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NCDC and WHO | EWARN & Diseases Surveillance Bulletin 1
EWARN: Early Warning Alert and Response Network
Libya: EWARN & Diseases Surveillance Bulletin 2018: Epidemiological Week: 15 Reporting Period: 09 April –15 April 2018
Number of reporting sites in week 15: One hundred and twelve (112) submitted their weekly reports
complete and in timely manner.
Total number of consultations in week 15: 45,797 marking an increase of 2,090 to last week consultation
of 43,707. The number of consultations for other disease this was week was 39,007.
Highlights
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 2
Leading causes of morbidity in week 15: Acute Upper Respiratory Infections (AURI) (n=4162; 9.21% of
consultations number), Acute Lower Respiratory Infections (ALRI) (n=1384; 3.06%) and acute diarrhea
(AD) (n=1057; 2.34%) remained the leading causes of morbidity this reporting week.
Number of alerts in week 15: fifteen (15) alert were generated through EWARN. (details: see Alerts and
Outbreaks Section). The health authorities of each municipality have the capacity to respond to
outbreaks. The alerts were discussed with the focal person and respected surveillance officers of the
municipalities. (Details: see Alert and Outbreak Section).
NOTE: In all the figures below that represent trends, numbers from week 15 in 2018 were compared
to three different averages from 2017 representing the following:
The average value for epidemiological weeks 01 – 52 in 2017, representing the entirety of 2017.
The average value for epidemiological weeks 39 – 52 in 2017, representing the period of
reporting that followed the first EWARN training workshop in September of 2017.
The average value for epidemiological weeks 49 – 52 in 2017, representing the period of
reporting that followed the second EWARN training workshop in December of 2017.
Figure 1. Distribution of reporting health facilities
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No of reporting sites in Libya comparing averages of weeks, week 1 - 52 2017, weeks 39 -52 2017, weeks 49
- 52 2017 and week 01 - 15 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 3
Morbidity Patterns:
During week 15, the proportions of AURI, AD and ALRI decreased in comparison with the previous week
as it can be seen in figure 2.
Figure 2. Distribution of AURI, AD and ALRI in week 1 – 52 2017 and 15 2018
2018 Epidemiological week 15:
Below is the distribution of the leading causes of morbidity by municipalities for the epidemiological
week 15.
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Comparing average cases of AURI, ALRI and AD of all of 2017, beyond 1st EWARN workshop, beyond 2nd
EWARN workshop and week 01 - 15 2018
AURI ALRI AD
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 4
Figure 3. Distribution of common disease by municipalities for week 15, 2018
Trend of pertussis:
In total 454 cases of suspected pertussis have been reported from EWARN sites this year. This week 24
cases were reported and they are distributed as follow: Aljofra (2), Imsalata (12) and Bengazi (10).
0%
10%
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Distribution of common disease by municipalities for week 15, 2018
ALRI
AD
AURI
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 5
Figure 4. Distribution of suspected pertussis cases reported by week and by municipality week 15 2018.
Trend of Acute Upper Respiratory Infections
During week 15, a total of 4162 cases were reported (9.09 % of total consultations) and are summed up
in table 1 below:
Municipality AURI cases Municipality AURI cases
ALJEMAIL 12 Ghdames 83
ALJOFRA 127 Sert 46
ALKOFRA 59 Aljaghboub 1
ALMARIJ 178 SUBRATA 175
BANIWALED 252 ALKOBA 172
BENGAZI 583 ALBAIDA 67
GARIAN 45 ALAJILAT 215
IGDABYA 384 ASHATI EAST 33
00 00 0 2 1 1 2 2 3 2 2 0 1 0 30 00 00 00 0 0 0 0 0 0 0
0 0 00
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WEEK 01 2018
WEEK 02 2018
WEEK 03 2018
WEEK 04 2018
WEEK 05 2018
WEEK 06 2018
WEEK 07 2018
WEEK 08 2018
WEEK 09 2018
WEEK 10 2018
WEEK 11 2018
WEEK 12 2018
WEEK 13 2018
WEEK 14 2018
WEEK 15 2018
Distribution of S. pertussis reported cases by week and by municipality up to week 15, 2018
ALABYAR ALAJILAT ALBAIDA Aljaghboub ALJEMAIL ALJOFRAALKOBA ALKOFRA ALMARIJ ASHATI ASHATI EAST ASHATI WestBANIWALED BENGAZI DARNAH ESBEAA GARIAN GHATGhdames IGDABYA IMSALATA JALO KHOMS MEZDAHMISURATA MORZIG MRADA OUBARI Qasir Ben Ghashir REGDALINSABHA Sert SUBRATA SURMAN TARHUNA TAZIRBUTobruk TRAGHEN Tripoli YEFRIN ZAWIA ZELTONZENTAN ZLETIN ZWARA ALZAHRAA TRIPOLI central ALSWANIALAZIZIYA Souq Eljomaa NESMAA
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 6
IMSALATA 255 Tobruk 13
KHOMS 93 Qasir Ben Ghashir 96
MISURATA 161 MEZDAH 14
MORZIG 64 TRAGHEN 5
MRADA 12 ALABYAR 37
REGDALIN 45 JALO 25
SABHA 98 TAZIRBU 59
ZAWIA 265 ZENTAN 6
ZLETIN 42 ESBEAA 47
ZWARA 138 ABOU SALEM
28
TRIPOLI central 146 HAY ALANADALOUS
34
Souq Eljomaa 47
Table 1. Summary of AURI cases by Municipality in week 15
Figure 5 below shows the trend of AURI cases in the period from week 01 2017 to week 15/2018
through the EWARN system. Moreover, Figure 6 shows the trend of AURI cases percentage from the
total consultations in the period between week 39 and week 15/2018.
The cumulative AURI during this year reached 68658 cases. Benghazi reported 15% of all cases (10087).
Trend of the disease showed peaks of over the past two months.
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 7
Figure. 5 Distribution of AURI cases by week, week 1 – 52, 2017 and week 15, 2018.
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DISTRIBUTION OF AURI CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 15, 2018
1.44
7.067.526.48
7.266.40
8.53
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Week15
Percentage of AURI cases from the total consultation number by week, week 39 - 52, 2017 and week 15, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 8
Figure.6 Distribution of AURI percentage by week, week 39 – 52, 2017 and 15, 2018
Trend of Acute Lower Respiratory Infection:
During week 15, a total of 1384 cases of acute lower respiratory infections were reported (3.02% of total
consultations) and are summarised by municipality in Table 2 below:
Municipality ALRI cases Municipality ALRI cases
ALJEMAIL 7
TRIPOLI central 53
ALJOFRA 31 Souq Eljomaa
12
ALKOFRA 3 Ghdames 23
ALMARIJ 57 Sert 14
BANIWALED 128 SUBRATA 148
BENGAZI 129 ALKOBA 65
GARIAN 11 ALBAIDA 21
IGDABYA 45 ALAJILAT 66
IMSALATA 30 ASHATI EAST 2
KHOMS 5 Tobruk 11
MISURATA 98 Qasir Ben Ghashir 93
MORZIG 28 MEZDAH 10
REGDALIN 39 TRAGHEN 1
SABHA 73 ALABYAR 8
ZAWIA 80 HAY ALANADALOUS 32
ZLETIN 4 ZELTIN 16
ESBEAA 40 Table 2. Summary of ALRI cases by Municipality in week 15
Figure 7 below shows the trend of ALRI cases in the period from week 01 2017 to week 15/2018 through
the EWARN system. Moreover, Figure 8 shows the trend of ALRI cases percentage from the total
consultations in the period between week 39 and week 15/2018.
The cumulative ALRI during this year reached 19038 cases. Baniwaled reported 9% of all cases (1688).
Trend of the disease showed peaks of cases reported over the past two months.
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 9
Figure. 7 Distribution of ALRI cases by week, week 1 – 52, 2017 and week 15, 2018.
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DISTRIBUTION OF ALRI CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 15, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 10
Figure.8 Distribution of ALRI percentage by week, week 39 – 52, 2017 and week 15, 2018
Trend of Acute Diarrhea
During week 15, a total of 1057 (2.31% of total consultations) cases of Acute Diarrhoea were reported
and are summerised per municipality in Table 3 below:
Municipality AD cases Municipality AD cases
ALJEMAIL 17 TRIPOLI central 47
ALJOFRA 125 Souq Eljomaa 2
ALKOFRA 14 Ghdames 19
ALMARIJ 47 Aljaghboub 4
BANIWALED 143 SUBRATA 36
BENGAZI 93 ALKOBA 84
GARIAN 5
ALBAIDA 31
IMSALATA 88 ALAJILAT
33
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3.383.153.053.11
2.642.932.92
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Percentage of ALRI cases from the total consultation number by week, week 39 - 52, 2017 and week 15, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 11
KHOMS 4 ASHATI EAST 39
MISURATA 47 Tobruk 5
REGDALIN 37 TRAGHEN 8
SABHA 18 ALABYAR
3
ZAWIA 16
TAZIRBU 32
ZLETIN 38 ABOU SALEM 8
HAY
ALANADALOUS 14
Table 3. Summary of AD cases by Municipality in week 15
Figure 5 below shows the trend of AD cases in the period from week 01 2017 to week 15/2018 through
the EWARN system. Moreover, Figure 6 shows the trend of AD cases percentage from the total
consultations in the period between week 39 and week 15/2018.
The cumulative AD during this year reached 16195 cases. Bengazi reported 19% of all cases (3074).
Trend of the disease showed peaks of cases reported over the last two months.
Figure 9. Distribution of AD cases by week, week 1 – 52, 2017 and week 15, 2018.
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DISTRIBUTION OF AD CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 15, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 12
Figure 10. Distribution of AD percentage by week, week 39 – 52, 2017 and week 15, 2018
Trend of vaccine preventable diseases:
Durign week 15, 40 VPD cases was reported and they are summerised in the table below:
VPD No of Cases Municipality Age Sex
Meningitis 3 Ghat (1), Tripoli central (1) and Tobruk (1)
Below 5 years (1) above five years (2)
Male (1) Female (2)
Pertussis 24 Aljofra (2), Bengazi (10), Imsalata (12)
Below 5 years (23) above 5 years (1)
male (9) female (15)
Measles 9 Zwara (3), Alkofra (1),Bengazi (2), Sabha (2) and Zletin (1)
Below 5 years (5) above five years (4)
males (4) and females (5)
AFP 3 Bengazi (1), Garian (1), Sabha (1)
Below 5 years (2) above five years (1)
Male (1) and females (2)
Summary of all cases reported in week 15:
0.59
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2.582.21
2.592.192.17
3.68
2.16
3.002.612.76
2.232.63
4.17
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2.722.872.552.502.572.53
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Week14
Week15
Percentage of AD cases from the total consultation number by week, week 39 - 52, 2017 and week 15, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 13
Disease No of cases Percentage from total consultations
AURI 4162 9.09
ALRI 1384 3.02
AD 1057 2.31
BD 65 0.14
AJS 11 0.02
Leishmania 16 0.03
Meningitis 3 0.01
Pertussis 24 0.05
Measles 9 0.02 AFP 3 0.01
Food Poisoning 3 0.01
Alerts & Outbreaks
Fifteen (15) alerts were generated through EWARN following the case definition thresholds. All the alerts were notified to surveillance adminstration and local muncipality health offcials. No epidemic was resported during this period. (Details: see below table).
SN Alert Municipality No of Cases
Investigation and
Response within 48-72
hrs DOH/ WHO/ NGO
Sample Taken
Yes/No
Alerts Confirmed True/False
Public Health Interventions
Conducted
1 Pertussis Benghazi 10 No No DK No 2 Pertussis Imsalata 12 No No DK No 3 Pertussis Aljofra 2 No No DK No 4 Leishmania Khoms 10 Yes Clinical
Diagnosis Yes No
5 AFP Sabha 1 Yes Yes DK No 6 AFP Bengazi 1 Yes Yes DK No 7 AFP Garian 1 Yes Yes DK No 8 measles Sabha 2 Yes Yes DK No 9 measles Bengazi 2 Yes Yes DK No 10 measles Zletin 1 Yes Yes DK No 11 measles Alkofra 1 Yes Yes DK No 12 measles Zwara 3 Yes Yes DK No 13 BD Baniwaled 56 No No DK No 14 BD Ghat 5 No No DK No 15 AJS Almarij 5 Yes No DK No
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 14
