1. Report on Field work EPI Week 31 – 42, 2015 PRESENTED BY: KLEEKER M.D. JUKORYAN District Surveillance Officer Date: November 2, 2015

2. Background Commonwealth District projected population of 302,829 72 functional health facilities. The District has Four Zones 1100A1 (Duport Road – Soul Clinic/Omega) – 144,717 1100A2 (R2 – ELWA Junction /Zubah Town/GSA Road) – 77,710 1100B2 (Pipeline – Wein Town/FDA) – 46,712 1500 (Mt. Barclay/ Fendell – Johnsonville/Louisiana) – 33,690 2

3. Expanded Surveillance Report Summary Total IMRD = 294 Cases All zones reported regularly except for Epi week 31 of zone 1500 which did not report. All facilities were proactive, except in week 31 that 8 facilities out of 72 did not report Reporting timeliness was not effective at the beginning, things improve later Suspected EVD: 90 Alive and 10 Deaths Expectation : facilities will be able to submit their reports on time 3

4. Zones Wk 31 Wk 32 Wk 33 Wk 34 Wk 35 Wk 36 Wk 37 Wk 38 WK 39 Wk 40 Wk 41 Wk 42 %Timeliness cumulative YTD % Completeness Cumulative YTD 1100 A1 LLLTTTTTTTTT75%100% 1100 A2 LTTTTTTTTTTT92%100% 1100 B2 LLTTTT T TTTTT83%100% 1500 MLLTTT T TTTTT75%92% Timeliness and completeness of Zonal reporting Table, Commonwealth District-Liberia, Epi (Wks 31 – Wk42) 2015 weeks Report on Time = T Late=L Never Reported=M % Completeness Cumulative >=80% on Time >= 50 - 79.9% on Time < 50% on Time Legend: 4

5. Timeliness of Zonal weekly reporting, Commonwealth District, Epi Wk 31 – Wk42, 2015 Public health Action: The District Health Team conducted a meeting with HF heads on importance of timely reporting of data 5

6. Completeness of Zonal weekly reporting, Commonwealth District, Epi Wk 31- 42-2015 All Zones met the national target 80% and above Public health action: Zones encouraged to keep it up; Zone 1500 will require monitoring 6

7. DISEASE/ EVENTTotal CasesTotal DeathsCase Fatality Rate ACUTE FLACCID PARALYSIS( AFP) 200% SUSPECTED MEASLES 7200% NEONATAL TETANUS 100% SUSPECTED EBOLA VIRUS DISEASE (EVD) 901011% DYSENTERY (NON BLOODY) 3800% CHOLERA 000% LASSA FEVER 000% YELLOW FEVER 000% OTHER VHF 000% MENINGITIS 000% HUMAN RABIES ( ANIMAL BITES) 3500% MATERNAL DEATH 0 0 NEONATAL DEATH 2 2 AWD 5200% CHICKEN POX 300% Summary of key Notifiable Diseases of Cases and Deaths, Commonwealth District, Liberia, Epi Wk31- Wk42 7

8. Trend of Measles Cases in Commonwealth District, Liberia, Epi Wk 31 – 42, 2015 Epi wk 35: High increase in suspected measles cases from the Fofe Community in the District Public Health Action: Outbreak investigation was conducted and outreach Campaign intensified in affected community 8

9. Trend of EVD Cases and Deaths in Commonwealth District, Liberia, Epi Wk 31 – 42, 2015 High increase in suspected EVD Cases in Epi Wk 38 and Epi Wk 39 due change in case definition Public Health Action: suspected EVD cases were investigated; all tested negative 9

10. Surveillance Quality Analysis Problem Weak Reporting System Team Composition/ Members gCHVs Health Facility OICs and Surveillance Focus Persons District Health Team County Health Team Partners (WHO, IRC, ETC) 10

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12. Recommendations DHT organize training for Health facility Staff for preparing graphs and using it to analyze and interpret data provide feedback to facilities MCHT/ MOH/Partners establish laboratory testing for Immediately Reportable Diseases (IRDs) at Health Facilities make reporting/ surveillance tools available at all District offices provide support to District to conduct its regular monthly meeting for OICs and Surveillance focal persons provide Transportation( Vehicles or Motorcycles) to enable the DHT function actively 12

13. Acknowledgement I wish to acknowledge the following persons All our Mentors Faculties and Staff of Emory and AFENET Our Bosses at the CHT and MOH All local and International Partners 13

14. Thanks 14