Presentation On Projects 1 & 2 Basic FETP, Liberia

PREPARED BY ISAAC B. COLE

COHORT I TRAINEE COUNTY SURVEILLANCE OFFICER

NIMBA COUNTY

ACKNOWLEDGMENT• I will like to acknowledge:

– Ministry of Health, Liberia– AFENET– Emory University– CDC.– WHO– My mentors (Justin and Peter)

SUMMARY• During the weeks under review the following

immediately reportable diseases, conditions and events was:

• Acute Flaccid Paralysis (AFP) …………………3• Suspected Measles …………………………… 25• Maternal Mortality ……………………………… 2• Neonatal Mortality ……………………………… 1• Suspected EVD ………………………………. 1,351• Acute Watery Diarrhea ……………………….. 782

Figure 1:- Timeliness of Reporting, Week 31-42, Nimba County

District WEEK 31

WEEK 32

WEEK 33

WEEK 34

WEEK 35

WEEK 36

WEEK 37

WEEK 38

WEEK 39

WEEK 40

WEEK 41

WEEK 42

% of cum. Week 31-42

Gbehlay-Geh T T T T T T T T T T T T

100%

Sanniquellie-Mah T T T T T T T T T T T T

100%

Tappita L L L L L L L L L L L L72%

Yarwin Mehnsoonoh L L L L T T T L L T L L

79%

Zoe-Geh L L L L L L L L L L L L70%

Saclepea-Mah T T T T T T T T T T T T

100%

The weeks

On Time T Late L No report received NR

% Cumulative

≥80% on Time

≥50-79.9% on Time

≤50% on Time

Legend

Figure 2: Immediate Reportable Diseases , Weeks 31 -42, 2015, Nimba County

DISEASES

Cases Death CFRAcute Flaccid Paralysis (AFP)

3 0 0%

Yellow Fever 0 0 0%Lassa Fever 0 0 0%Neonatal Tetanus 0 0 0%Cholera 0 0 0%Acute Watery Diarrhea 782 0 0%Bloody Diarrhea 0 0 0%Human Rabies 0 0 0%Meningitis 0 0 0%Measles 25 0 0%Suspected VHF/EVD 1,351 116 8.6%Neonatal Mortality 1Maternal Mortality 2

Figure 3: Timeliness of Reporting, Weeks 31-42 2015 Nimba County

Trend of Suspected EVD, Week 31-42, 2015,Nimba County

Trend of suspected Measles ,Week 31-42, 2015,Nimba County

Project 2Outbreak of Acute Flaccid Paralysis, Nimba County

INTRODUCTION• Poliomyelitis is a highly contagious viral disease• The virus infects mostly children < 5years• Incubation period is 7 to 14 days

– paralytic cases has range of approximately 3 to 35 days

• AFP Surveillance is an active surveillance system

• In Nimba County, there was an alert of three cases of AFP in week 40 (week beginning 28th September and ending 4th October, 2015)

OBJECTIVES

• To confirm the existence of the reported Acute Flaccid Paralysis

• To collect samples from affected patients who have paralysis

• To commence response

METHODS• Nimba County borders two countries (Cote d’Ivoire and

Guinea) with population of 534,376

• A case is defined as – any AFP < 15 years of age or

– case of any age in which a clinician suspects polio followed by onset of paralysis in Nimba County between 15 th September to 8th October, 2015

• The outbreak affected 2 of the 6 health districts (Manbor in Gbehlay-Geh and Yekepa Area K in Sanniquellie-Mah)

• The parents of each case were orally interviewed

• Specimens were collected– 2 stool samples each patient at Interval of 24 hours

RESULTS 1/3• A total of three (3) cases were reported, all of them are

male. Median Age is 77 months (18-95)

• Case A: - is a 1 year 6 months old male child who started having progressive flaccid paralysis and fever on the 21st of September, 2015

• Paralysis is asymmetrical and affects both lower limbs

• Patient has had two doses of OPV since birth

• 2 stool specimens were collected 8th and 9th day after the onset of paralysis

• Result of investigation is being awaited

RESULTS 2/3 • Case B: - is a 7 year and 11 months old male child who

presented on the 28th September, 2015 at the Karnplay Health Center, Gbehlay-Geh District with 8 days history of progressive flaccid paralysis and fever

• Paralysis is symmetrical and affects all limbs

• Patient has received 2 doses of OPV from birth

• 2 stool specimens were collected 9th and 10th day after the onset of paralysis

• Result of investigation is being awaited

RESULTS 3/3 • Case C: - is a 6 years old male child who started

having progressive flaccid paralysis and associated fever from the 24th of September, 2015

• Paralysis is asymmetrical and affects both lower limbs

• Patient has received three doses of OPV from birth

• 2 stool specimens were collected 8th and 9th day after the onset of paralysis

• Result of investigation is being awaited

Epicurve of Outbreak of Acute Flaccid Paralysis in Nimba County, September, 2015

CONCLUSION• Two of the cases live in the same district and one live in

a district very close to Guinea

• The three cases had no travel history outside of their home towns since one year ago each

PUBLIC HEALTH ACTIONS Parents were sensitized on the importance of presenting

to the Health center on time

Active case search continue in Nimba County

Specimens were collected and sent to Liberia Institute of Bio-Medical Research (LIBR)