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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: 14 Reporting Period: 02 April –08 April 2018
Number of reporting sites in week 14: One hundred and five (105) submitted their weekly reports
complete and in timely manner.
Total number of consultations in week 14: 43,707 marking an increase of 4,733 to last week consultation
of 48,440. The number of consultations for other disease this was week was 36,557.
Highlights
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 2
Leading causes of morbidity in week 14: Acute Upper Respiratory Infections (AURI) (n=4389; 10.04% of
consultations number), Acute Lower Respiratory Infections (ALRI) (n=1552; 3.55%) and acute diarrhea
(AD) (n=1105; 2.53%) remained the leading causes of morbidity this reporting week.
Number of alerts in week 14: Twelve (12) 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 14 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 - 14
2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 3
Morbidity Patterns:
During week 14, the proportions of AD and ALRI increased 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 14 2018
2018 Epidemiological week 14:
Below is the distribution of the leading causes of morbidity by municipalities for the epidemiological
week 14.
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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 - 14 2018
AURI ALRI AD
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 4
Figure 3. Distribution of common disease by municipalities for week 14, 2018
Trend of pertussis:
In total 430 cases of suspected pertussis have been reported from EWARN sites this year. This week 26
cases were reported and they are distributed as follow: Albaida (3), Subrata (8), Imsalata (12) and
Bengazi (3).
0%
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Distribution of common disease by municipalities for week 14, 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 14 2018.
Trend of Acute Upper Respiratory Infections
During week 14, a total of 4389 cases were reported (10.04 % of total consultations) and are summed up
in table 1 below:
Municipality AURI cases Municipality AURI cases
ALJOFRA 249 Souq Eljomaa 300
ALKOFRA 113 Ghdames 92
ALMARIJ 192 Sert 77
BANIWALED 182 Aljaghboub 1
BENGAZI 554 SUBRATA 195
GARIAN 36 ALKOBA 111
IGDABYA 293 ALBAIDA 70
IMSALATA 255 ALAJILAT 235
00 00 0 2 1 1 2 2 3 2 2 0 1 0 30 00 00 00 00 1 0 0 03 0 0 0 0
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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
Distribution of S. pertussis reported cases by week and by municipality up to week 14, 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
KHOMS 82 ASHATI EAST 89
MISURATA 186 Tobruk 5
MORZIG 73 Qasir Ben Ghashir 82
MRADA 17 MEZDAH 10
REGDALIN 49 TRAGHEN 5
SABHA 48 ALABYAR 24
ZAWIA 193 JALO 20
ZLETIN 38 TAZIRBU 61
ZWARA 157 ABOU SALEM 29
TRIPOLI central 117 HAY ALANDALUS
37
DARNAH 101 OUBARI
8
ESBEAA 12
Table 1. Summary of AURI cases by Municipality in week 14
Figure 5 below shows the trend of AURI cases in the period from week 01 2017 to week 14/2018
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 14/2018.
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 14, 2018.
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DISTRIBUTION OF AURI CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 14, 2018
1.44
7.067.526.48
7.266.40
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Percentage of AURI cases from the total consultation number by week, week 39 - 52, 2017 and week 14, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 8
Figure.6 Distribution of AURI percentage by week, week 39 – 52, 2017 and 14, 2018
Trend of Acute Lower Respiratory Infection:
During week 14, a total of 1552 cases of acute lower respiratory infections were reported (3.55% of total
consultations) and are summarised by municipality in Table 2 below:
Municipality ALRI cases Municipality ALRI cases
ALJOFRA 51
TRIPOLI central 21
ALKOFRA 1 Souq Eljomaa
222
ALMARIJ 63 Ghdames 25
BANIWALED 71 Sert 38
BENGAZI 148 SUBRATA 216
GARIAN 10 ALKOBA 53
IGDABYA 26 ALBAIDA 23
IMSALATA 30 ALAJILAT 65
KHOMS 4 ASHATI EAST 22
MISURATA 94 Tobruk 13
MORZIG 11 Qasir Ben Ghashir 91
REGDALIN 49 MEZDAH 7
SABHA 96 ALABYAR 3
ZAWIA 35 JALO 1
ZLETIN 28 TAZIRBU 3
DARNAH 8 HAY ALANDALUS 14
ESBEAA 10 Table 2. Summary of ALRI cases by Municipality in week 14
Figure 7 below shows the trend of ALRI cases in the period from week 01 2017 to week 14/2018 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 14/2018.
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 14, 2018.
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DISTRIBUTION OF ALRI CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 14, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 10
Figure.8 Distribution of ALRI percentage by week, week 39 – 52, 2017 and week 14, 2018
Trend of Acute Diarrhea
During week 14, a total of 1105 (2.53% of total consultations) cases of Acute Diarrhea were reported
and are summerised per municipality in Table 3 below:
Municipality AD cases Municipality AD cases
ALJOFRA 98 TRIPOLI central 11
ALKOFRA 42 Souq Eljomaa 39
ALMARIJ 99 Ghdames 16
BANIWALED 115 Aljaghboub 5
BENGAZI 128 SUBRATA 23
GARIAN 5 ALKOBA 129
IMSALATA 81
ALBAIDA 46
KHOMS 2 ASHATI EAST
17
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Percentage of ALRI cases from the total consultation number by week, week 39 -52, 2017 and week 14, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 11
MISURATA 60 TRAGHEN 1
REGDALIN 47 ALABYAR 4
SABHA 26 JALO 1
ZAWIA 26 TAZIRBU
40
ZLETIN 18
OUBARI 4
Tobruk 5 ABOU SALEM 5
HAY
ALANDALUS 12
Table 3. Summary of AD cases by Municipality in week 14
Figure 5 below shows the trend of AD cases in the period from week 01 2017 to week 14/2018 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 14/2018.
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 14, 2018.
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DISTRIBUTION OF AD CASES BY WEEK, WEEK 1 - 52, 2017 AND WEEK 14, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 12
Figure 10. Distribution of AD percentage by week, week 39 – 52, 2017 and week 14, 2018
Trend of vaccine preventable diseases:
Durign week 14, 35 VPD cases was reported and they are summerised in the table below:
VPD No of Cases Municipality Age Sex
Meningitis 4 Tripoli central (3) and Tobruk (1)
Below 5 years (1) above five years (3)
Male (3) Female (1)
Pertussis 26 Albaida (3), Subrata (8), Bengazi (3), Imsalata (12)
Below 5 years (21) above 5 years (5)
male (15) female (11)
Measles 4 Bengazi (1), Sabha (2) and Regdalin (1)
Below 5 years (2) above five years (2)
males (4)
AFP 1 Bengazi (1) Below 5 years (1)
Male (1)
Summary of all cases reported in week 14:
0.59
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2.232.63
4.17
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2.722.872.552.502.572.53
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Percentage of AD cases from the total consultation number by week, week 39 - 52, 2017 and week 14, 2018
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 13
Disease No of cases Percentage from total consultations
AURI 4389 10.04
ALRI 1552 3.55
AD 1105 2.53
BD 22 0.05
AJS 4 0.01
Leishmania 15 0.03
Meningitis 4 0.01
Pertussis 26 0.06
Measles 4 0.01 AFP 1 0.00
Food Poisoning 4 0.01
Alerts & Outbreaks
Twelve (12) 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 3 No No DK No 2 Pertussis Imsalata 12 No No DK No 3 Pertussis Albaida 3 No No DK No 4 Pertussis Subrata 8 No No DK No 5 Leishmania Garian 3 Yes Clinical
Diagnosis Yes No
6 Leishmania Khoms 11 Yes Clinical Diagnosis
Yes No
7 Meningitis Tripoli central
3 Yes Yes DK No
8 AFP Bengazi 1 Yes Yes DK No 9 measles Sabha 2 Yes Yes DK No 10 measles Bengazi 1 Yes Yes DK No 11 measles Regdalin 1 Yes Yes DK No 12 BD Baniwaled 12 No No DK No
NCDC and WHO | EWARN & Diseases Surveillance Bulletin 14
