South Sudan IDSR Annex - W45 2017 Nov 6-Nov 12 · 4 W45 2017 (Nov 06-Nov 12) • Overall, malaria...

South Sudan

Ministry of Health

Republic of South SudanPrinted: 07:42 Wednesday, 15 November 2017 UTC

Integrated Disease Surveillance and

Response (IDSR)

Annexes W45 2017 (Nov 06-Nov 12)

Access and Utilisation

Slide 2 Map 1 Map of consultations by county (2017)

Indicator-based surveillance

Slide 3 Figure 1 Proportional mortality

Slide 4 Figure 2 Proportional morbidity

Slide 5 Figure 3 Trend in consultations and key diseases

Disease trends and maps

Malaria

Slide 6 Trend in malaria cases over time

Slide 7 Malaria maps and alert management

Acute Watery Diarrhoea (AWD)

Slide 8 Trend in AWD cases over time

Slide 9 AWD maps and alert management

Bloody diarrhoea

Slide 10 Trend in bloody diarrhoea cases over time

Slide 11 Bloody diarrhoea maps and alert management

Measles

Slide 12 Trend in measles cases over time

Slide 13 Measles maps and alert management

Sources of data

1. Weekly IDSR Reporting Form

2. Weekly EWARS Reporting Form

Contents

1 W45 2017 (Nov 06-Nov 12)

Map 1 | Map of total consultations by county (W45 2017)

Number of consultations

0 1 1,000 2,500 5,000

Hub W45 2017

South Sudan 98,183 6,159,766

Access and Utilisation | Map of consultations by county

2 W45 2017 (Nov 06-Nov 12)

Manyo

Rumbek North

Tambura

Rumbek CentreTwic East

Aweil West

Wulu

Ulang

Magwi

BudiYei

Aweil NorthGuit

Mayom

Abiemnhom

Tonj North

ToritLainya

Tonj East

Bor

Mundri East

Cueibet

Rumbek EastYirol East

Juba

Ibba

Awerial

Pochalla

Koch

Pariang

Yambio

Baliet

DukAkobo

Jur River

Tonj South

Terekeka

Kajo Keji

Maridi

Kapoeta 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 South

Aweil Centre

FangakLongechuk

Yirol West

Maban

Melut

Luakpiny Nasir

Fashoda

Panyijiar

Mayendit

Malakal

Rubkona

Ayod

Mundri West

Leer

Uror

Nyirol

Aweil 8,936 723,274

Bentiu 12,253 919,324

Bor 8,169 384,991

Juba 11,288 472,623

Kwajok 10,196 816,003

Malakal 6,005 724,187

Rumbek 16,511 728,112

Torit 3,648 342,294

Wau 9,524 581,891

Yambio 11,653 467,067

Figure 2 | Proportional morbidity (2017)

Malaria

Acute Respiratory Infection

(ARI)

Acute Watery Diarrhoea

Bloody diarrhoea

Acute Jaundice Syndrome (AJS)

Measles

Other

Syndrome W45 2017

# cases % morbidity # cases % morbidity

Malaria 37,799 59.1% 2,243,696 60.5%

ARI 7,437 11.6% 387,261 10.4%

AWD 5,510 8.6% 511,620 13.8%

Bloody

diarrhoea

747 1.2% 80,384 2.2%

AJS 0 0.0% 1,598 0.0%

Measles 517 0.8% 1,604 0.0%

Other 11,906 18.6% 480,507 13.0%

Total cases 63,916 100% 3,706,670 100%

Proportional morbidity

4 W45 2017 (Nov 06-Nov 12)

• Overall,malariaisthetopcauseofmorbidityaccountingfor59%ofthetotalconsultationsinweek45;followedbyARI(12%),andAWD(8.6%).

Figure 3 | Trend in total consultations and key diseases (W39)

Total consultations

Malaria

Acute Respiratory Infection (ARI)



Measles

Trend in consultations and key diseases

5 W39 2017 (Sep 25-Oct 01)

Num

ber

W39 2

016

W44 2

016

W48 2

016

W52 2

016

W05 2

017

W09 2

017

W13 2

017

W18 2

017

W22 2

017

W26 2

017

W31 2

017

W35 2

017

W39 2

017

0

25000

50000

75000

100000

125000

150000

175000

200000

225000

250000

275000

IDSRtrendsinabsolutecountsFigure 3 | Trend in total consultations and key diseases (W45)

Total consultations

Malaria




Measles


5 W45 2017 (Nov 06-Nov 12)

Num

ber

W48 2

016

W52 2

016

W05 2

017

W09 2

017

W13 2

017

W18 2

017

W22 2

017

W26 2

017

W31 2

017

W35 2

017

W39 2

017

W44 2

017

0

25000

50000

75000

100000

125000

150000

175000

200000


Total consultations

Malaria




Measles


5 W39 2017 (Sep 25-Oct 01)

Num

ber

W39 2

016

W44 2

016

W48 2

016

W52 2

016

W05 2

017

W09 2

017

W13 2

017

W18 2

017

W22 2

017

W26 2

017

W31 2

017

W35 2

017

W39 2

017

0

25000

50000

75000

100000

125000

150000

175000

200000

225000

250000

275000

IDSRProportionatemorbiditytrends

Intherelativelystablestates,malariaisthetopcauseofmorbidityaccountingfor48%oftheconsultationsinweek45withacumulative41%in2017.Themalariaproportionatemorbidityincreasedfromanaverageof30%priortothemalariatransmissionseasontonearly48%currently.

0

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0%

10%

20%

30%

40%

50%

60%

70%

1 2 3 4 5 6 7 8 9 101112131415161718192021222324252627282930313233343536373839404142434445

Num

bero

fcon

sulta

tions

Thou

sand

s

Morbidity%

Epidemiologicalweekofreportingin2017

Fig.1|IDSRProportionatemorbiditytrends,week1to45,2017

Consultations Malaria ARI AWD ABD Measles


Total consultations

Malaria




Measles


5 W39 2017 (Sep 25-Oct 01)

Num

ber

W39 2

016

W44 2

016

W48 2

016

W52 2

016

W05 2

017

W09 2

017

W13 2

017

W18 2

017

W22 2

017

W26 2

017

W31 2

017

W35 2

017

W39 2

017

0

25000

50000

75000

100000

125000

150000

175000

200000

225000

250000

275000

IDPProportionatemorbiditytrends

IntheIDPs,ARIsurpassedmalariaasthetopcauseofmorbidityinweek45.HenceARIandmalariaaccountedfor24%and21%ofconsultationsinweek45.

0

5,000

10,000

15,000

20,000

25,000

30,000

35,000

40,000

45,000

50,000

0%

5%

10%

15%

20%

25%

30%

35%

40%

45%

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45

Consultatio

ns

%ofM

obidity

Epiweek2017

Fig.2|IDPProportionatemorbiditytrends,week01-45,2017

Consultations Malaria ARI AWD ABD Measles

Figure 1 | Proportional mortality (2017)

Malaria

Acute Respiratory Infection

(ARI)


Bloody diarrhoea


Measles

Other

Syndrome W45 2017

# deaths % mortality # deaths % mortality

Malaria 948 99.9% 2,067 80.7%

ARI 1 0.1% 40 1.6%

AWD 0 0.0% 90 3.5%

Bloody

diarrhoea

0 0.0% 32 1.3%

AJS 0 0.0% 1 0.0%

Measles 0 0.0% 11 0.4%

Other 0 0.0% 319 12.5%

Total deaths 949 100% 2,560 100%

Proportional mortality

3 W45 2017 (Nov 06-Nov 12)

Acute Watery Diarrhoea | Trends over time

8 W45 2017 (Nov 06-Nov 12)

Figure 5a | Trend in AWD cases over time (South Sudan)

0

5000

2500

7500

10000

12500

15000

17500

20000

Graph legend

2017

− · − · − · − − 2016

− − − − − − − 2015

· · · · · · · · · · 2014

511,620Cases

90Deaths

67Alerts

Key AWD indicators (2017) Figure 5b | % morbidity Figure 5c | Age breakdown

Jan Mar May Jul Sep Nov

Map 4 | Map of AWD cases by county (2017)

a. 2014 b. 2015

c. 2016 d. 2017

Acute Watery Diarrhoea | Maps and Alert Management

9 W45 2017 (Nov 06-Nov 12)

Map 5 | Map of AWD alerts by county (2017)

Map legend

Number of AWD cases

0 1 5,000 10,000 20,000

Number of AWD alerts

0 1 10

Alert threshold

Twice the average number of cases over

the past 3 weeks. Source: IDSR

67Alerts

21Verified

0Low Risk

0Moderate Risk

0High Risk

0Very High Risk

Risk Assessment

Acute Bloody Diarrhoea | Trends over time

10 W45 2017 (Nov 06-Nov 12)

Figure 6a | Trend in bloody diarrhoea cases over time (South Sudan)

0

500

1000

1500

2000

2500

3000

3500

Graph legend

2017

− · − · − · − − 2016

− − − − − − − 2015

· · · · · · · · · · 2014

80,384Cases

32Deaths

121Alerts

Key bloody diarrhoea indicators (2017) Figure 6b | % morbidity Figure 6c | Age breakdown


Map 6 | Map of bloody diarrhoea cases by county(2017)

a. 2014 b. 2015

c. 2016 d. 2017

Acute Bloody Diarrhoea | Maps and Alert Management

11 W45 2017 (Nov 06-Nov 12)

Map 7 | Map of bloody diarrhoea alerts by county (2017)

Map legend

Number of bloody diarrhoea cases

0 1 500 1,000 2,000

Number of alerts

0 1 10

Alert threshold

Twice the average number of cases over the

past 3 weeks. Source: IDSR

121Alerts

44Verified

1Low Risk

0Moderate Risk

0High Risk

0Very High Risk

Risk Assessment

Sincethebeginningof2017,atleast1,124suspectmeaslescasesincludingatleast11deaths(CFR0.97%)havebeenreported.Ofthese,616suspectcaseshaveundergonemeaslescase-basedlaboratory-backedinvestigation.Atleast323sampleshavebeencollected,withatotalof84measlescasesbeinglaboratoryconfirmed,while321casesand26caseswereepidemiologicallyandclinicallyconfirmedrespectively.Consequently,measlesoutbreakswereconfirmedinninecounties– Panyijiar,AweilSouth,GogrialEast,GogrialWest,Wau,Juba,Torit,Yambio,andJurRiver.MeaslesfollowupcampaignimplementedfromMay2017ineightstatehubswhere1,639,947childrensixto49months(87%)werereachedwithmeaslesvaccine.

Measles | Trends over time

12 W45 2017 (Nov 06-Nov 12)

Figure 7a | Trend in number of cases over time (South Sudan)

0

50

100

150

200

250

300

Graph legend

2017

− · − · − · − − 2016

− − − − − − − 2015

· · · · · · · · · · 2014

1,124Cases

11Deaths

55Alerts

Key measles indicators (2017) Figure 7b | % morbidity Figure 7c | Age breakdown


Map 7 | Map of measles cases by county (2017)

a. 2014 b. 2015

c. 2016 d. 2017

Measles | Maps and Alert Management

13 W45 2017 (Nov 06-Nov 12)

Map 8 | Map of measles alerts by county (2017)

Map legend

Number of measles cases

0 1 50 100 250

Number of measles alerts

0 1 10

Alert threshold

1 case.

Source: IDSR

55Alerts

20Verified

0Low Risk

0Moderate Risk

1High Risk

1Very High Risk

Risk Assessment

Malaria | Trends over time

6 W45 2017 (Nov 06-Nov 12)

Figure 4a | Trend in number of cases over time (South Sudan)

0

20000

40000

60000

80000

100000

120000

Graph legend

2017

− · − · − · − − 2016

− − − − − − − 2015

· · · · · · · · · · 2014

2,243,696Cases

2,067Deaths

71Alerts

Key malaria indicators (2017) Figure 4b | % morbidity Figure 4c | Age breakdown


Map 2 | Map of malaria cases by county (2017)

a. 2014 b. 2015

c. 2016 d. 2017

Malaria | Maps and Alert Management

7 W45 2017 (Nov 06-Nov 12)

Map 3 | Map of malaria alerts by county (2017)

Map legend

Number of malaria cases

0 1 10,000 20,000 50,000

Number of malaria alerts

0 1 10

Alert threshold

Twice the average number of cases

over the past 3 weeks. Source: IDSR

71Alerts

21Verified

1Low Risk

0Moderate Risk

0High Risk

0Very High Risk

Risk Assessment

RainfallexperienceforOctober2017

• MapsshowrainfallforOctober2017percentageofaverage(lessthan25%bellowisbellownormal,75-125%isnormal,greaterthan125%isabovenormal) andstandardizedprecipitationindex(SPI)

• InOctober2017;allcountiesreceivedeithernormalorbelownormalrainsapartfromKapoetaSouth;KapoetaNorth;KapoetaEast;andBudithatwereextremelywet(SPI- map).

• ProjectionsforNovember2017showthattheSouthernStatesarelikelytoreceive>300mmofrainfall;areasofcentralSouthSudanwilllikelyreceive10mm-100mmofrainfall;whilenorthernSouthSudanwillreceivetheleast(<10mm)ofrainfall.

• MostmalariacasesareoccurringincountiesinIPCcrisisphase

• TwocountieswithhighmalariacasesareinIPCemergencyphase-

• ManyofthecountiesinJongleiareinIPCcrisisphasebutmalariasurveillancedataisnotavailableforthoselocations

Malariatrendsbycounty

o At least 23 countries - Awerial, Cueibet,Rumbek East, Rumbek North, Wulu, YirolEast, Yirol West, Aweil East, Aweil North,Aweil South, Jur River, Gogrial East, TonjNorth, Tonj South, Rubkona, Twic East, Duk,Kapoeta North, Ikotos, Kapoeta East, &Terekeka have reported increasing trends ator above the third quartile [see next fourslides].

Countieswithmalariacasesexceedingthethirdquartileinweek45of2017

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400

600

800

1,000

1,200

1,400

1,600

1,800

Weeks

MalariatrendsforTerekekacountyin2017

3rdQuartile C-sum 2017

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500

600

Weeks

MalariatrendsforKapoetaEastcountyin2017


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1,000

1,200

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MalariatrendsforIkotoscountyin2017


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Weeks

MalariatrendsforKapoetaNorthcountyin2017


Malariatrendsbycountyandrainfallpatterns

In October 2017; 4 countiesreceived rainfall that exceed thethird quartile of the rainfall forperiod 2013-2016. Thesecounties should be monitored forpotential increase in malariacases (see table)

County

Budi

Kapoeta East

Kapoeta South

KapoetaNorth


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500

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MalariatrendsforDukcountyin2017


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MalariatrendsforTwicEastcountyin2017


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MalariatrendsforAwerialcountyin2017


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1,000

1,500

2,000

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MalariatrendsforCueibetcountyin2017


Malariatrendsbycountyandrainfallpatterns

• During 2017, the mean rainfallin millimeters increased from2.7 and 13 in January andFebruary to a peak of 158-185in July, August, andSeptember).

• The mean precipitationreduced from 158 millimetersin September 2017 to 85.5millimeters in October 2017


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500

1,000

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MalariatrendsforRumbekCentercountyin2017


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MalariatrendsforRumbekEastcountyin2017


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MalariatrendsforRumbekNorthCountyin2017


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MalariatrendsforWuluCountyin2017


MalariatrendsbycountyandrainfallpredictionsforOctobertoDecember2017

The rainfall outlook for Oct-Dec2017 as shared by the IGADclimate prediction & applicationcenter (ICPAC) shows that:

• Southwestern parts the countrywill likely receive normal toabove normal rainfall (near tobelow normal rains in rest ofcountry)

• Above normal temperaturescountrywide

• The above normal rains in thesouthwest will likely lead toflooding, a protracted malariatransmission season, increasedrisk of waterborne diseases

• In the rest of country, low rainswill likely reduce quality of waterthus a possibly exaggerated riskof waterborne diseases


-

500

1,000

1,500

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2,500

Weeks

MalariatrendsforYirolEastCountyin2017


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MalariatrendsforYirolEastCountyin2017


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MalariatrendsforAweilCenterCountyin2017


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16,000

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MalariatrendsforAweilEastCountyin2017


Malariatrendsbycountyandproposedmitigationmeasures

Proposed mitigation measures forareas expected to receive normalor above normal rain:• Contingency planning, riskcommunication

• Preposition kits for malaria,waterborne diseases

• Enhance surveillance for malaria,AWDs

• Preventive vaccination whereapplicable

As for areas expected to have lessthan normal rains, therecommended measures entail:

• Enhance WASH, water qualitytesting, water trucking, & watertreatment

• Nutrition surveillance &prepositioning of SAM kits


-

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1,000

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MalariatrendsforAweilNorthCountyin2017


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MalariatrendsforRubkonaCountyin2017


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MalariatrendsforJurRiverCountyin2017


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MalariatrendsforGogrialEastCountyin2017


MalariatrendsbycountyandproposedmitigationmeasuresCountieswithmalariacasesexceedingthethirdquartileinweek45of2017

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MalariatrendsforTonjEastCountyin2017


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MalariatrendsforTonjNorthCountyin2017


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MalariatrendsforTonjSouthCountyin2017


Malaria trends in select IDP sites

Malaria trends in four of the large IDP sites - Bentiu Poc; UN House Poc; Malakal PoC; and Renk are either at or belowthe third quartile

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10

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70

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

Proportionatemorbidity%

EpiWeek

Figure10a|MalariatrendforIDPsinBentiuPoC2017

Thirdquartile Propmob 2017

- 5

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50

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51

Proportionatemrobidity%

Epiweek

Figure10c|EWARNtrendsforMalariainUNHouse,2017


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80

1 3 5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53

Proportio

natemorbidity%

Weekofreporting

Figure10b|MalariatrendforIDPsinMalakalPoC,2017


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Proportio

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orbidity%

Figure10d|EWARNtrendsforMalariainRenk,2017


Visceral Leishmaniasis | Kala-azar

Kala-azar is endemic in Upper Nile, Unity,Jonglei, & Kapoeta. Responseinterventions have been complicated byinsecurity, population displacement, poorliving conditions, increasing food insecurity,closure of treatment facilities; and lowtreatment completion rates.

Since the beginning of 2017, a total of2,722 cases including 56 deaths (CFR2.1%); 23 (0.8%) defaulters; 2,339(85.9%) new cases; 119(4.4%) PKDL; and264(9.7%) relapses - all reported from lessthan half of the 23 treatment centers.

In the corresponding period of 2016, a totalof 3,513 cases including 85 deaths (CFR2.6%) and 65(2.0%) defaulters werereported from 21 treatment centers.The majority of cases in 2017 have been reported from Lankien (1,181), Old Fangak (733), Kurwai (201), Chuil (103), Walgak (122), Pagil (62), Malakal IDP (96), Kapoeta (42), and Bunj (45).

The most affected groups include, males [1,322 cases (48.6%)], those aged 5 - 14years [1,112(40.9%) and ≥15years and above[922 cases (33.9%)]. A total of 519 cases (19.1%)] occurred in children <5years.

We are currently in the peak transmission season [September to December]. Hence current efforts by the taskforce entail trainingof health workers, and stocking ample supplies of diagnostics and medicines at all designated treatment centers.

In recent years, we have seen more than expected transmission from September to December in areas affected by conflict,displacement, severe food insecurity, and poor living conditions.

3

patients. Currently one team is in Kapoeta South and Kapoeta East the next teams will travel to Malakal and Fangak

x IMA/KalaCore in collaboration with WHO/MOH have responded to two suspected cases

(both are children) of KA at Alshaba Hospital in Juba. One of the cases is positive, currently on treatment and the other negative.

x Strengthening coordination amongst partners, there will be KA coordination meeting on the 3rd of Nov 2017.

x Conduct training on the use of IEC materials and conduct KA awareness using the IEC materials in KA endemic areas.

Graph:1Cummulative number of VL new cases by 43 (23rd Oct 2017 – 29th Oct 2017).

Graph: 2 Cumulative numbers of VL new cases and total cases by facilities – Week 1- to 43

Hepatitis E Virus (HEV)

Hepatitis E virus transmissioncontinues to be reported indisplaced populations.Genotype 1 has been isolatedfrom these outbreaks since2012. This therefore suggestssub-optimal access to safewater and sanitation astransmission drivers.

Cumulatively, a total of 452HEV cases have been reportedfrom Bentiu PoC in 2017 [onecase reported in the week]. (Fig.19). Current response entailsbehavior changecommunication to improvehygiene, access to safe water,and sanitation.Since the beginning of the crisis, 3,692 HEV cases including 25 deaths (CFR 0.68%) reported in Bentiu; 174 casesincluding seven deaths (CFR 4.4%) in Mingkaman; 38 cases including one death (CFR 2.6%) in Lankien; 3 confirmed HEVcases in Melut; 3 HEV confirmed cases in Guit;1 HEV confirmed case in Leer; and Mayom/Abyei [75 cases including 13deaths with 7 HEV PCR positive cases.

0

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02468

10121416

3 9 152127333945515 11172329354147536 121824303642482 8 1420263238

2014 2015 2016 2017

No.ca

sesinBentiu

No,casesinothersites

Epidemiological weekAwerial Lankien Bentiu

Acute Flaccid Paralysis | Suspected Polio

In week 44, 13 new AFP cases were reported with date of onset in 2017 from Eastern Equatoria (2), Jonglei (2), Lakes (2), Northern Bahr el Ghazal (1), Unity (2), Upper Nile (2), and Warrap (3).

During 2017, a cumulative of 321 AFP cases have been reported countrywide. The annualized non-Polio AFP (NPAFP) rate (cases per 100,000 population children 0-14 years) is 4.61 per 100,000 population of children 0-14 years (target ≥2 per 100,000 children 0-14 years).

Stool adequacy was 88% in 2017, a rate that is higher than the target of ≥80%.

Environmental surveillance ongoing sinceMay 2017; with 16 samples testing positivefor non-polio enterovirus.

Source: South Sudan Weekly AFP Bulletin

By County 2016

2017

*As of epidemiological week 44/2017 # of Counties / stool adequacy rates in 2017*

State Hubs =0 >0<79 80-89% >90 Total

CENTRAL EQUATORIA HUB 3 0 1 2 6 EASTERN EQUATORIA HUB 1 0 0 7 8 JONGLEI HUB 4 1 0 6 11 LAKES HUB 0 0 1 7 8

NORTHERN BAHR EL GHAZAL HUB 0 1 2 2 5

UNITY HUB 3 3 0 3 9 UPPER NILE HUB 5 5 1 1 12 WARRAP HUB 0 0 1 6 7

WESTERN BAHR EL GHAZAL HUB 0 2 0 1 3

WESTERN EQUATORIA HUB 0 1 0 9 10

Total number 16 13 6 44 79

Percent 20% 16% 8% 56% 100% *As of epidemiological week 44/2017

Mortality in the IDPs

Prospective mortality surveillance is ongoing in the large internally displaced population camps that areprincipally located in the UN Protection of Civilian sites in Bentiu, Malakal, Wau, and Juba.

Among the IDPs from these locations, mortality data was received from Akobo and UN House PoC in week45. (Table 6). Four deaths were reported during the reporting week. UN House PoC reported 4 (100%)deaths in the week. During the week, 4 (100%) deaths were recorded among children <5 years in (Table 6).

The causes of death in the IDP sites during the current week are shown in Table 6. The top causes of mortality in the week were pneumonia and malaria each accounting for 50% of the respective deaths in the week.

Table 6 | Proportional mortality by cause of death in IDPs W45 2017

CauseofDeathbyIDPsite

Juba3Totaldeaths

Proportionatemortality[%]<5yrs

Malaria 2 2 50

Pneumonia 2 2 50

GrandTotal 4 4 100

Crude and under five mortality rates in IDPs

The U5MR in all the IDP sites that submitted mortality data in week 45 of 2017 is below the emergency threshold of 2 deaths per 10,000 per day (Fig. 20).

The Crude Mortality Rates [CMR] in all the IDP sites that submitted mortality data in week 45 of 2017were below the emergency threshold of 1 death per 10,000 per day (Fig. 21).

0.0

0.5

1.0

1.5

2.0

2.5

1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 3 6 9 12 15 18 21 24 27 30 33 36 39 42 45

2016 2017

deathsper10,000perd

ay

Epidemiological week

Figure20|EWARNU5MRbySite- W12016toW45of2017

Bentiu Juba3 Malakal Threshold WauPoC

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

1.6

1 4 7 10 13 16 19 22 25 28 31 34 37 40 43 46 49 52 3 6 9 12 15 18 21 24 27 30 33 36 39 42

2016 2017

deathsper10,000perd

ay

Epidemiological week

Figure21|EWARNCrudeMortalityRateforW12016toW45of2017

Bentiu Juba3 Malakal MelutAkobo WauShiluk Threshold WauPoC

Overall mortality in the IDPs in 2017

• A total of 808 deaths have been reported from the IDP sites in 2017 Table 7.

• The top causes of mortality in the IDPs in 2017 include malaria, medical complications ofmalnutrition, pneumonia, perinatal complications, and TB are shown in Table 7.

Table 7 | Mortality by IDP site and cause of death as of W45, 2017WEEK45

IDPsite Acutewatery

diarrhoe

a

GSW

HeartFailure

Kala-Azar

Malaria

Materna

ldeath

Men

ingitis

Perina

taldeath

Pneu

mon

ia

Rab

ies

SAM

Stroke

TB/H

IV/A

IDS

Cancer

TB Cholera

HIV/A

IDS

Hypertention

Susp.TB

TB

Others

Grand

Total

Bentiu 20 10 14 2 39 4 3 31 18 1 55 3 7 10 2 2 8 24 20 223 496Juba3 3 5 19 11 20 1 1 2 15 1 2 14 32 126Kodok 1 2 3Malakal 2 2 7 5 2 5 6 1 1 6 64 101Akobo 3 2 2 16 8 1 1 1 14 48BorPOC 1 14 15WauPoC 9 1 1 1 1 6 19GrandTotal 35 12 21 4 76 6 3 50 51 2 57 9 8 19 2 2 25 2 29 40 355 808Proportionate

mortality[%] 4.3 1.5 2.6 0.5 9.4 0.7 0.4 6.2 6.3 0.2 7.1 1.1 1.0 2.4 0.2 0.2 3.1 0.2 3.6 5.0 43.9 100.0

For more help and support,

please contact:

Dr. Pinyi Nyimol Mawien

Director General Preventive Health Services

Ministry of Health

Republic of South Sudan

Telephone: +211 955 604 020

Dr. Mathew Tut Moses

Director Emergency Preparedness and Response (EPR)

Ministry of Health

Republic of South Sudan

Telephone: +211 956 420 189Notes

WHO 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 and

USAID for providing financial support.

The data has been collected with support from the EWARS project. This is an initiative to strengthen

early warning, alert and response in emergencies. It includes an online, desktop and mobile

application that can be rapidly configured and deployed in the field. It is designed with frontline users

in mind, and built to work in difficult and remote operating environments. This bulletin has been

automatically published from the EWARS application.

More information can be found at http://ewars-project.org

Ministry of Health

Republic of South

Sudan

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