indicators by population lifestyle, 2018
Week-31 Somalia Weekly EPI/POL Update
Validation and zero dose investigation of AFP cases, 2018
AFP Cases Validation
Zone
# of AFP cases Reported
# of AFP cases
Validated
% of AFP cases
Validated
Central 69 31 45%
Somaliland 40 20 50%
South Zone 59 37 63%
Puntland 33 25 76%
Grand Total 201 113 56%
▪ Of the 201 AFP cases reported in 2018, 56% (n=113) were validated by the RPOs. Of the 113 AFP cases validated, (n=81, n=19, n=13) were from accessible, partially accessible and inaccessible districts respectively
▪ There were 23 zero OPV dose AFP cases reported in 2018, out of which 782% (n=18/23) were investigated
Week-31 Somalia Weekly EPI/POL Update
Table no.-8
Zero Dose Investigation
Zone# of Zero dose AFP
cases Reported# of Zero dose
AFP cases investigated
% of Zero dose AFP cases
investigated
Comment
Central 7 6 86% 2 from accessible and remaining from access-compromised areas
Somaliland --- ---
South Zone 15 12 80%
Puntland 1 0 0%
Grand Total 23 18 78%Table no.-9
Summery of investigation for a hot AFP case(Zero OPV dosage) from Mudug region in Puntland (SOM/MUD/JIR/18/00)
• The child is from nomadic settlement with no health facility providing immunizations. The nearest health facility is about 23 km away, in very rough road with no transportations in between
• During the last OPV Campaign ( NID December 2017) this area was not covered due to tribal conflict between two villages (Saad and Dir tribal) in the border of Puntland and Galmudug new state
• Immunizations coverage survey shows 4 children (15%) are zero dose for routine immunizations but the immunity profile was good among the target populations (91%), had more than 4 OPV dosage by SIAs
• Plan to prevent such zero dosage cases in this area
➢ Establish TPV between the two states especially in the high risk areas (CO team to agree with Galmudug new state)
➢ Improve routine immunization service delivery to remote high risk areas by establishing mobile strategies, GAVI/EPI officer to follow with UNICEF and MOH
➢ Establish community based surveillance among the nomads (focal persons and involve the key informants) ➢ Strengthen monitoring and supervision during the NID and hard to reach areas to minimize missed area (to be
done by RPOs and DPOs)
Tracking lab results of AFP cases
Total AFP cases
201
AFP cases with stool specimens
AFP cases without stool specimens
201 0
With lab results
En route In the lab
165 36
cVDPV type 2 and 3 coinfection
cVDPV2 cVDPV3 SL EV -ve
1 1 2 10 14 137
1
24
137
36
Tracking AFP with stool specimens
cVDPV2
cVDPV3
Other viruses
neg st
in lab
en route
Week-31 Somalia Weekly EPI/POL Update
Samplesource
#Specimen collected
# Specimen with culture
result
# Specimens pending lab
result
# Specimenwith culture result within
14 days
% of specimen with culture
result within 14 days
Number of specimen with NPEV
% of specimen
with NPEV
Number of cases with
Sabinisolation
% of Cases with Sabinisolation
Cases 402 330 72 262 79% 21 6% 10 6%
Contacts 604 459 145 364 79% 37 8% 27 6%
Total 1006 789 217 626 79% 58 7% 37 6%
Lab performance indicators for AFP surveillance in Somalia, 2018
Week-31 Somalia Weekly EPI/POL Update
Table no.-10
Median and average number of days from onset of paralysis to final lab results - 2018
Date of Notification
Second stool collected
Specimen reached to Lab
Primary Culture result
Date of onset ITD result
Median: 20 daysAverage: 22 days
Date second stool
collected
Date final ITD results
Median: 3 daysAverage: 3.53 days
Median: 2 daysAverage: 1.89 days
1 day
Week-31 Somalia Weekly EPI/POL Update
Chart no. 2
Median: 3 daysAverage: 3.8 days
Median: 11 daysAverage: 11.7 days
Week-31 Somalia Weekly Polio Update
Village polio volunteers weekly house to house visit and number of AFP cases notified, 05 Aug 2018
Central
January Feberuary March April May June July Aug Sept Oct Nov December
No. of HH
visited
No. of AFP cases notified
No. of HH visited
No. of AFP cases
notified
No. of HH
visited
No. of AFP
cases notified
No. of HH
visited
No. of AFP
cases notified
No. of HH
visited
No. of AFP
cases notified
No. of HH
visited
No. of AFP
cases notified
No. of HH
visited
No. of AFP
cases notified
No. of HH
visited
No. of AFP cases notified
No. of HH
visited
No. of AFP
cases notified
No. of HH visited
No. of AFP cases notified
No. of HH
visited
No. of AFP
cases notifie
d
No. of HH
visited
No. of AFP
cases notifie
d
Central38002 6 39361 8 48588 5 38442 3
38,481 2
49,819 4
39,208 3 - - - - - - - - - -
South35756 2 35545 3 45593 4 36456 4
36,073 3
45,257 4
36,012 1 - - - - - - - - - -
Puntland 16237 3 16148 3 20107 2 16230 3
16,077 1
19,967 3
12,047 0 - - - - - - - - - -
Somaliland32180 6 32370 1 39613 2 32532 1
32,325 2
40,207 2
32,194 1 - - - - - - - - - -
Total 122175 17 123424 15 153901 13 123660 11 122956 8 155250 13 119461 5 0 0 0 0 0 0 00 0 0
Week-31 Somalia Weekly Polio Update
Routine immunization services, status of cold chain & vaccine stocks in AFP surveillance sites, 05 Aug 2018
Region
Expected weekly
AFP sites visits
Health facility have a
routine EPI service
AFP sites with EPI service and functional
cold chain
Health facility have EPI
vaccine availableHealth facility have IPV vaccine available
No No. % No. % No. % No. %
Nugal 33 19 58% 19 100% 19 100% 17 89%
Bari 116 34 29% 32 94% 34 100% 32 94%
Mudug 58 39 67% 38 97% 38 97% 24 63%
Galbeed 40 23 58% 23 100% 23 100% 23 100%
Sahil 25 10 40% 10 100% 10 100% 8 80%
Sanag 21 11 52% 11 100% 11 100% 11 100%
Sool 30 10 33% 10 100% 10 100% 0 0%
Awdal 52 23 44% 23 100% 23 100% 23 100%
Togdher 47 21 45% 21 100% 21 100% 21 100%
Middle Shabelle 38 19 50% 15 79% 19 100% 19 100%
Hiran 27 22 81% 5 23% 22 100% 22 100%
Galgadud 40 26 65% 15 58% 26 100% 25 96%
Banadir 125 70 56% 25 36% 67 96% 64 96%
Lower Shabelle 56 30 54% 16 53% 30 100% 24 80%
Middle Juba 29 1 3% 0 0% 1 100% 0 0%
Bakool 31 44 142% 47 107% 11 25% 10 91%
Gedo 54 21 39% 20 95% 21 100% 19 90%
Bay 74 30 41% 30 100% 30 100% 31 103%
Lower Juba 59 30 51% 8 27% 30 100% 27 90%
Somalia 955 483 51% 368 76% 446 92% 400 90%
Part II
Fever and rash surveillance
Week-31 Somalia Weekly Polio UpdateEpi-curve on suspected measles cases by week, Somalia (2015-2018)
2015 (n=7498)
2016 (n=5657)
2015W13
2015W14
2015W15
2015W16
2015W17
2015W18
2015W19
2015W20
2015W21
2015W22
2015W23
2015W24
2015W25
2015W26
2015W27
2015W28
2015W29
2015W30
2015W31
2015W32
2015W33
2015W34
2015W35
2015W36
2015W37
2015W38
2015W39
2015W40
2015W41
2015W42
2015W43
2015W44
2015W45
2015W46
2015W47
2015W48
2015W49
2015W50
2015W51
2015W52
2016W01
2016W02
2016W03
2016W04
2016W05
2016W06
2016W07
2016W08
2016W09
2016W10
2016W11
2016W12
2016W13
2016W14
2016W15
2016W16
2016W17
2016W18
2016W19
2016W20
2016W21
2016W22
2016W23
2016W24
2016W25
2016W26
2016W27
2016W28
2016W29
2016W30
2016W31
2016W32
2016W33
2016W34
2016W35
2016W36
2016W37
2016W38
2016W39
2016W40
2016W41
2016W42
2016W43
2016W44
2016W45
2016W46
2016W47
2016W48
2016W49
2016W50
2016W51
2016W52
2017W01
2017W02
2017W03
2017W04
2017W05
2017W06
2017W07
2017W08
2017W09
2017W10
2017W11
2017W12
2017W13
2017W14
2017W15
2017W16
2017W17
2017W18
2017W19
2017W20
2017W21
2017W22
2017W23
2017W24
2017W25
2017W26
2017W27
2017W28
2017W29
2017W30
2017W31
2017W32
2017W33
2017W34
2017W35
2017W36
2017W37
2017W38
2017W39
2017W40
2017W41
2017W42
2017W43
2017W44
2017W45
2017W46
2017W47
2017W48
2017W49
2017W50
2017W51
2017W52
2018W01
2018W02
2018W03
2018W04
2018W05
2018W06
2018W07
2018W08
2018W09
2018W10
2018W11
2018W12
2018W13
2018W14
2018W15
2018W16
2018W17
2018W18
2018W19
2018W20
2018W21
2018W22
2018W22
2018W23
Series1 161414201817171921171415161813151112969585101286908472107289881110129711151087668610121195121087888310141310111114121414109812908274796091928176708476747167851017109393121112131512151719212222302540373938434467496965686669707268695856535546484440324333272935325044413841364448404240344135312831343932464140263122221929212319181215
163
149
144
208
182
172
174
199 21
417
514
0 156
161
180
134 15
111
3 127
96 9585
107 12
486 9084
7210
272
89 8811
510
012
597
111
158
105
8766
8610
312
511
295
122
109
87 88 8310
514
013
210
2 115
116
142
127 14
114
510
998
124
9082
74 7960
91 9281 76
7084
76 74 71 6785
101
170
102
93 9312
811
712
2 133
154
122
155
173
196 21
022
822
230
925
540
837
339
938
343
644
167
049
669
965
768
566
369
6 703 72
068
6 693
584
560
538 55
446
348
844
440
032
543
633
027
7 290
352
320
507
441
416
389
410
362
440
487
401
426
406
349
416
351
315
286
317
346
393
325
461
410
407
269
314
224
227
198
292
219
239
191
180
126
153
0
100
200
300
400
500
600
700
800 2017(n=23,353)
20
18
(n=
69
79
)
Week-31 Somalia Weekly Polio Update
Fever and rash cases reported through the AFP surveillance system , 05 Aug 2018
Region
Tota
l 20
17
Fever and Rash Cases by weekly 2018
Tota
l 20
18
W1
W2
W3
W4
W5
W6
W7
W8
W9
W1
0
W1
1
W1
2
W1
3
W1
4
W1
5
W1
6
W1
7
W1
8
W1
9
W2
0
W2
1
W2
2
W2
3
W2
4
W2
5
W2
6
W2
7
W2
8
W2
9
W3
0
Nugal 2050 32 26 26 26 24 19 30 21 17 11 7 10 10 13 19 20 15 4 7 3 4 7 6 2 2 1 2 2 2 0 368
Bari 1968 21 26 20 17 20 26 26 18 22 27 33 25 27 26 29 46 28 22 13 13 18 13 14 10 16 18 10 7 11 11 613
Mudug 2566 47 45 36 27 44 25 23 24 30 15 21 20 16 10 13 14 7 17 0 8 1 0 3 5 0 1 0 0 1 4 457
N/East Zone 6584 100 97 82 70 88 70 79 63 69 53 61 55 53 49 61 80 50 43 20 24 23 20 23 17 18 20 12 9 14 15 1438
Galbeed 758 4 2 4 7 1 4 0 4 0 0 6 7 0 1 5 4 0 1 0 2 2 1 0 0 0 0 1 0 0 0 56
Sahil 576 2 0 9 2 13 5 24 5 18 4 4 4 13 2 1 1 2 0 7 0 2 0 4 2 3 0 0 0 0 0 127
Sanag 259 4 6 5 11 0 5 7 5 5 2 0 0 12 0 6 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 70
Sool 698 17 7 20 20 45 20 43 13 26 6 26 0 18 6 6 1 1 0 0 1 0 1 2 2 0 0 0 0 0 0 281
Awdal 105 2 0 11 2 5 0 10 0 3 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 33
Togdher 2324 11 11 27 13 31 7 51 25 37 14 49 28 29 13 17 17 8 13 19 7 6 3 11 8 4 2 6 3 0 1 471N/West Zone 4720 40 26 76 55 95 41 135 52 89 26 85 39 72 22 35 23 12 14 27 10 10 5 17 12 7 2 7 3 0 1 1038
M/ Shabelle 716 18 15 19 23 23 23 43 30 30 33 38 22 14 17 12 5 12 12 11 5 16 10 7 9 9 4 14 13 22 19 528
Hiran 1461 12 13 3 26 26 15 22 12 18 1 5 1 0 20 17 0 35 5 0 0 0 15 16 27 0 6 1 18 13 0 327
Galgadud 625 5 7 4 6 6 8 16 11 8 6 4 7 6 4 8 5 7 4 11 7 5 7 3 2 4 3 4 2 4 3 177
Banadir 5617 72 73 79 70 70 68 56 66 59 54 48 36 26 20 40 32 58 62 47 53 40 42 25 18 16 21 32 31 48 63 1425
L/Shabelle 2106 25 28 40 36 36 28 29 52 36 35 33 20 31 23 32 20 29 31 25 19 22 19 22 23 22 23 14 21 22 18 814Central Zone 10525 132 136 145 161 161 142 166 171 151 129 128 86 77 84 109 62 141 114 94 84 83 93 73 79 51 57 65 85 109 103 3271
Middle Juba 62 0 3 3 0 1 1 2 3 0 0 2 3 3 3 4 3 4 3 4 6 3 4 3 8 2 5 3 4 2 3 85
Bakool 99 4 2 2 0 4 0 0 4 2 0 0 4 0 4 4 0 2 0 0 2 3 0 2 0 2 0 4 2 0 0 47
Gedo 241 0 1 1 51 23 61 51 100 77 35 26 32 8 8 31 3 6 3 0 0 0 1 4 2 0 3 0 0 0 2 529
Bay 654 17 17 2 0 9 4 11 11 9 0 0 0 0 0 5 5 5 5 5 0 0 1 0 2 0 0 0 0 3 0 111
Lower Juba 468 22 4 6 9 12 6 17 6 10 27 12 5 14 28 43 43 19 9 30 0 31 5 26 22 25 11 8 4 4 2 460
South Zone 1524 43 27 14 60 49 72 81 124 98 62 40 44 25 43 87 54 36 20 39 8 37 11 35 34 29 19 15 10 9 7 1232
Grand Total 23353 315 286 317 346 393 325 461 410 407 270 314 224 227 198 292 219 239 191 180 126 153 129 148 142 105 98 99 107 132 126 6979
161 133 115 97 14062 43 39 19 33 12 1539 30 48 70 119 83 24 27 27 11 40 036 71
214282
491
925
667 634510
891 882979
349 300221 240
110 78 73 15
0
200
400
600
800
1000
1200
Puntland
2015 2016 2017 2018
161 142
269202 243
93 72 47 29 47 29 1514 3682 104
33 35 16 9 4296
37 8
265
95
861909
823
503
275
132 99 87 113194197
323222
92 61 41 19 1
0
200
400
600
800
1000
January February March April May June July AUG Sept. Oct. Nov. Dec
Somaliland
2015 2016 2017 2018
455 443 441348
545450
514
328 281388 383 401367 315
401265 324 307 278 271 310
142
350
30
503
742
11111205
1340
1494
925
659547 568 515
916
574640
420 396 375296
367
103
0
200
400
600
800
1000
1200
1400
1600
January February March April May June July AUG Sept. Oct. Nov. Dec
Central
2015 2016 2017 2018
40 27 27 3046
22 27 19 14 13 18 18937 29
4675
50
9 217
33 4626
4577
115136 128 139
8264
83
207189
32
144
326
171
220
104 10982
7
0
50
100
150
200
250
300
350
January February March April May June July AUG Sept. Oct. Nov. Dec
South
2015 2016 2017 2018
Cam
pai
gn
(11
-15
M
arch
)
Cam
pai
gn
(2-6
Jan
)
Cam
pai
gn
(11
-15
M
arch
)
Cam
pai
gn
(11
-15
M
arch
)
Trends of reported fever and rash cases by zone in, 2015 -2018 Source: AFP Surveillance Reporting System
Week-31 Somalia Weekly Polio Update
Data shows there is a steady decline of suspected measles reported after the measles mass immunization conducted in January in Puntland and March in central, south and Somaliland
Fever and rash cases reported, 05 Aug 2018Source: AFP surveillance reporting system
Week -21 Somalia Weekly Polio Update
3271
14381038 1232
6979
0
1000
2000
3000
4000
5000
6000
7000
8000
Central North East North West South Total Somalia
Zone-wise cases of fever and rash reported by AFP surveillance system in 2018
<1yr, 1141, 16%
1_4 yrs, 3933, 56%
5_9yrs, 1085, 16%
Yrs10+, 820, 12%
Age-wise distribution of fever and rash cases reported by AFP surveivallance system during 2018
Part III
Population Immunity
Maps showing accessibility and security/ risk level, Somalia
Week-31 Somalia Weekly EPI/POL Update
Map no.11
Source: UNDSS
Map no.10
Week-31 Somalia Weekly EPI/POL Update
Summary programmatic features and initiatives in Somalia by accessibility
Zone AccessibilityNumber of
SettlementPopulation
Under 15 YearsVPV
AFP active Surveillance sites
TPVP
CENTRALAccessible 2,475 2,419,077 127 251 150Inaccessible 984 516,928 63 34 21Total 3,459 2,936,005 190 285 171
PUNTLAND
Accessible 1,220 459,639 105 207 53Inaccessible 0 0 0 0 0Total 1,220 459,639 105 207 53
SOMALILANDAccessible 3,435 1,469,450 81 214 53Inaccessible 0 0 0 0 0Total 3,435 1,469,450 81 214 53
SOUTHAccessible 2,234 1,040,648 75 216 123Inaccessible 1,548 459,119 84 33 22Total 3,782 1,499,767 159 249 145
SOMALIAAccessible 9,364 5,388,814 388 888 379Inaccessible 2,532 976,047 147 67 43Total 11,896 6,364,861 535 955 422
Note: the data are preliminary and U 15 population is estimated from Surveillance historical data and U5 SIA data and are being reviewed.
Week-31 Somalia Weekly EPI/POL Update
Table no.-16
▪A total of 1,320,443< 10 years individuals were vaccinated week 29,2018. Among them 13,187(1%) were vaccinated for the first time.
Transit Points Vaccination activities using bOPV - 05 Aug 2018
Zones
January February March April May June July
Nu
mb
er o
f va
ccin
ated
Zero
do
ses
% Z
ero
do
ses
Nu
mb
er o
f va
ccin
ated
Zero
do
ses
% Z
ero
do
ses
Nu
mb
er o
f va
ccin
ated
Zero
do
ses
% Z
ero
do
ses
Nu
mb
er o
f va
ccin
ated
Zero
do
ses
% Z
ero
do
ses
Nu
mb
er o
f va
ccin
ated
Zero
do
ses
% Z
ero
do
ses
Nu
mb
er o
f va
ccin
ated
Zero
do
ses
% Z
ero
do
ses
Nu
mb
er o
f va
ccin
ated
Zero
do
ses
% Z
ero
do
ses
CENTRAL 99939 334 0.3% 106321 362 0.3% 134103 366 0.3% 104803 334 0.3% 103405 313 0.3% 128304 401 0.3% 76710 237 76710
PUNTLAND 25067 58 0.2% 24610 59 0.2% 31565 71 0.2% 25519 61 0.2% 25516 55 0.2% 30051 54 0.2% 18135 38 18135
SOMALILAND 14705 350 2.4% 14490 377 2.6% 17807 430 2.4% 14898 343 2.3% 15809 337 2.1% 19051 481 2.5% 12001 297 12001
SOUTH 32225 1073 3.3% 34364 1123 3.3% 46605 1589 3.4% 42947 1336 3.1% 34650 937 2.7% 54538 1287 2.4% 19118 484 19118
SOMALIA 171936 1815 1.1% 179785 1921 1.1% 230080 2456 1.1% 188167 2074 1.1% 179380 1642 0.9% 231944 2223 1.0% 125964 1056 125964
Immunity Profile of NP-AFP cases and Contacts 2013-2018
▪ 23 zero dose AFP cases reported in 2018 from inaccessible and partially accessible areas of South (n=15), Central (n=7) and 1 from Puntland.▪ 6 AFP cases with zero doses reported in 2018 are in the age group of 6-59 moths and the remaining 5 AFP cases with zero dose are out of the 5-59 months age group
Week-31 Somalia Weekly EPI/POL Update
Graph no.-22 Graph no.-19
51 0
11
17
7
3
1
5
16
1210
11
16
49
2311
20
8
62
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Immunity Profile of NP-AFP cases 6-59 Months by Zone, 2018
0 dose 1-3 doses 4-6 doses 7+ doses
29
21 9 10 117
34
206
2034
6
26
2717
28
3422
25
83 37
3135
12
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2013 2014 2015 2016 2017 2018
Immunity Profile of NP-AFP Cases 6-23 Months, 2013-2018
0 dose 1-3 doses 4-6 doses 7+ doses
Graph no.-20 Graph no.-21
888
341148 155 172 86
539
198
152 182252
88
424
230178 245
243211
493
812 575 635 650 363
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
2013 2014 2015 2016 2017 2018
Immunity Profile of NP-AFP Cases and Contacts combined Months, 2013-2018
0 Dose 1-3 doses 4-6 doses 7+ doses
21
0
4
5
02
1
3
6
6 6
7
3
16
4 5 5
2
12
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Immunity Profile of NP-AFP cases 6-23 Months by Zone, 2018
0 Dose 1-3 Doses 4-6 Doses 7+ Doses
Immunity profile of NP-AFP cases and Contacts combined by Zone 2012-2018
Week-31 Somalia Weekly EPI/POL Update
Graph no.-24 Graph no.-25
Graph no.-26 Graph no.-27
317
77101
97 99 56
102
68
5077 85
26
77
36
38 74 84
67
87100
57 78 81 68
0%
20%
40%
60%
80%
100%
2013 2014 2015 2016 2017 2018
SOUTH
0 dose 1-3 doses 4-6 doses 7+ doses
14 12 5 0 0 0
5836 25
23 27 7
66
2716 52 62 44
114
156145 187 178 101
0%
20%
40%
60%
80%
100%
2013 2014 2015 2016 2017 2018
SOMALILAND
0 dose 1-3 doses 4-6 doses 7+ doses
484
12729 58 69 26
306
5151
53 78 37
234
11976 59
81 60
230
430 268 273 294 132
0%
20%
40%
60%
80%
100%
2013 2014 2015 2016 2017 2018
CENTRAL
0 dose 1-3 doses 4-6 doses 7+ doses
34 38 13 0 4 4
48
3926
29
6218
32
4748 60
1640
54123 105 97 97 62
0%
20%
40%
60%
80%
100%
2013 2014 2015 2016 2017 2018
PUNTLAND
0 dose 1-3 doses 4-6 doses 7+ doses
Part -IV Routine Immunization
73
81
72
62
71
39
57
7173
52
73
5
5457
43 4346
0
58
66
57
50
57
0
72
96
87
81
90
63.1
54
76
71
59
71
38.4
57
69
53 54 54
35.2
59
75
6360
64
40.5
88.1
83.2
69.8
87.6
78.6
73.9
78.7
55
43.3
55.8
46.2
54.1
46.5
33.8
57.5
73.5
64.167.6 66.8
47.3
0
10
20
30
40
50
60
70
80
90
100
BC
G
P-1
P-3
Mea
sles
OP
V-3
IPV
BC
G
P-1
P-3
Mea
sles
OP
V-3
IPV
BC
G
P-1
P-3
Mea
sles
OP
V-3
IPV
BC
G
P-1
P-3
Mea
sles
OP
V-3
IPV
PUNTLAND SOMALILAND SOUTH CENTERAL SOMALIA
Routine Immunization coverage by zone, Somalia (2015-2018 Six months)
2016 2017 2018 (6 months)
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Sum of Pent1 24215 48781 73263 98229 124707 152394 181148 207148 235011 266781 299618 331481
Sum of Penta3 27543 48616 70816 91732 113674 136589 160723 181282 203464 229673 256554 283080
Sum of Measles 18379 39266 60502 81562 103608 127044 150435 174056 193371 209302 230710 249465
Sum of Montly target on surval% 8% 17% 25% 33% 42% 50% 58% 67% 75% 83% 92% 100%
Sum of P-1% 5% 10% 15% 20% 25% 30% 36% 41% 47% 53% 60% 66%
Sum of P-3% 5% 10% 14% 18% 23% 27% 32% 36% 41% 46% 51% 56%
Sum of Measles% 4% 8% 12% 16% 21% 25% 30% 35% 39% 42% 46% 50%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
50000
100000
150000
200000
250000
300000
350000
Somalia Monitoring chart 2016
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Sum of Pent1 31367 61990 89840 119005 148901 178493 215415 247586 280838 316732 347716 390910
Sum of Penta3 26790 53670 77763 102433 127572 152696 178791 203443 232459 264569 291804 327981
Sum of Measles 20594 44105 64886 89207 115739 139255 166186 190981 216931 245101 272845 310220
Sum of Montly target on surval% 8% 17% 25% 33% 42% 50% 58% 67% 75% 83% 92% 100%
Sum of P-1% 6% 12% 17% 23% 29% 34% 42% 48% 54% 61% 67% 75%
Sum of P-3% 5% 10% 15% 20% 25% 29% 34% 39% 45% 51% 56% 63%
Sum of Measles% 4% 8% 13% 17% 22% 27% 32% 37% 42% 47% 53% 60%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
50000
100000
150000
200000
250000
300000
350000
400000
450000
Somalia Monitoring Chart 2017
Somalia Monitoring Chart 2018
Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec
Sum of BCG 26236 56728 77239 103127 135505 162439
Sum of Pent1 37081 71460 96358 130621 166707 197335
Sum of Penta3 31324 61096 83426 113811 145058 172025
Sum of Measles 31908 63535 90555 122624 154946 181609
% of Monthly target 8% 17% 25% 33% 42% 50% 58% 67% 75% 83% 92% 100%
Sum of P-1% 7% 13% 18% 24% 31% 37%
Sum of P-3% 6% 11% 16% 21% 27% 32%
Sum of Measles% 6% 12% 17% 23% 29% 34%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
0
50000
100000
150000
200000
250000
Week-31 Somalia Weekly EPI/POL Update
C4D and Cold Chain Management
C4D Updates (1)
Week-31 Somalia Weekly EPI/POL Update
Timelines of Major Activities for 2nd round Synchronized mOPV2 SIAActivity Dates Remarks
1 Engagement of Media-Radio & TV 29th Jul to 7th Aug 10 days of Radio and TV broadcast
2 Training of Community mobilizers at district level 30th July Trainings will be conducted in all districts
3Orientation of Nomadic Elders, community & local religious leaders in all Regions / Districts
31st July Orientations will be at District level
4 Community meetings in 11 cross border Districts 1st August
5 Engagement of NIAG members in 6 regions 3rd to 7th August NIAG members engagement for 5 days
6 House to house visits in 11 cross districts 1st to 7th August 7 days house to house visits in 11 cross border districts
7 House to house visits in other districts 3rd to 7th August 5 days house to house visits in other districts
8Engagement of nomadic elders during the campaign in all districts of 6 regions
3rd to 6th August Nomadic elders engagement for 4 days in all districts
9 Sound trucks engagement at District level 3rd to 7th August 5 days-All districts10 Post campaign communication Assessment 9th to 11th August Final data to be shared by 16th August
Vaccines and Cold Chain Management
• All 37,800 vials of mOPV2 for the August synchronized campaign received in Mogadishu on 16th July.
• Available balance of 3,983 vials of mOPV2 from the 1st round.
• The following regional cold chain hubs have already receive vaccine: Dhusamareb (6,998 vials), Gedo (6,600 vials) and Hudur (902 vials).
• Distribution to the other 8 cold chain hubs is going on and would be completed by 1st August.
• Routine immunization vaccines for the 3rd quarter 2018 already received also.
• IEC materials produced and available in regions and districts
Week-31 Somalia Weekly EPI/POL Update
Outbreak response trainings sessions conducted
Week-31 Somalia Weekly EPI/POL Update
Number of participants
Campaigns1st round mOPV2
In 3 regions
2nd round mOPV2
in 3 regions
3rd roundmOPV2
in 3 regions
IPV campaign
in 3 regions
Synchronized mOPV2
6 regions
bOPVcampaign
in 3 regions
Synchronized mOPV2 6 regions
RSMCs 3 3 3 3 7 3 7
DSMCs 30 30 33 32 31 32 31
CMs 871 871 893 893 655 935 655
NIAG members
0 12 12 12 18 12 16
Nomadic Elders
120
Post-campaign Supervisors & Monitors
0 0 16 16 21 16 21
C4D Updates (2)
Week-31 Somalia Weekly EPI/POL Update
Awareness per district 1st round mOPV2 Synchronized SIA
95%
86%
100% 100%94%
100%94%
80%
100% 100%
83%
100% 100% 99% 100%
89%
100% 100% 100%
94%
100% 100% 100% 100% 100% 100% 100% 100%97%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
BDB BDL DNS ELB HUD RBD WJD ABD ADD BLB DSB GLS GUR BDB BLH BRD DLO ELW GBH LUQ BBT BLT JLX MAH MTB AFM BDD KIS
BAY BKL GDD GDO HRN LJB Total
Post-Campaign Independent Monitoring Data (14-17 July 2018)
C4D Updates (3)
92%89%
95% 95% 96% 94% 93%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Baidoa Hudur Belet weyne Dhusmareb Garbaharey Kismayu Total (6 Districts)
Week-31 Somalia Weekly EPI/POL Update
Polio Risk Perception: Do you think Polio is a risk in your community?
Post-Campaign Communication Assessment Data (14-17 July 2018)
C4D Updates (4)
87% 89%87% 86%
88%91%
88%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Baidoa Hudur Belet weyne Dhusmareb Garbaharey Kismayu Total (6 Districts)
Week-31 Somalia Weekly EPI/POL Update
OPV Safety Perception: Do you believe that polio vaccine is safe?
Post-Campaign Communication Assessment Data (14-17 July 2018)
C4D Updates (5)
83% 84% 85% 84% 84% 83% 84%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Baidoa Hudur Belet weyne Dhusmareb Garbaharey Kismayu Total (6 Districts)
Week-31 Somalia Weekly EPI/POL Update
Campaign Repetition: Do you believe your child should be vaccinated each time there is a polio campaign?
Post-Campaign Communication Assessment Data (14-17 July 2018)
C4D Updates (6)
96%99%
91% 93%91%
95% 94%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Baidoa Hudur Belet weyne Dhusmareb Garbaharey Kismayu Total (6 Districts)
Week-31 Somalia Weekly EPI/POL Update
RI Awareness: Have you ever heard of Routine immunization?
Post-Campaign Communication Assessment Data (14-17 July 2018)
The END
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