Week-35 Ending 3 rd September 2017

(1)

Somalia Weekly

Update

Week-35

(2)

Part -I

(3)

Week-35 Somalia Weekly EPI/POL Update

Epidemiological Curve January 1, 2014

–

September 03, 2017

Graph no. 1

0 2 4 6 8 10 12 14 16 18 2 0 1 4W 0 1 2 0 1 4W 0 3 2 0 1 4W 0 5 2 0 1 4W 0 7 2 0 1 4W 0 9 2 0 1 4W 1 1 2 0 1 4W 1 3 2 0 1 4W 1 5 2 0 1 4W 1 7 2 0 1 4W 1 9 2 0 1 4W 2 1 2 0 1 4W 2 3 2 0 1 4W 2 5 2 0 1 4W 2 7 2 0 1 4W 2 9 2 0 1 4W 3 1 2 0 1 4W 3 3 2 0 1 4W 3 5 2 0 1 4W 3 7 2 0 1 4W 3 9 2 0 1 4W 4 1 2 0 1 4W 4 3 2 0 1 4W 4 5 2 0 1 4W 4 7 2 0 1 4W 4 9 2 0 1 4W 5 1 2 0 1 5W 0 1 2 0 1 5W 0 3 2 0 1 5W 0 5 2 0 1 5W 0 7 2 0 1 5W 0 9 2 0 1 5W 1 1 2 0 1 5W 1 3 2 0 1 5W 1 5 2 0 1 5W 1 7 2 0 1 5W 1 9 2 0 1 5W 2 1 2 0 1 5W 2 3 2 0 1 5W 2 5 2 0 1 5W 2 7 2 0 1 5W 2 9 2 0 1 5W 3 1 2 0 1 5W 3 3 2 0 1 5W 3 5 2 0 1 5W 3 7 2 0 1 5W 3 9 2 0 1 5W 4 1 2 0 1 5W 4 4 2 0 1 5W 4 6 2 0 1 5W 4 8 2 0 1 5W 5 0 2 0 1 5W 5 2 2 0 1 6W 0 2 2 0 1 6W 0 4 2 0 1 6W 0 6 2 0 1 6W 0 8 2 0 1 6W 1 0 2 0 1 6W 1 2 2 0 1 6W 1 4 2 0 1 6W 1 6 2 0 1 6W 1 8 2 0 1 6W 2 0 2 0 1 6W 2 2 2 0 1 6W 2 4 2 0 1 6W 2 6 2 0 1 6W 2 8 2 0 1 6W 3 0 2 0 1 6W 3 2 2 0 1 6W 3 4 2 0 1 6W 3 6 2 0 1 6W 3 8 2 0 1 6W 4 0 2 0 1 6W 4 2 2 0 1 6W 4 4 2 0 1 6W 4 6 2 0 1 6W 4 8 2 0 1 6W 5 0 2 0 1 6W 5 2 2 0 1 7W 0 2 2 0 1 7W 0 4 2 0 1 7W 0 6 2 0 1 7W 0 8 2 0 1 7W 1 0 2 0 1 7W 1 2 2 0 1 7W 1 4 2 0 1 7W 1 6 2 0 1 7W 1 8 2 0 1 7W 2 0 2 0 1 7W 2 2 2 0 1 7W 2 4 2 0 1 7W 2 6 2 0 1 7W 2 8 2 0 1 7W 3 0 2 0 1 7W 3 2 2 0 1 7W 3 4 2 0 1 7W 3 6 2 0 1 7W 3 8 N u m b er o f c a se s

(4)

Weekly AFP cases reported by Provinces, 2016-2017 Somalia. (

cases are distributed across weeks based on date of onset of paralysis

).

- 11 new AFP cases were reported this week making the total 248 AFP cases reported in 2017.

- In addition 744 contact samples (3 contacts for each case) and 83 community samples were collected from 14 districts.

- Mudug region is silent for 8 or more consecutive weeks. Silent regions are advised to collect community samples

Tab

le

n

o.

-1

Silent (not reporting) for > 8 weeks

Reported AFP cases

Community Samples collected in silent regions

Community Samples collected but regions not silent

PROVINCE 20 16 W2 8 20 16 W2 9 20 16 W3 0 20 16 W3 1 20 16 W3 2 20 16 W3 3 20 16 W3 4 20 16 W3 5 20 16 W3 6 20 16 W3 7 20 16 W3 8 20 16 W3 9 20 16 W4 0 20 16 W4 1 20 16 W4 2 20 16 W4 3 20 16 W4 4 20 16 W4 5 20 16 W4 6 20 16 W4 7 20 16 W4 8 20 16 W4 9 20 16 W5 0 20 16 W5 1 20 16 W5 2 20 16 T ot al 20 17 W0 1 20 17 W0 2 20 17 W0 3 20 17 W0 4 20 17 W0 5 20 17 W0 6 20 17 W0 7 20 17 W0 8 20 17 W0 9 20 17 W1 0 20 17 W1 1 20 17 W1 2 20 17 W1 3 20 17 W1 4 20 17 W1 5 20 17 W1 6 20 17 W1 7 20 17 W1 8 20 17 W1 9 20 17 W2 0 20 17 W2 1 20 17 W2 2 20 17 W2 3 20 17 W2 4 20 17 W2 5 20 17 W2 6 20 17 W2 7 20 17 W2 8 20 17 W2 9 20 17 W3 0 20 17 W3 1 20 17 W3 2 20 17 W3 3 20 17 W3 4 20 16 T ot al BANADIR 2 1 ₁ ₁ ₁ _{2 1} ₂ ₁ ₃₀ ₁ _{1 1 2 1} _{3 1} _{2 1 1 1 1 1} _{2 1 1} ₂ ₂ 25 GALGADUD 1 1 1 ₂ _{2 1} ₁ ₂₅ ₁ _{1 1} _{1 1} ₁ _{1 2 1} ₁ ₁ _{1 1} ₂ _{1 1} ₂ ₂₀ M. SHABELLE 1 1 ₁ _{1 1} ₁ ₁ ₁₉ ₁ ₁ _{1 1} _{1 1} _{1 1} ₁ ₁ ₁ _{1 1} ₁ ₁ ₁ ₁₆ L. SHABELLE 1 1 ₂ _{1 1 1} ₁ ₁ ₂ ₁ ₂₄ ₁ ₁ ₁ ₁ ₁ ₂ _{1 1 1 1} ₁ _{1 1} ₁ _{1 1} ₁ ₁₈ HIRAN 2 ₁ ₁ ₁ ₁₅ _{1 1 1} ₁ _{1 1 1} _{1 1 1} ₁ ₁ ₁ _{1 1} ₁₅ BARI 1 1 ₁ _{1 1} ₁ ₁ ₂ ₁ ₁ ₂₄ ₁ _{2 1} _{1 1} ₂ _{1 1 1 1 1} ₂ ₁ _{1 1} ₁₈ NUGAL 1 2 1 1 1 11 2 1 1 1 1 1 7 MUDUG 1 1 1 _{1 1} ₂ ₁ ₁ ₁₄ ₁ ₂ ₁ ₁ ₁ ₁ ₁ ₁ 9 TOGDHER 1 1 ₁ _{1 1} ₁ ₁₁ ₁ ₁ ₁ ₁ ₁ ₁ ₁ ₇ GALBEED 1 ₁ ₁ _{1 1} _{1 1 1 1 1} ₁₉ ₁ ₃ ₁ ₁ ₁ ₁ _{1 1 1} ₁ ₂ ₁ ₁₅ SANAQ 1 1 2 1 7 1 1 1 1 1 5 AWDAL 2 1 ₁ ₁ ₁ ₁ ₁ ₁ ₁₈ _{1 1 1} ₁ ₂ _{1 1 1 1} ₁ _{1 1} _{1 1} ₁₅ SAHIL 1 _{1 1} ₈ ₁ ₁ ₁ ₁ _{1 1} ₁ 7 SOOL 1 1 5 1 2 1 1 1 1 1 8 LOWER JUBA 1 2 1 2 1 1 1 1 2 1 1 26 2 1 1 2 2 1 1 1 1 1 1 1 1 2 2 1 1 22 BAY 1 1 1 2 1 2 19 3 1 3 1 1 1 1 1 1 13 GEDO 1 2 1 1 1 21 1 2 1 1 1 1 1 1 1 1 1 1 2 15 MIDDLE JUBA 1 1 1 1 1 1 11 1 1 1 1 2 1 7 BAKOOL 1 ₁ ₁ ₁ ₉ ₁ ₁ ₁ ₁ ₁ ₁ ₆ Total Somalia 2 6 9 9 3 7 5 1 6 5 6 6 7 5 11 7 3 4 4 12 7 7 3 5 4 316 6 8 10 6 3 8 9 11 7 12 8 6 9 8 8 4 10 8 6 9 8 5 9 10 2 5 9 3 7 6 7 7 5 9 248

(5)

REGION

2016

2017

Pending Discarded VDPV

Total

Discarded Pending Total

BANADIR

0

30

0

30

23

2

25

GALGADUD

0

25

0

25

18

2

20

HIRAN

0

15

0

15

12

3

15

L. SHABELLE

0

24

0

24

15

3

18

M. SHABELLE

0

19

0

19

15

1

16

BARI

0

24

0

24

16

2

18

MUDUG

0

14

0

14

9

0

9

NUGAL

0

11

0

11

6

1

7

AWDAL

0

18

0

18

14

1

15

GALBEED

0

19

0

19

13

2

15

SAHIL

0

8

0

8

6

1

7

SANAQ

0

7

0

7

4

1

5

SOOL

0

5

0

5

7

1

8

TOGDHER

0

10

1

11

7

0

7

BAKOOL

0

9

0

9

6

0

6

BAY

0

19

0

19

12

1

13

GEDO

0

21

0

21

15

0

15

LOWER JUBA

0

26

0

26

21

1

22

MIDDLE JUBA

0

11

0

11

7

0

7

Grand Total

0

315

1

316

226

22

248

Classification of AFP cases by status (2016 & 2017)

22

In process

(lab)

0

Pending

ITD

226

Discarded

0

WPV

22

Pending

0

Compatible

0

VDPV

248 AFP

Cases

Reported in 2017

Tab

le

n

o.

-2

Chart no. 1

(6)

Surveillance Indicators by Zone and Region 2017

Graph no. 2

Graph no. 3

Map no. 1

Map no. 2

5.0

11.7

6.1

6.6

6.1

0.0 2.0 4.0 6.0 8.0 10.0 12.0 14.0

Central Puntland Somaliland South Total Somalia

Annualized NP-AFP Rate by Zone, 2017

7.9

5.7

6.1

2.0 4.0 6.0 8.0 10.0 In-accessible Partially Acceessible Accessible Somalia

(7)

Surveillance Indicators (NP-AFP rate and Stool adequacy) by district, 2017

▪

Except Qansah Dere of south zone, 99%

(n=114) of the 115 districts in Somalia have

reported at least one AFP case since the

beginning of 2017.

▪

The NP-AFP rate for all the 112 districts is

>2/100,000 U-15 Population.

▪

111 districts had stool adequacy of above

80% while three districts (Badade,Kismayo

and Bossaso) did not meet the required stool

adequacy rate. Badade and kismayo are

partially while Bossaso is fully accessible

district.

(8)

Distribution of NP-AFP cases and zero-dose cases Vs accessibility of districts

Week-35 Somalia Weekly EPI/POL Update

▪

AFP cases were reported from across

the country from all zones, all regions

and also from the accessible and the

inaccessible parts of the country.

▪

All but one of the total 32 zero dose

AFP cases reported in 2017 were

reported from access compromised

districts.

Map no.6

Map no. 5

(9)

Number of NP-AFP cases reported across years during the same period (2013-2017) by zone

▪

Overall number of AFP cases reported in 2017 exceeded the number of AFP cases reported in 2015 and 2016 in all zones for the same period.

34 16 25 17 92 23 23 44 93 390 133 47 ₄₄ 77 305 84 42 ₃₈ 48 212 80 28 42 51 201 94 34 57 63 248 0 50 100 150 200 250 300 350 400 450

CENTRAL Puntland Somaliland SOUTH SOMALIA

(10)

Number of AFP Cases and Contact samples with

Entero virus and Sabin like Virus Isolation

Zone

NP-AFP Cases

Contact Cases

# Sampl

es

from

Ca

se

s w

ith

lab

res

ult

# Sampl

es

from

ca

se

s

w

ith

NP

-EV

# S

Ls

# Sampl

es

from

C

on

ta

cts

wi

th

lab

re

su

lt

# Sampl

es

from

co

ntac

ts w

ith

NP

-EV

# SL

Vs

Central

166

29

8

252

33

18

Puntland

62

6

5

92

14

6

Somaliland

102

5

6

156

13

3

South

122

18

2

179

27

3

Somalia

452

58

21

679

87

30

Table no.-3

17.5% 13.1% 10% 7% 9.7% 15.2% 16% 7% 4.9% 8.3% 12% 2% 14.8% 15.1% 3% 2% 12.8% 12.8% 9% 4% 0.0% 2.0% 4.0% 6.0% 8.0% 10.0% 12.0% 14.0% 16.0% 18.0% 20.0%

% Specimens from cases with NPEV

% Specimens from Contactswith NPEV

% SL from cases % SL from Contacts

CASES AND CONTACT SAMPLES WITH LAB RESULT OF NP-EV AND SLV

(11)

▪

94% (n=232/248) of AFP cases reported in 2017 are notified within 7 days of onset.

▪

16 cases were notified more than seven days after the onset of paralysis from 7 regions {Lower Jubba (8), Gedo (3) , Middle Juba (1), Bari (1), Sanaq (1), Bakool (1), Bay (1) and Galbeed (1)}.

Early case detection within 7 days from onset of paralysis at zonal and region levels

Graph no.6

Graph no.7

94

33

55

50

232

0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

CENTRAL NE NW SOUTH SOMALIA

Notification within 7 days, Zonal

25 20 15 18 16 17 9 7 15 14 7 4 8 7 6 12 12 14 6 232 0% 20% 40% 60% 80% 100%

CENTRAL NE NW SOUTH SOMALIA

(12)

ZONE

#

AFP

ca

se

s

NP

-AFP

R

at

e

#

Ca

se

s

w

ith

Adq

.

Spe

ci

m

e

n

% tool Adq.

% inv. within

48 hrs.

% Notif.

within 7 days

Cas

es

p

end

in

g

la

b

re

sul

ts

Ca

se

s

w

ith

la

b.

re

sul

t.

Cas

es

w

ith

st

oo

l

in

g

oo

d

c

on

d

.

%

Ca

se

s

w

ith

st

ool

in

good

cond

.

#

of

sa

m

pl

e

s

w

ith

N

P

-EV

Isola

te

d

%

Sa

m

p

les

w

ith

N

P

EV

Isol

at

ed

#

c

as

e

s

w

ith

Sa

b

in

li

ke

viru

s

Isola

ti

on

%

of

c

as

es

w

ith

S L

V

irus

Isola

ti

on

Central

94

5.0

94

100%

99%

100%

8

83

100%

29

17%

8

10%

Puntland

34

11.7

33

97%

100%

97%

2

31

100%

6

10%

5

16%

Somaliland

57

6.1

57

100%

98%

96%

6

51

100%

5

5%

6

12%

South

63

6.6

61

97%

98%

79%

4

61

100%

18

15%

2

3%

Total

248

6.1

245

99%

94%

20

226

100%

58

13%

21

9%

Summary of AFP surveillance key indicators by Zone, 2017

▪

Surveillance indicators at national and sub-national levels perform above global standard, however, notification within 7 days in south zone particularly in Bakool and L. Juba regions is deteriorating.

▪

Except 3 AFP cases; one from El-Waq district of Gedo region in South zone, one from Ainabo district of Togdheer region in Somaliland and one from Buloburti distrct of Hiran Region in Central zone,

all the other AFP cases were investigated within 48 hrs of notification.

▪

Three cases from Badade, Bosaso and Kismayo districts (one from each) had low stool adequacy levels.

(13)

Summary of AFP surveillance key indicators by Province, 2017

ZONE PROVINCE Number of AFP cases

reported NP-AFP Rate % Stool Adq.

% inv. within 48 hrs. % Notif. within 7 days % Stool condition % Samples with EV isolated % cases with SL isolated # Cases with late 60 days followup

CENTRAL

BANADIR

25

3.5

100%

26%

9%

0

GALGADUD

20

11.8

100%

17%

6%

0

HIRAN

15

10.1

100%

93%

100%

4%

0%

1

LOWER SHABELLE

18

3.0

100%

20%

33%

0

MIDDLE SHABELLE

16

6.7

100%

13%

0%

0

PUNTLAND

BARI

18

15.6

94%

100%

92%

100%

6%

19%

3

MUDUG

9

7.6

100%

17%

22%

1

NUGAL

7

12.1

100%

8%

0%

1

SOMALILAND

AWDAL

15

9.6

100%

0%

14%

1

GALBEED

15

4.3

100%

92%

100%

0%

8%

1

SAHIL

7

12.8

100%

0%

33%

1

SANAQ

5

5.2

100%

75%

100%

0%

1

SOOL

8

10.5

100%

21%

14%

3

TOGDHER

7

3.5

100%

86%

100%

14%

0%

1

SOUTH

BAKOOL

6

5.2

100%

75%

100%

0%

₀

BAY

13

3.8

100%

91%

100%

0%

2

GEDO

15

7.6

100%

93%

75%

100%

10%

13%

6

LOWER JUBA

22

11.5

91%

100%

68%

100%

29%

0%

7

MIDDLE JUBA

7

6.8

100%

86%

100%

14%

0%

2

SOMALIA

248

6.1

99%

94%

100%

13%

9%

31

(14)

ZONE

# AFP

Cases

#

CONTACTS

# Contact

samples

with Lab

result

Average

contacts

per cases

% contacts

< 5 age

% Contact

collected

within 7

days of AFP

notified

# Contact

with stool

in Good

Condition

# Contact

pending

lab

results

#

specimens

with NPEV

isolated

%

Specimens

with NPEV

Isolated

#

Contacts

with

Sabin

virus

isolated

%

contacts

with

Sabin

like virus

Isolated

Central

94

282

252

3

94%

100%

252

30

33

13%

18

7%

Puntland

34

102

92

3

98%

97%

92

10

14

15%

6

7%

Somaliland

57

171

156

3

94%

96%

156

15

13

8%

3

2%

South

63

189

179

3

94%

79%

179

10

27

15%

3

2%

Somalia

248

744

679

3

94%

679

65

87

13%

30

4%

Note: One specimen is collected for each contact

Week-35 Somalia Weekly EPI/POL Update

Table no.-5

(15)

Zone

Number

of VPVs

Number

of cases

reported

# of cases

Notified by

VPV

Proportion of

cases reported

by VPV

CENTRAL

190

94

71

76%

PUNTLAND

105

34

16

47%

SOMALILAND

81

57

19

33%

SOUTH

159

63

30

48%

Somalia

535

248

136

55%

Distribution of AFP cases by source of case notification, 2017

Key:

1. VPVs: Village polio volunteers

2. HFs: MCH, Hospitals and Private clinics

3. Others: community members, district field assistants, traditional healers

Table no.-6

71 16 19 30 136 14 13 29 17 73 9 5 9 16 39 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Central Puntland Somaliland South Somalia

Pro p . c as es n o ti fed b y

Source of AFP cases notification

(16)

Distribution of AFP cases by life style, age group and sex, 2017

▪

Of the total 248 AFP

cases reported in 2017,

42% (n=105) and 36%

(n=90) are from Urban

and Rural population

respectively. Nomadic

communities account for

only 21% (n=53).

▪

92% (n=229) of the cases

are less than 5 years old.

▪

46% (n=113) AFP cases

are female.

Graph no.-10

Graph no.- 11

Graph no.-12

31 ₉₇ 91 80 70 53 51 150 144 87 117 ₉₀ 65 281 181 112 129 105 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2012 2013 2014 2015 2016 2017

Distribution of AFP cases by Life style

Nomadic Rural Urban

56 221 167 115 164 113 92 324 252 166 152 135 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2012 2013 2014 2015 2016 2017

Distribution AFP cases by Sex

Female Male 129 129 348 249 105 229 19 83 72 32 33 19 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2012 2013 2014 2015 2016 2017

Distribution of AFP cases by Age group

(17)

AFP surveillance indicators by accessibility status of districts

Accessibility

# of

districts

U-15 Pop

in this

area

# of AFP

cases

Reported

# of Cases

reported

by VPVs

% of Cases

reported

by VPVs

NP

AFP

rate

Number

of cases

with lab

result

% of

Stool

adequacy

% inv.

Within

48 hrs.

% of

Notif.

within 7

days

%

Specime

ns with

NPEV

% cases

with

Sabin like

virus

Inaccessible

17

601,282

31

25

81%

7.9

30

100%

87%

28%

0%

Partially

accessible

23

1,670,705

62

31

50%

5.7

54

97%

98%

90%

3%

5%

Accessible

75

3.907,440

155

80

52%

6.1

142

99%

96%

13%

15%

National

115

6,179,427

248

136

55%

6.1

226

99%

94%

13%

9%

▪

VPVs continue to support AFP surveillance and have reported 80% (n=25/31) of cases from inaccessible and 50% (n=31/62) from partially accessible districts.

▪

Most of the surveillance indicators in the accessible and access compromised areas are above global standards; however, SL and NP-EV isolation is very low

in the access compromised districts.

Tab

le

n

o.

(18)

Accessibility

% of <15

populatio

n in the

area

# of AFP

cases

Reported

# of Cases

reported

by VPVs

% of Cases

reported

by VPVs

Number

of cases

with lab

result

% of cases

with lab

result

within 14

days

% of

Stool

adequacy

% inv.

Within

48 hrs.

% of

Notified

within 7

days

%

Specime

ns with

NPEV

% cases

with Sabin

like virus

Nomadic

28.8%

53

35

66%

49

86%

96%

98%

92%

11%

8%

Rural

25.9%

90

59

66%

83

89%

100%

99%

93%

14%

8%

Urban

45.3%

105

42

40%

94

93%

99%

94%

13%

11%

National

100%

248

136

55%

226

90%

99%

94%

13%

9%

AFP surveillance indicators by Life Style of Population 2017

(19)

Validation and zero dose investigation of AFP cases, 2017

AFP cases Validation

Zone

# of AFP cases

Reported

# of AFP

cases

Validated

% of AFP

cases

Validated

Central

94

47

50%

Somaliland

57

41

72%

South Zone

63

27

43%

Puntland

34

17

50%

Somalia

248

132

53%

▪

Of the total 248 cases, 53% (n=132) were validated by the RPOs.

▪

There were 32 zero OPV dose AFP cases reported in 2017, 91% (n=29/32) were investigated.

Week-35 Somalia Weekly EPI/POL Update

Table no.-8

Zero dose Investigation

Zone

# of Zero dose

AFP cases

Reported

# of Zero dose

AFP cases

investigated

% of Zero dose

AFP cases

investigated

Central

13

12

69%

Puntland

1

100%

Somaliland

---

---South

18

16

89%

Somalia

32

29

91%

Table no.-9

(20)

Tracking lab results of AFP cases

Total AFP cases

248

Total AFP cases

with stool

specimens

Total AFP cases

without stool

specimens

248

0

With lab

results

En route

In the lab

226

0

20

cVSPV2

SL

EV

-ve

0

21

34

171

55

171

22

Tracking AFP with stool specimens

cVDPV2

Other viruses

neg st

in lab

en route

(21)

Sample

source

#

Specimen

collected

# Specimen

with culture

result

# Specimens

pending lab

result

# Specimen

with culture

result within

14 days

% of specimen

with culture

result within 14

days

Number of

specimen

with NPEV

% of

specimen

with

NPEV

Number of

Specimens

with Sabin

isolation

% of

Specimen

s with

Sabin

isolation

Cases

496

452

40

407

90%

58

13%

21

9%

Contacts

744

679

65

611

90%

87

13%

30

4%

Total

1240

1131

105

1018

90%

145

13%

51

6%

Lab performance indicators for AFP surveillance in Somalia, 2017

(22)

Median days from onset of paralysis up to final lab result (all cases) - 2017

Date of

Notification

Second stool

collected

Specimen

reached to Lab

Primary

Culture result

Date of

onset

ITD result

17 days

Date

second

stool

collected

Date final

ITD results

3 days

1 day

4 days

11 days

2 day

(23)

Village polio volunteers weekly house to house visit and AFP cases notified , 03 Sept. Aug 2017

Week-35 Somalia Weekly Polio Update

Zones

January Feberuary March April May June July Aug Sept October November December

No. of HH visited No. of AFP cases notifie d No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notifie d No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notifi ed No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notifie d No. of HH visited No. of AFP cases notifie d No. of HH visited No. of AFP cases notified No. of HH visited No. of AFP cases notifie d Central 31757 6 31780 6 39997 10 35672 12 37438 10 46730 13 38112 2 37100 12 0 0 0 0 0 0 0 0 South 33599 4 32985 4 41237 5 34252 3 33505 4 43001 2 32761 6 33131 2 0 0 0 0 0 0 0 0 Puntland 15237 2 15591 4 18903 4 15193 1 15291 1 14887 2 15175 0 15245 1 0 0 0 0 0 0 0 0 Somaliland 36646 5 36882 2 45971 0 35634 2 35446 3 41710 3 33807 0 35059 4 0 0 0 0 0 0 0 0 Total 117239 17 117238 16 146108 19 120751 18 121680 18 146328 20 119855 8 120535 19 0 0 0 0 0 0 0 0

(24)

Routine Immunization Services, status of Cold Chain & Vaccine stocks in AFP Surveillance Sites as of 03 Sept 2017

Region

Expected weekly

AFP sites visits

Health facility have a

routine EPI service

AFP sites with EPI service and

functional cold chain

Health facility have EPI

vaccine available

Health facility have IPV vaccine

available

No

No.

%

No.

%

No.

%

No.

%

Nugal

33

19

58%

19

100%

19

100%

17

89%

Bari

116

34

29%

32

94%

34

100%

31

91%

Mudug

58

39

67%

38

97%

38

97%

32

84%

Galbeed

40

23

58%

23

100%

23

100%

23

100%

Sahil

24

10

42%

10

100%

10

100%

8

80%

Sanag

19

11

58%

11

100%

11

100%

11

100%

Sool

28

10

36%

10

100%

10

100%

10

100%

Awdal

43

23

53%

23

100%

23

100%

23

100%

Togdher

52

21

40%

21

100%

21

100%

21

100%

Middle Shabelle

35

18

51%

15

83%

16

89%

15

94%

Hiran

24

23

96%

6

26%

23

100%

23

100%

Galgadud

36

23

64%

14

61%

23

100%

23

100%

Banadir

101

51

50%

22

43%

51

100%

51

100%

Lower Shabelle

49

27

55%

13

48%

25

93%

20

80%

Middle Juba

15

1

7%

0

0%

1

100%

0

0%

Bakool

26

10

38%

10

100%

10

100%

10

100%

Gedo

51

20

39%

20

100%

20

100%

17

85%

Bay

75

30

40%

30

100%

30

100%

30

100%

Lower Juba

46

23

50%

8

35%

23

100%

20

87%

Somalia

870

416

48%

325

78%

411

99%

385

94%

(25)

Part -II

Fever and rash

Surveillance

(26)

▪

Number of reported cases has been showing a steady decline since week 24 except this week.

▪

The cumulative reported cases also still remain higher than the number of cases reported at the same period in the past 4 years.

▪

All regions have reported suspected measles cases in 2017. Banadir, Togdhere, Hiran, Lower shabelle and Glbeed regions of Central and Somaliland are the top 5 regions with a very high

number of cases reported.

Epi-curve on suspected measles cases by week, Somalia (Week 20, 2015-Week 35, 2017)

2017

(n=16,314)

2015

(n=7498)

(n=5657)

2016

163 149 ₁₄₄ 208 182 172 174 199 214 175 140 156 161 180 134 151 113 127 96 95 85 107 124 86 90 84 72 102 72 89 88 115 100 125 97 111 158 105 87 66 86 103 125 112 95 122 109 87 88 ₈₃ 105 140 132 102 115 116 142 127 141 145 109 ₉₈ 124 90 82 74 79 60 91 92 81 ₇₆ 70 84 76 74 71 67 85 101 170 102 93 93 128 117 122 133 154 122 155 173 196 210 228 ₂₂₂ 309 255 408 373 399 383 436 441 670 496 699 657 685 663 696 703 720 686 693 584 560 538 554 463 488 444 400 325 436 330 0 100 200 300 400 500 600 700 800 2 0 1 5W1 3 2 0 1 5W1 4 2 0 1 5W1 5 2 0 1 5W1 6 2 0 1 5W1 7 2 0 1 5W1 8 2 0 1 5W1 9 2 0 1 5W2 0 2 0 1 5W2 1 2 0 1 5W2 2 2 0 1 5W2 3 2 0 1 5W2 4 2 0 1 5W2 5 2 0 1 5W2 6 2 0 1 5W2 7 2 0 1 5W2 8 2 0 1 5W2 9 2 0 1 5W3 0 2 0 1 5W3 1 2 0 1 5W3 2 2 0 1 5W3 3 2 0 1 5W3 4 2 0 1 5W3 5 2 0 1 5W3 6 2 0 1 5W3 7 2 0 1 5W3 8 2 0 1 5W3 9 2 0 1 5W4 0 2 0 1 5W4 1 2 0 1 5W4 2 2 0 1 5W4 3 2 0 1 5W4 4 2 0 1 5W4 5 2 0 1 5W4 6 2 0 1 5W4 7 2 0 1 5W4 8 2 0 1 5W4 9 2 0 1 5W5 0 2 0 1 5W5 1 2 0 1 5W5 2 2 0 1 6W0 1 2 0 1 6W0 2 2 0 1 6W0 3 2 0 1 6W0 4 2 0 1 6W0 5 2 0 1 6W0 6 2 0 1 6W0 7 2 0 1 6W0 8 2 0 1 6W0 9 2 0 1 6W1 0 2 0 1 6W1 1 2 0 1 6W1 2 2 0 1 6W1 3 2 0 1 6W1 4 2 0 1 6W1 5 2 0 1 6W1 6 2 0 1 6W1 7 2 0 1 6W1 8 2 0 1 6W1 9 2 0 1 6W2 0 2 0 1 6W2 1 2 0 1 6W2 2 2 0 1 6W2 3 2 0 1 6W2 4 2 0 1 6W2 5 2 0 1 6W2 6 2 0 1 6W2 7 2 0 1 6W2 8 2 0 1 6W2 9 2 0 1 6W3 0 2 0 1 6W3 1 2 0 1 6W3 2 2 0 1 6W3 3 2 0 1 6W3 4 2 0 1 6W3 5 2 0 1 6W3 6 2 0 1 6W3 7 2 0 1 6W3 8 2 0 1 6W3 9 2 0 1 6W4 0 2 0 1 6W4 1 2 0 1 6W4 2 2 0 1 6W4 3 2 0 1 6W4 4 2 0 1 6W4 5 2 0 1 6W4 6 2 0 1 6W4 7 2 0 1 6W4 8 2 0 1 6W4 9 2 0 1 6W5 0 2 0 1 6W5 1 2 0 1 6W5 2 2 0 1 7W0 1 2 0 1 7W0 2 2 0 1 7W0 3 2 0 1 7W0 4 2 0 1 7W0 5 2 0 1 7W0 6 2 0 1 7W0 7 2 0 1 7W0 8 2 0 1 7W0 9 2 0 1 7W1 0 2 0 1 7W1 1 2 0 1 7W1 2 2 0 1 7W1 3 2 0 1 7W1 4 2 0 1 7W1 5 2 0 1 7W1 6 2 0 1 7W1 7 2 0 1 7W1 8 2 0 1 7W1 9 2 0 1 7W2 0 2 0 1 7W2 1 2 0 1 7W2 2 2 0 1 7W2 3 2 0 1 7W2 4 2 0 1 7W2 5 2 0 1 7W2 6 2 0 1 7W2 7 2 0 1 7W2 8 2 0 1 7W2 9 2 0 1 7W3 0 2 0 1 7W3 1 2 0 1 7W3 2 2 0 1 7W3 3 2 0 1 7W3 4 2 0 1 7W3 5 2 0 1 7W3 6 2 0 1 7W3 7

(27)

Fever & Rush cases reported by AFP surveillance System, 03 Sept. 2017

Region Total

2016

Fever and Rash Cases by weekly

Total 2017 W1 W2 W3 W4 W5 W6 W7 W8 W9 W10 W11 W12 W13 W14 W15 W16 W17 W18 W19 W20 W21 W22 W23 W24 W25 W26 W27 W28 W29 W30 W31 W32 W33 W34 Nugal 112 3 1 1 2 2 0 1 1 0 2 0 0 4 3 4 5 15 3 6 18 27 25 23 21 17 22 19 38 42 42 53 70 82 54 606 Bari 202 1 7 5 3 7 0 1 4 4 12 0 11 23 21 31 26 22 47 74 73 74 81 114 85 44 90 98 67 75 47 62 44 34 56 1343 Mudug 270 1 3 7 2 1 21 18 15 29 28 16 35 50 24 53 51 27 26 26 45 72 82 78 77 93 73 44 52 70 73 51 42 51 37 1373 N/East Zone 584 5 11 13 7 10 21 20 20 33 42 16 46 77 48 88 82 64 76 106 136 173 188 215 183 154 185 161 157 187 162 166 156 167 147 3322 Galbeed 45 0 3 1 5 2 7 10 8 8 12 18 19 30 29 50 60 45 63 85 41 44 19 29 19 22 9 11 14 12 13 5 3 2 1 699 Sahil 226 12 18 37 25 22 17 28 17 28 18 31 20 27 16 24 10 27 11 11 10 13 17 15 9 39 2 17 7 17 2 3 0 5 0 555 Sanag 16 0 3 0 0 1 0 0 0 0 5 0 1 2 1 9 0 11 1 5 5 19 5 11 19 22 11 13 19 10 10 16 0 8 6 213 Sool 24 8 11 6 22 26 24 41 20 32 36 37 36 37 40 28 24 14 24 14 13 15 16 5 5 11 13 9 5 3 0 0 2 4 4 585 Awdal 56 0 1 4 1 6 0 0 0 0 0 0 0 0 1 0 0 3 0 11 1 2 0 6 4 23 2 24 0 4 0 4 1 0 0 98 Togdher 223 42 22 26 18 63 28 103 36 105 66 118 87 88 111 162 87 157 108 141 98 88 31 50 37 23 29 42 13 22 8 29 2 30 7 2077 N/West Zone 590 62 58 74 71 120 76 182 81 173 137 204 163 184 198 273 181 257 207 267 168 181 88 116 93 140 66 116 58 68 33 57 8 49 18 4227 Middle Shabelle 206 5 10 6 18 7 10 8 11 5 19 23 23 20 20 12 14 25 10 8 7 6 16 18 20 20 16 20 16 28 13 9 14 14 21 492 Hiran 107 0 4 9 3 19 15 23 66 28 29 28 37 45 63 78 75 74 76 78 84 57 52 69 24 48 58 15 21 0 21 14 3 3 13 1232 Galgadud 261 4 3 2 5 5 6 3 11 4 7 4 5 149 17 28 23 19 17 13 7 9 13 8 12 9 13 29 19 14 17 13 18 5 8 519 Banadir 2226 89 78 76 71 95 79 119 128 91 83 93 108 110 65 134 184 172 209 162 225 205 226 202 181 116 138 140 123 117 134 93 71 140 76 4333 Lower Shabelle 1217 25 27 45 23 37 25 33 42 42 45 36 32 45 53 45 45 59 30 38 47 52 52 49 47 47 40 59 58 45 36 33 43 39 29 1403 Central Zone 4017 123 122 138 120 163 135 186 258 170 183 184 205 369 218 297 341 349 342 299 370 329 359 346 284 240 265 263 237 204 221 162 149 201 147 7979 Middle Juba 51 0 0 0 0 2 0 0 2 3 3 0 2 0 0 0 3 3 3 0 0 3 5 0 3 0 0 0 0 6 3 0 3 3 0 47 Bakool 37 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 10 15 5 8 2 4 44 Gedo 104 0 0 4 1 1 6 0 0 0 0 0 0 0 0 6 0 5 0 0 12 13 14 2 0 0 0 0 0 0 0 1 0 0 0 65 Bay 9 0 0 0 3 0 0 0 0 14 0 23 9 33 19 23 42 3 31 18 12 18 28 12 19 26 22 8 8 12 6 7 1 10 6 413 Lower Juba 265 6 19 0 12 15 17 20 14 6 7 1 7 7 8 12 8 4 4 6 5 3 4 2 2 0 0 6 3 1 4 2 0 4 8 217 South Zone 466 6 19 4 16 18 23 20 16 23 10 24 18 40 27 41 53 15 38 24 29 37 51 16 24 26 22 14 11 29 28 15 12 19 18 786 Grand Total 5657 196 210 229 214 311 255 408 375 399 372 428 432 670 491 699 657 685 663 696 703 720 686 693 584 560 538 554 463 488 444 400 325 436 330 16314

(28)

Regional distribution of fever and rash cases reported in 2014, 2015, 2016 & 2017.

Map no.7

Map no.8

▪

Data source: from the Polio surveillance system and CSR.

Region Fever & rash cases (2014) Fever & rash cases (2015) Fever & rash cases (2016) Fever & rash cases (2017) Nugal 1110 82 112 606 Bari 1284 226 202 1,343 Mudug 542 561 270 1,373 Galbeed 121 212 45 699 Sahil 30 60 226 555 Sanag 115 114 16 213 Sool 187 86 24 585 Awdal 1 15 56 98 Togdher 407 864 223 2,077 M. Shab. 285 500 206 492 Hiran 63 663 107 1,232 Galgadud 299 229 261 519 Banadir 2594 1974 2226 4,333 L. Shab. 1978 1611 1217 1,403 M. Juba 177 48 51 47 Bakool 3 26 37 44 Gedo 126 8 104 65 Bay 309 145 9 413 L.Juba 648 74 265 217 Total 10,279 7,498 5,657 16,314

Map no.9

(29)

Fever & Rush cases reported by AFP surveillance System,

03 Sept 2017

Week -35

Somalia

Weekly Polio Update

<1yr, 2871, 18%

1_4 yrs, 8021,

49%

5_9yrs, 2702,

16%

Yrs10+, 2720,

17%

Age-wise distribution of fever and rash cases reported by

AFP surveillance system during 2017

7979

3322

4227

786

16314

0

2000

4000

6000

8000

10000

12000

14000

16000

18000

Central

North East

North West

South

Total Somalia

Zone-wise cases of fever and rash reported by AFP

surveillance system in 2017

(30)

Trend of reported fever and rash cases by zone in 2015 /16/17

Source AFP surveillance,

•

Number of fever and rash cases reported is shown decline in July and August compared to the previous month; However, it is still very high/4 times higher (n=15,223) than cases reported during the

same period in 2016 (n=3,228).

M eas le s C am pa ig n (21 -25 M ay ) M ea sl es Ca m p ai gn (2 4 -2 8 A p ri l) M eas le s C am pa ig n (21 -25 M ay ) M eas le s C am pa ig n (24 -28 M ay ) 161 ₁₃₃ ₁₁₅ 97 140 ₆₂ ₄₃ ₃₉ 19 33 ₁₂ ₁₅ 39 30 48 70 119 83 24 27 27 11 40 0 36 71 214 282 491 925 667 ₆₃₄ 0 200 400 600 800 1000

January February March April May June July AUG Sept. Oct. Nov. Dec

Puntland

2015 2016 2017 161 ₁₄₂ 269 202 243 93 ₇₂ ₄₇ 29 47 29 15 14 36 82 104 33 35 16 9 42 96 37 8 265 459 861 909 ₈₂₃ 503 275 132 0 200 400 600 800 1000

Somaliland

2015 2016 2017 455 443 441 348 545 450 514 328 ₂₈₁ 388 383 401 367 ₃₁₅ 401 265 324 307 278 271 310 142 350 30 503 742 1111 1205 1340 1494 925 659 0 200 400 600 800 1000 1200 1400 1600

Central

2015 2016 2017 40 27 27 30 46 22 27 ₁₉ 14 13 18 18 9 37 29 46 75 50 9 21 7 33 46 ₂₆ 45 77 115 136 128 139 82 64 0 20 40 60 80 100 120 140 160

South

(31)

Part -III

(32)

Supplemental

(33)

Maps showing accessibility and security/ risk level, Somalia

Map no.11

Map no.10

(34)

Somalia Total

501

869

457

11689

6,179,427

Summary Strategic features and initiatives in Somalia by accessibility

Zones

Accessibility

status

VPV

AFP active

Surveillance site

TPVP

Settlement

Under 15- POP.

CENTRAL

Accessible

128

216

147

2354

2,230,697

Inaccessible

62

29

21

1042

619,775

Total

190

245

168

3396

2,850,471

PUNTLAND

Accessible

105

207

53

1076

446,241

Inaccessible

0

Total

105

207

53

1076

446,241

SOMALILAND

Accessible

81

206

53

3435

1,426,642

Inaccessible

0

Total

81

206

53

3435

1,426,642

SOUTH

Accessible

75

179

123

2234

1,010,326

Inaccessible

84

33

22

1548

445,747

Total

159

212

145

3782

1,456,073

Somalia

Accessible

389

808

376

9099

5,113,906

Inaccessible

146

62

43

2590

1,065,522

Somalia Total

535

870

419

11689

6,179,428

(35)

2017 SIA Calendar, Implementation status and coverage Summary

Tab

le

n

o.

-14

Somalia SIA Callender for 2017

Planned Date

Campaign

Type Geographic Areas to be covered

Target Age Group

Total Target Pop. for the

Rnd Target Population Implementation date Vaccine type # Reached/ Vaccinate d Admin Coverage in % IM Coverage in

% LQAS Report timeliness

26-Feb-17 NIDs R-1

All accessible areas of Central zone

Under 5 years

2,441,996

904,454 26-29 Feb. 2017 b-OPV 848,340 94% 94% Of 11 lotes, 9=passed 2=Satisfactory and Received

Puntland all districts 530,201 05-08 April 2017 b-OPV 546,302 103% 97% Of 31 lotes, 27=PassedSatisfactory and 1=Failed, 3= Received

Somaliland all districts 621786 26-29 Feb. 2017 b-OPV 612,911 99% 97%

Of 29 lotes, 19=Passed,

6=satisfactory,3 =failed and 1

discarded Received

All accessible areas of South zone 385,555 26-29 Feb. 2017 b-OPV 369,517 96% 91% Of 5 lotes, 4=Passed and 1=Failed Received

02-04, April-17 NIDs R-2

Under 5

years 2,455,942

904,451 02-05 April 2017 b-OPV 850,772 94% 93% Of 11 lots, 9=passed, 2= Satisfactoryand 0=failed Received

Puntland all districts 529602 6-9 May 2017 b-OPV 546,673 103% 98% Received

Somaliland all districts 623462 02-05 April 2017 b-OPV 609,734 98% 97% Of 28 lotes, 25=PassedSatisfactory and 2=Failed, 1= Received

All accessible areas of South zone 398427 02-05 April 2017 b-OPV 385,584 97% 95% Of 5 lotes, 3=PassedSatisfactory and 1=Failed, 1= Received

23-Jul-17 HtR - R-1

Nomadic; Agro pastoral; Scattered, remote, far settlements & Small villages with difficult / no road access

Under 5

years 438,074

73,447 C. Z: 23-26 July 2017

b-OPV

64,160 87% No IM No LQAS Received

32,803 S.Z: 23-26 July 2017 31,095 95% 92% No LQAS Received

185,844 P.L: 15-18 August 2017

145,980 SL: 23-26 July 2017 142,794 98% No IM No LQAS Received

14-Aug-17 HtR - R-2

Nomadic; Agro pastoral; Scattered, remote, far settlements; & Small villages with difficult / no road access

Under 5 years 735,752 275,010 C. Z: 29 Aug-01 Sept. 2017 b-OPV 157,991 S.Z: 29- Aug-01 Sept. 2017 185,844 116,908 SL: 09- 12 Sept. 2017 22-Oct-17 NIDs R-3

Under 5

years 2,452,976

904,451

b-OPV

Puntland all districts 526636

Somaliland all districts 623462

All accessible areas of South zone 398427

A) Target population: includes all accessible areas including the areas/districts that became accessible in 2015 and 3% population growth added 2016. B) Buffer stock: 1 million bOPV doses kept in country for: Transit/Cross Border Permanent Vaccination Teams and SIADs for new areas accessible.

(36)

NID-1, NID-2 2017 Summary

▪

NID1 & NID 2 was

conducted as scheduled in

March and April 2017.

▪

HtR 1 also conducted in

South, Central and

Somaliland, Puntland will

conducted in August

▪

Cumulatively 5,336,012

under 5 children were

targeted in the two NIDs

and 1 HTR rounds and

5,007,882 million children

were reached.

▪

IM data showed overall

national coverage of 95%,

96% and 92% respectively

for NID-1 and NID 2.

▪

Regional

summary

and

district level IM coverage

is presented on the table

and the maps on the left

ZONE/REGION NID-1 NID-2 HtR-1 # U -5 Targeted # U-5 Reached IM coverage # U -5 Targeted # U-5 reached IM coverage # U -5 Targete d # U-5 reached IM coverag e Banadir 424086 398999 96% 424083 399509 95% 19,323 18,056 No IM Galgadud 100060 91815 86% 100060 91077 86% 25,047 20,559 Hiran 77692 72736 97% 77692 70991 94% 8,025 6,699 L. Shabelle 182368 167848 94% 182368 171852 94% 8,304 7,618 M. Shabelle 120248 116942 98% 120248 117343 98% 12,748 11,228 Central Total 904454 848340 94% 904451 850772 93% 73447 64160 Ayn 12662 12157 97% 12662 12375 Bari 138029 167908 103% 138029 163261 99% Karkar 48509 47142 99% 48509 47807 98% Mudug 208301 201496 94% 208401 202736 100% Nugal 81659 77952 94% 80961 80267 94% Sanag 27755 26773 96% 27755 27068 96% Sool 13286 12874 97% 13286 13159 97% Puntland Total 530201 546302 98% 529602 546673 99% Awdal 107324 104100 100% 107324 105201 98% 23,910 23,351 92% Sanag 65777 62900 96% 205431 201208 95% 15,965 15,212 92% Sool 59781 64651 98% 46202 44442 96% 14,510 15,843 70% Togder 138946 134347 99% 65777 61014 97% 30,519 29,294 97% Marodijeh 203756 203756 93% 59781 63193 94% 49,862 48,407 74% Sahil 46202 43157 100% 138946 134676 100% 11,214 10,687 100% Somaliland Total 621786 612911 97% 623462 609734 96% 145,980 142,794 92% Bakool 36758 35575 90% 36758 34187 95% 2,088 1,938 No IM Bay 162935 157910 93% 162935 158629 95% 7,275 6,678 Middle Juba NO NID (Inaccessible Region)

Gedo 111491 106423 89% 111491 108737 93% 11,448 10,845 Lower Juba 74371 69609 93% 87243 84031 96% 11,992 11,634

South Total 385555 369517 92% 398427 385584 95% 32,803 31,095

(37)

Week-35 Somalia Weekly EPI/POL Update

Transit Points Vaccination Activities as of September 03, 2017

Table no.-16

▪

A total of

1,498,453

< 10 years individuals were vaccinated week 34,2017. Among them,76,529 (5%)

were vaccinated for the first time

Zones

January

February

March

April

May

June

July

August

Nu

m

b

e

r

of

va

cc

in

at

e

d

Ze

ro

d

os

e

s

%

Ze

ro

d

os

e

s

Nu

m

b

e

r

of

va

cc

in

at

e

d

Ze

ro

d

os

e

s

%

Ze

ro

d

os

e

s

Nu

m

b

e

r

of

va

cc

in

at

e

d

Ze

ro

d

os

e

s

%

Ze

ro

d

os

e

s

Nu

m

b

e

r

of

va

cc

in

at

e

d

Ze

ro

d

os

e

s

%

Ze

ro

d

os

e

s

Nu

m

b

e

r

of

va

cc

in

at

e

d

Ze

ro

d

os

e

s

%

Ze

ro

d

os

e

s

Nu

m

b

e

r

of

va

cc

in

at

e

d

Ze

ro

d

os

e

s

%

Ze

ro

d

os

e

s

Nu

m

b

e

r

of

va

cc

in

at

e

d

Ze

ro

d

os

e

s

%

Ze

ro

d

os

e

s

Nu

m

b

e

r

of

va

cc

in

at

e

d

Ze

ro

d

os

e

s

%

Ze

ro

d

os

e

s

CENTRAL

102390 12082 11.8% 109859 7779 7.1% 144262 7777 5.4% 110748

3902

3.5%

102455

2583

2.5%

130637 1742

1.3%

102700

786

0.8%

102028 535

0.5%

PUNTLAND

22653

93

0.4%

21444

71

0.3%

27405

83

0.3% 21282

67

0.3%

20612

59

0.3%

28689

91

0.3%

23886

63

0.3%

22255

59

0.3%

SOMALILAND

14367

208

1.4%

15220

428

2.8%

18818

752 4.0% 14696

426

2.9%

15646

485

3.1%

18904 515

2.7%

15998

477

3.0%

15966 499

3.1%

SOUTH

39301 12498 31.8% 41710 14632 35.1% 39045 2388 6.1% 29791

1125

3.8%

29842

1135

3.8%

38680 1332

3.4%

29127

929

3.2%

28037 928

3.3%

SOMALIA

178711 24881 13.9% 188233 22910 12.2% 229530 11000 4.8% 176517

5520

3.1%

168555

4262

2.5%

216910 3680 1.7%

171711

2255

1.3%

168286 2021 1.2%

(38)

Performance of Permanent Vaccination sites in inaccessible areas of S/C zone and distribution as of Sept. 03, 2017

Since the first weeks of 2017, a total of

107,951

<10 years children were reached through the newly established permanent vaccination sites in fully

inaccessible area in South and Central zones.

52% (n=55,956)

of the children are vaccinated for the first time.

Number of U-10 Children vaccinated by Newly Established permanent vaccination sites in inaccessible areas of

South and Central zones of Somalia.

ZONE

REGION

DISTRICT

Number of

vaccinated kids

Number of Zero

doses vaccinated

Proportion of Zero

doses (%)

CENTRAL

GALGADU

D

Elbur

2,928

2,315

79%

Galhareri

Data not received

Elgaras

7,273

6,305

87%

L.Shabelle

Awdegle

29,846

11,788

39%

Sablale

30,306

11,231

37%

South

L. Jubba

Hagar

5,397

3,226

60%

Jamame East

4,137

3,950

95%

Jamame West

3,071

2,857

93%

Kismayo

11,379

2,705

24%

M. Jubba

Buale

7,800

6,714

86%

Sakaw

5,814

4,865

84%

TOTAL

107,951

55,956

52%

(39)

Immunity Profile of NP-AFP cases (6-59 Months)

▪

In 2017, 32 zero-dose NP-AFP cases were reported; 18 from South, 13 from Central and 1 from Puntland. One of the cases is out of the 6-59 months age group

▪

Review of five years data reveals, the proportion of zero dose AFP cases is declining progressively, however, there are significant proportion of children at risk due to

under vaccination.

Graph no.-20

Graph no.-19

76 73 38 ₃₇ ₃₁ 63 33 29 ₃₇ 41 61 50 ₄₃ ₅₆ 44 69 182 127 143 109 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 2013 2014 2015 2016 2017

Immunity Profile of NP-AFP Cases 6-59 Months, 2013-2017

0 dose 1-3 doses 4-6 doses 7+ doses

13 1 ₀ 17 31 14 12 5 10 41 14 3 13 14 44 49 16 31 13 109 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%

Central Puntland Somaliland South Somalia

Immunity Profile of NP-AFP cases 6-59 Months by Zone, 2017

(40)

Immunity profile of 6-59 months age NP-AFP cases by Zone 2012-2017

Graph no.-21

Graph no.-22

(41)

(42)

Source: HMIS data 2016 and 2017.

33%

44%

58%

46%

41%

54%

66%

58%

34%

45%

57%

52%

34%

43%

50%

61%

32%

41%

57%

53%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

2014

2015

2016

2017 six month

BCG

Penta1

Penta3

Measles

OPV 3

(43)

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Pent1 24215 48781 73263 98229 124707 152394 181148 207148 235011 266781 299618 331481 Penta3 27543 48616 70816 91732 113674 136589 160723 181282 203464 229673 256554 283080 Measles 18379 39266 60502 81562 103608 127044 150435 174056 193371 209302 230710 249465 Target 7.50% 15.00% 22.50% 30.00% 37.50% 45.00% 52.50% 60.00% 67.50% 75.00% 82.50% 90.00% Penat1% 5% 11% 16% 22% 28% 34% 40% 46% 52% 59% 66% 73% Penta3% 6% 11% 16% 20% 25% 30% 36% 40% 45% 51% 57% 63% measles% 4% 9% 13% 18% 23% 28% 33% 39% 43% 46% 51% 55% 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100% 0 50000 100000 150000 200000 250000 300000 350000

Immuinzation monitoring chart, Somalia2016

Pent1 Penta3 Measles Target Penat1% Penta3% measles%

Week-35 Somalia Weekly EPI/POL Update

N.B

The graph shows that the data is from Jan-June, 2017

Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec Sum of Pent1 31154 62595 89585 116079143067150888

Sum of Penta3 27701 55745 79984 103221126247134438 Sum of Measles 26476 57585 84740 117956150345158934

Sum of Montly target on surval% 8% 17% 25% 33% 42% 50% 58% 67% 75% 83% 92% 100%

Sum of P-1% 8% 16% 23% 30% 37% 39% Sum of penta-3% 7% 14% 21% 27% 32% 35% Sum of Measless% 7% 15% 22% 30% 39% 41% 0% 20% 40% 60% 80% 100% 120% 0 20000 40000 60000 80000 100000 120000 140000 160000 180000

(44)

Part -IV

Vaccines and Cold Chain

Management

(45)

Vaccines and Cold Chain Management

USSC (Country Office)

•

IRC CCEOP application comments addressed and to be shared with GAVI

by 21

st

Aug deadline

•

All pending routine vaccines to zones have been shipped

•

Quarterly cold chain equipment inventory updated for all