1. Liberia Field Epidemiology Training Programme (LFETP)Liberia Field Epidemiology Training Programme LFETP) Field Placement 2 Project Reports, Cohort 1, Liberia Basic FETP By L. Hilton Saye District Surveillance Officer, Gbehlay-Geh District, Nimba Co.

2. Liberia Field Epidemiology Training Programme (LFETP) Acknowledgement I will like to acknowledge the following: – Ministry of health, Liberia – AFENET – Emory University – US CDC – WHO – My mentors (Justin and Dr Peter)

3. Liberia Field Epidemiology Training Programme (LFETP)Liberia Field Epidemiology Training Programme LFETP) Expanded Surveillance Summary Report (week 31-42)

4. Liberia Field Epidemiology Training Programme (LFETP) Summary Between weeks 31-42: –Eight suspected diarrhea cases from Slangonplay clinic –One suspected AFP and three measles cases all from Marbor –One neonatal death and 1 maternal death all from Vayenglay –Silent clinic was able to join the health reporting system Overall, two clinics had late reports and one clinic had 25% cumulative report

5. Liberia Field Epidemiology Training Programme (LFETP) Fig.1.1: Timeliness of Reporting and Completeness, Week 31-42, 2015, Gbehlay-Geh, Nimba County FacilityWk 31 Wk 32Wk 33 Wk 34 Wk 35 Wk 36 Wk 37 Wk 38 Wk 39 Wk 40 Wk 41 Wk 42 % Cumulative Timeliness % Cumulative Completen ess Zorgowee TTTLTTTTTTTT92100 Goagortuo TTTLTLLTTTLL58.3092 Younlay TTLTTLLTTTLL58.3092 KHC TTTTTTTTTTTT100 Duoplay TTTTTTTTTTTT100 Loguatuo TTTLTTTTTTTT92100 Vayenglay TTTLTTTTTTTT92100 T ON Time L Late NR No report % Cumulative >80% On Time >50% to 80% On Time < 50 % On Time Legend

6. Liberia Field Epidemiology Training Programme (LFETP) Fig.1.1: Timeliness of Reporting and Completeness, Week 31-42, 2015, Gbehlay-Geh, Nimba County T ON Time L Late NR No report % Cumulative >80% On Time >50% to 80% On Time < 50 % On Time Legend FacilityWk 31Wk 32Wk 33Wk 34Wk 35Wk 36 Wk 37 Wk 38 Wk 39 Wk 40 Wk 41 Wk 42 %Cumulative Timeliness %Cumulative Completeness GarplayTTTTTTTTTTTT100 GbeivonweaTTTTTTTTTTTT100 Bea-YoolarTTTTTTTTTTTT100 KpairplayTTTTTTTTTTTT100 SlangonplayTTTTTTTTTTTT100 Give Them Hope NR TTT2567

7. Liberia Field Epidemiology Training Programme (LFETP) Fig 2:Timeliness and Completeness of Reporting of Health Facilities (weeks 31-42) Gbehlay-Geh District, Nimba County Percentages Health Facilities

8. Liberia Field Epidemiology Training Programme (LFETP) Fig. 3: Summary of Key Notifiable Diseases, Week 31-42, 2015, Gbehlay-Geh, Nimba County Priority Diseases/Events Cumulative week31- 42 CasesDeaths Case Fatality Rate Acute Flaccid Paralysis (AFP) 100 Yellow Fever 000 Cholera 000 Bloody Diarrhea 800 Meningitis 000 Measles 300 Human Rabies 000 VHF/EVD 000 Lassa Fever 000 Neonatal Tetanus 000 Maternal Deaths 100 Neonatal Deaths 100 Other VHF 000

9. Liberia Field Epidemiology Training Programme (LFETP) Graph of Priority Diseases/Events, Weeks 31-42, 2015 Gbehlay-Geh District, Nimba County No of Cases Disease/Events

10. Liberia Field Epidemiology Training Programme (LFETP) Trend of blooded diarrhea, Week 31-42, 2015, Slangonplay, Gbehlay-Geh District, Nimba County

11. Liberia Field Epidemiology Training Programme (LFETP) Public Health Action Public awareness – hand hygiene and proper sanitation practices – avoiding over crowdedness in sleeping places Recommendation – MOH to support effective communication system – MOH should support DSOs movement for supervision – MOH should establish quarterly review meeting on surveillance

12. Liberia Field Epidemiology Training Programme (LFETP) Measles Case Investigation Marbor Community Of Gbehlay-Geh District, Nimba County

13. Liberia Field Epidemiology Training Programme (LFETP) Introduction Measles is a very contagious disease affecting under five year children On September 22 nd and 23 rd 2015, there were reports of measles disease from Karnplay Health Center, Marbor community The objectives of the investigation are the: –existence of an outbreak –Review of patient’s records –Determination of vaccination exercise –Community awareness

14. Liberia Field Epidemiology Training Programme (LFETP) Methods 1/2 Study area: –Marbor has total population of 1983 – Of which 337 are under five years Case Definition –as any person with fever and rashes – with or without running nose, –redness of eyes –from September 19 to September 28, 2015 – in Marbor community

15. Liberia Field Epidemiology Training Programme (LFETP) Methods 2/2 The response team conducted –One on one interview –Active case search –Collected blood samples from cases

16. Liberia Field Epidemiology Training Programme (LFETP) Result Out of the 3 cases, 2 (66.7%) are male No death reported Attack rate is 15/10,000 population Attack rate for under < 5years is 8.9 per 1000 populations Three blood specimens were collected

17. Liberia Field Epidemiology Training Programme (LFETP) Result The patients treated have recovered Active case search done did not reveal more cases A one day outreach campaign was done –Seven dropped out target took measles vaccine among others Health awareness is ongoing

18. Liberia Field Epidemiology Training Programme (LFETP) intervention

19. Liberia Field Epidemiology Training Programme (LFETP) Conclusion Cases did not spread beyond the reported cases Since the intervention the number of suspected cases is contained Outbreak seems to have been brought under control. We recommended that the MOH through NCHT should support mass immunization campaign across the district