South Sudan
Ministry of HealthRepublic of South Sudan Printed: 17:56 Monday, 25 September 2017 UTC
Integrated Disease Surveillance andResponse (IDSR)
Epidemiological Update W37 2017 (Sep 11-Sep 17)
Surveillance
Slide 1 Table 1 IDSR surveillance performance indicators by county (W37)
Table 2 Summary of key IDSR surveillance indicators
Table 3 IDSR report submissions (W37)
Slide 2 Figure 1 Trend in IDSR completeness over time
Slide 3 Map 1a Map of IDSR completeness by county (W37)
Map 1b Map of IDSR timeliness by county (2017)
Slide 4 Table 4 EWARS surveillance performance indicators by partner(W37)
Table 5 Summary of key EWARS surveillance indicators
Table 6 EWARS report submissions (W37)
Alert
Slide 5 Table 7 Alert performance indicators by Hub (W37)
Table 8 Summary of key alert indicators
Slide 6 Table 9 Alert performance indicators by event (W37)
Table 10 Event risk assessment
Slide 7 Map 2a - 2f Maps of key disease alerts by county (W37)
Response
Cholera
Slide 8 Table 11 Summary of key cholera response indicators
Slide 9 Figure 2 Cholera epidemic curve (National)
Slide 10 Map 3a - 3d Maps of distribution of cholera cases (Jul 2016 -present)
Slide 11 Figure 3a - 3k Cholera epidemic curves by county
Slide 12 Table 12 Summary of response indicators by Hub
Slide 13 Figure 4a Cholera cases by sex (2017)
Figure 4b Cholera cases by age (2017)
Figure 4c Cholera cases by patient outcome (2017)
Sources of data
1. Weekly IDSR Reporting Form
2. Weekly EWARS Reporting Form
3. Daily cholera line list
4. Event based surveillance form
Contents
W37 2017 (Sep 11-Sep 17)
Highlights W37 2017
Surveillance
Completeness for IDSR reporting at county level was 59% . Completeness forEWARS reporting from IDP sites was 74% .
Alert
A total of 20 alerts were reported, of which 30% have been verified. 0 alerts wererisk assessed and 0 required a response.
Response
A total of 17 new cholera cases and 0 deaths (CFR 0.0% ) were reported.The cumulative total since the start of the current outbreak on 18 June 2016 is20,563 cases and 378 deaths (CFR 1.8% )*.
* Note: The cholera data may be subject to adjustments as linelist data continues to received and entered from the field.
W37 2017 (Sep 11-Sep 17)
Hub Reporting Performance
# counties # reportsreceived Completeness Timeliness
Aweil 5 2 40% 40%
Bentiu 9 5 56% 56%
Bor 11 6 55% 55%
Juba 6 4 67% 67%
Kwajok 7 3 43% 43%
Malakal 13 1 8% 8%
Rumbek 8 8 100% 100%
Torit 8 7 88% 88%
Wau 3 2 67% 67%
Yambio 10 9 90% 90%
South Sudan 80 47 59% 59%
Table 1 | IDSR surveillance performance indicators by county (W37 2017) Table 2 | Summary of key IDSR surveillance indicators
W37 Cumulative (2017)
80 - Number of counties
59% 72% Completeness
59% 64% Timeliness
Table 3 | IDSR report submissions
W37 Cumulative (2017)
47 2,239 total submissions
23 428 submissions by mobile
24 765 submissions by web
Surveillance | IDSR surveillance indicators
1 W37 2017 (Sep 11-Sep 17)
Figure 1 | Trend in IDSR completeness over time
Completeness
Surveillance | Trend in IDSR completeness
2 W37 2017 (Sep 11-Sep 17)
Per
cent
W39 2016 W44 2016 W48 2016 W52 2016 W05 2017 W09 2017 W13 2017 W18 2017 W22 2017 W26 2017 W31 2017 W35 20170%
20%
40%
60%
80%
100%
Map 1a | Map of IDSR completeness by county (W37 2017)
Completeness 0 25% 50% 75% 100%
Map 1b | Map of IDSR completeness by county (2017)
Completeness 0 25% 50% 75% 100%
Surveillance | Maps of IDSR completeness by county
3 W37 2017 (Sep 11-Sep 17)
Manyo
Rumbek North Uror
Tambura
Rumbek Centre Twic East
Aweil West
Wulu
Ulang
Magwi
BudiYei
Aweil North GuitMayom
Abiemnhom
Tonj North
ToritLainya
Tonj East
Bor
Mundri East
Cueibet
Rumbek EastYirol East
Nyirol
Juba
Ibba
Awerial
Pochalla
Koch
Pariang
Yambio
Baliet
DukAkobo
Jur River
Tonj South
Terekeka
Kajo Keji
MaridiKapoeta North
Renk
Ikotos
Kapoeta East
Kapoeta South
Lopa Lafon
Panyikang
Morobo
Twic
Raja
Canal Pigi
Wau
Mvolo
Nagero
Maiwut
Pibor
Gogrial East
Nzara
Abyei
Ezo
Aweil East
Gogrial WestAweil SouthAweil Centre
FangakLongechuk
Yirol West
Maban
Melut
Luakpiny Nasir
Leer
Fashoda
Panyijiar
Mayendit
Malakal
Rubkona
Ayod
Mundri West
Manyo
Rumbek North Uror
Tambura
Rumbek Centre Twic East
Aweil West
Wulu
Ulang
Magwi
BudiYei
Aweil North GuitMayom
Abiemnhom
Tonj North
ToritLainya
Tonj East
Bor
Mundri East
Cueibet
Rumbek EastYirol East
Nyirol
Juba
Ibba
Awerial
Pochalla
Koch
Pariang
Yambio
Baliet
DukAkobo
Jur River
Tonj South
Terekeka
Kajo Keji
MaridiKapoeta North
Renk
Ikotos
Kapoeta East
Kapoeta South
Lopa Lafon
Panyikang
Morobo
Twic
Raja
Canal Pigi
Wau
Mvolo
Nagero
Maiwut
Pibor
Gogrial East
Nzara
Abyei
Ezo
Aweil East
Gogrial WestAweil SouthAweil Centre
FangakLongechuk
Yirol West
Maban
Melut
Luakpiny Nasir
Leer
Fashoda
Panyijiar
Mayendit
Malakal
Rubkona
Ayod
Mundri West
Partner Performance Reporting
# sites # reportsreceived Completeness Timeliness
CMD 2 2 100% 100%
GOAL 2 2 100% 100%
HLSS 1 0 0% 0%
IMA 2 2 100% 100%
IMC 8 8 100% 100%
IOM 7 7 100% 100%
IRC 1 0 0% 0%
Medair 2 2 100% 100%
MSF-E 2 2 100% 100%
MSF-H 4 3 75% 75%
SMC 3 3 100% 100%
UNIDO 1 0 0% 0%
UNKEA 2 2 100% 100%
World Relief 1 0 0% 0%
Total 47 35 74% 74%
Table 4 | EWARS surveillance performance indicators by partner (W37 2017) Table 5 | Summary of key EWARS surveillance indicators
W37 Cumulative (2017)
47 - Number of EWARS reporting sites
74% 65% Completeness
74% 62% Timeliness
Table 6 | EWARS report submissions
W37 Cumulative (2017)
35 1,193 total submissions
0 67 submissions by mobile
35 1126 submissions by web
Surveillance | EWARS surveillance indicators
4 W37 2017 (Sep 11-Sep 17)
Hub W37 Cumulative (2017)
# alerts % verif. # alerts % verif.
Aweil 0 0% 7 29%
Bentiu 0 0% 68 37%
Bor 2 50% 99 44%
Juba 2 0% 55 15%
Kwajok 1 0% 31 32%
Malakal 2 0% 40 55%
Rumbek 5 20% 91 40%
Torit 4 75% 60 67%
Wau 2 50% 57 14%
Yambio 2 0% 43 40%
South Sudan 20 30% 551 38%
Table 7 | Alert performance indicators by Hub Table 8 Summary of key alert indicators
W37 Cumulative (2017)
20 551 Total alerts raised
30% 38% % verified
0% 31% % auto-discarded
0% 6% % risk assessed
0% 2% % requiring a response
Alert | Alert performance indicators
5 W37 2017 (Sep 11-Sep 17)
Event W37 Cumulative (2017)
# alerts % verif. # alerts % verif.
Indicator-based surveillance
Malaria 1 0% 49 35%
AWD 3 33% 43 37%
Bloody Diarr. 5 20% 86 38%
Measles 2 50% 42 33%
Meningitis 0 0% 0 0%
Cholera 3 0% 115 29%
Yellow Fever 0 0% 9 89%
Guinea Worm 4 25% 70 43%
AFP 1 100% 24 67%
VHF 0 0% 14 100%
Neo. tetanus 0 0% 6 100%
Event-based surveillance
EBS total 1 100% 21 95%
Table 9 | Alert performance indicators by event Table 10 | Event risk assessment
W37 Cumulative (2017)
0 9 Low risk
1 1 Medium risk
0 6 High risk
0 14 Very high risk
Alert | Event risk assessment
6 W37 2017 (Sep 11-Sep 17)
Map 2a | Malaria (W37 2017)
Number of alerts 0 1 10
Map 2d | Cholera (W37 2017)
Number of alerts 0 1 10
Map 2b | Bloody diarrhoea (W37 2017)
Number of alerts 0 1 10
Map 2e | Guinea Worm (W37 2017)
Number of alerts 0 1 10
Map 2c | Measles (W37 2017)
Number of alerts 0 1 10
Map 2f | Event-based surveillance (W37 2017)
Number of alerts 0 1 10
Alert | Maps of key disease alerts by county
7 W37 2017 (Sep 11-Sep 17)
Ulang
Nyirol
Juba
Budi
Yirol East
Kapoeta East
Mvolo
Malakal
Rumbek NorthJur RiverTonj South
Yirol West
Torit
Awerial
Torit
W24 2016 - W37 2017 Rapid Diagnostic Test Cholera Treatment Centre
Case fatality is likely to be under-estimated, due to under reporting of deaths that occur in the community and are not reported to health centres
W37
% n
17
82% 14
93% 13
88% 15
0.0% 0
0% 0
Cumul.
% n Indicator
20,563 1. Total number of cases reported
11% 2,261 2. % tested with cholera RDT
70% 1,581 3. % tested with cholera RDT that were positive
57% 11,762 4. % admitted to CTC
1.8% 378 5. Case Fatality Rate (CFR)
45% 171 6. % deaths in community
Response | Cholera response indicators
Table 11 | Summary of key cholera response indicators
8 W37 2017 (Sep 11-Sep 17)
1
2
3
4
1 2 3
4
Figure 2 Cholera epidemic curve (W24 2016 - W37 2017)
Cases Deaths
Response | Cholera epidemic curve
9 W37 2017 (Sep 11-Sep 17)
Num
ber
W26
201
6
W31
201
6
W35
201
6
W39
201
6
W44
201
6
W48
201
6
W52
201
6
W05
201
7
W09
201
7
W13
201
7
W18
201
7
W22
201
7
W26
201
7
W31
201
7
W35
201
7
0
200
400
600
800
1000
1200
1400
1600
1800
2000
Map 3a | Distribution of cholera cases (Jul 2016 - Sep 2016)
Map 3c | Distribution of cholera cases (Jul 2016 - Mar 2017)
Map 3b | Distribution of cholera cases (Jul 2016 - Dec 2016)
Map 3d | Distribution of cholera cases (Jul 2016 - present)
Number of cholera cases 0 1 10 50 100
Response | Maps of cholera distribution over time by county
10 W37 2017 (Sep 11-Sep 17)
Bor
Juba
Awerial
BorYirol East
Juba
Awerial
Duk
Canal PigiFangak
Panyijiar
Mayendit
Rubkona
Bor
Juba
Awerial
Canal PigiFangak
Panyijiar
Rubkona
Budi
Tonj East
BorYirol East
Juba
Awerial
Duk
Kapoeta NorthKapoeta East
Kapoeta South
Canal PigiFangak
Yirol West
Fashoda
Panyijiar
Mayendit
Rubkona
Ayod
Figure 3a | Bor Hub > Ayod county
Figure 3d | Bor Hub > Pigi Canal county
Figure 3b | Bor Hub > Duk county
Figure 3e | Rumbek Hub > Awerial county
Cases Deaths
Figure 3c | Bor Hub > Fangak county
Figure 3f | Rumbek Hub > Yirol East county
Response | Cholera epidemic curves by county
11 W37 2017 (Sep 11-Sep 17)
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
500
1000
1500
2000
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
50
100
150
200
250
300
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
50
100
150
200
250
300
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
50
100
150
200
250
300
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
50
100
150
200
250
300
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
50
100
150
200
250
300
Figure 3g | Rumbek Hub > Yirol West county
Figure 3j | Torit Hub > Kapoeta South county
Figure 3h | Torit Hub > Kapoeta East county
Figure 3k | Kwajok Hub > Tonj East county
Cases Deaths
Figure 3i | Torit Hub > Kapoeta North
Response | Cholera epidemic curves by county
11 W37 2017 (Sep 11-Sep 17)
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
50
100
150
200
250
300
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
50
100
150
200
250
300
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
100
200
300
400
500
600
700
800
900
1000
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
100
200
300
400
500
600
Num
ber
W35
201
6
W52
201
6
W18
201
7
W35
201
7
0
50
100
150
200
250
300
Case Fatality Rate % admitted to cholera treatment centre (CTC) % deaths that occurred in the commmunity
County W37
Cases Deaths CFR % adm. % comm.deaths
Awerial 0 0 0.0% 0% 0%
Ayod 0 0 0.0% 0% 0%
Canal Pigi 0 0 0.0% 0% 0%
Duk 0 0 0.0% 0% 0%
Fashoda 0 0 0.0% 0% 0%
Juba 17 0 0.0% 88% 0%
KapoetaEast
0 0 0.0% 0% 0%
KapoetaNorth
0 0 0.0% 0% 0%
KapoetaSouth
0 0 0.0% 0% 0%
Nyirol 0 0 0.0% 0% 0%
Panyijiar 0 0 0.0% 0% 0%
Tonj East 0 0 0.0% 0% 0%
Uror 0 0 0.0% 0% 0%
Yirol East 0 0 0.0% 0% 0%
Yirol West 0 0 0.0% 0% 0%
County Cumulative (W24 2016 - W37 2017)
Cases Deaths CFR % adm. % comm.deaths
Awerial 1,199 13 1.1% 57% 85%
Ayod 3,856 39 1.0% 8% 97%
Canal Pigi 206 5 2.4% 86% 0%
Duk 547 36 6.6% 94% 89%
Fashoda 771 12 1.6% 73% 8%
Juba 2,536 35 1.4% 84% 66%
KapoetaEast
2,105 26 1.2% 43% 62%
KapoetaNorth
993 1 0.1% 96% 0%
KapoetaSouth
1,017 10 1.0% 88% 60%
Nyirol 72 2 2.8% 93% 0%
Panyijiar 612 30 4.9% 73% 10%
Tonj East 2,456 43 1.8% 60% 56%
Uror 0 0 0.0% 0% 0%
Yirol East 1,502 67 4.5% 96% 0%
Yirol West 238 0 0.0% 96% 0%
Response | Cholera response indicators by county
Table 12 | Summary of key cholera response indicators in counties with active transmission
12 W37 2017 (Sep 11-Sep 17)
1 23
1 23
1 2 3
Figure 4a Cholera cases by sex (2017)
Male ( 46% ; n = 7,542 ) Female ( 53% ; n = 8,601)
Figure 4b Cholera cases by age (2017)
< 5 ( 21% ; n = 3,449 ) 5-14 ( 26% ; n = 4,160 ) 15-44 ( 41% ; n = 6,739 ) > 45 ( 11% ; n = 1,845 )
Figure 4c Cholera cases by outcome (2017)
Discharged ( 70.3% ; n = 11,423 ) Defaulted ( 0.3% ; n = 56 ) Died ( 1.8% ; n = 296 ) Admitted ( 6.3% ; n = 1,022 )
Response | Cholera cases by sex, age and outcome
13 W37 2017 (Sep 11-Sep 17)
For more help and support,please contact:
Dr. Pinyi Nyimol MawienDirector General Preventive Health ServicesMinistry of HealthRepublic of South Sudan
Telephone: +211 955 604 020
Dr. Mathew Tut MosesDirector Emergency Preparedness and Response (EPR)Ministry of HealthRepublic of South Sudan
Telephone: +211 955 295 257 NotesWHO and the Ministry of Health gratefully acknowledge health cluster and health pooled fund (HPF)partners who have reported the data used in this bulletin. We would also like to thank ECHO andUSAID for providing financial support.
The data has been collected with support from the EWARS project. This is an initiative to strengthenearly warning, alert and response in emergencies. It includes an online, desktop and mobileapplication that can be rapidly configured and deployed in the field. It is designed with frontline usersin mind, and built to work in difficult and remote operating environments. This bulletin has beenautomatically published from the EWARS application.
More information can be found at http://ewars-project.org
Ministry of HealthRepublic of SouthSudan
