Communicable Disease Surveillance in Somalia, 2012 Open Access

Cordes, Kristina (2014)

Permanent URL: https://etd.library.emory.edu/concern/etds/x059c7906?locale=en
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Abstract

Background: A complex humanitarian emergency (CHE) occurs when there is a disintegration of authority and the overwhelmed infrastructure of a society is unable to manage the complications that arise. During CHE there is an increased risk of communicable diseases, resulting in the need for heightened surveillance. In 2011, Somalia experienced the worst drought in 60 years and famine was declared in July of that year. The World Health Organization (WHO)-Somalia collaborated with the U.S. Centers for Disease Control and Prevention (CDC) to evaluate and revise the communicable disease surveillance system in Somalia. The revised system was used for the entire year of 2012 in all four zones of the country.

Methods: Data for 2012 was collected via the Somalia communicable diseases reporting system (CSR). Data quality and disease trends were analyzed using Statistical Analysis Software (SAS) and summarized in the 2012 WHO-Somalia Communicable Diseases Reporting System (CSR) annual surveillance report.

Results: Although a few suspected outbreaks were detected, analysis of priority health events (suspected cholera, suspected shigellosis, suspected measles and confirmed malaria) showed a general decreasing trend in proportional morbidity over the 52 reporting weeks.

Conclusions: Data quality was seen to improve in all four zones after switching from the Excel database to the Epi Info database, and continued use of Epi Info for surveillance purposes is recommended. As with any surveillance system, regular monitoring and periodic evaluations should be conducted.

Table of Contents

Chapter 1 Complex Humanitarian Emergencies..................................1
Definition and Characteristics.......................................................1
Sources of CHE..........................................................................2
Public Health Concerns and Healthcare during CHE............................4
Phases.....................................................................................5
Health Concerns.........................................................................6

Chapter 2 Surveillance................................................................10
Public Health Surveillance............................................................10
Surveillance during CHE...............................................................11
Evaluation of Surveillance............................................................13


Chapter 3 Background.................................................................14
Geography and Government of Somalia...........................................14
Famine and Humanitarian Emergency..............................................15
Public Health Surveillance............................................................15


Chapter 4 Methods.....................................................................17
Data Collection..........................................................................17
Assessing Data Quality................................................................18
Detecting Increased Patterns.......................................................20


Chapter 5 Results.......................................................................21
Data Quality..............................................................................21
Priority Health Events in 2012.......................................................24
Trends in Proportional Morbidity for Priority Health Events..................25
Vaccine Preventable Diseases.......................................................38
Facility-specific Disease Trends.....................................................44


Chapter 6 Discussion...................................................................50
Limitations.................................................................................51
Conclusions...............................................................................51


Appendix...................................................................................57

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