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Situation Report of Cholera Outbreak in Borno State No. 17: 22nd September 2018

Borno State Ministry of Health Highlights

96 additional suspected cases of cholera were reported on the 22nd of September 2018 in Borno State

2 new deaths reported from Jere and Chibok LGAs

Epidemiological Summary

The total number of suspected cholera cases reported as at 22nd of September 2018 stands at 2,396, with 42 associated deaths, (CFR – 1.75%). 937 in Jere, 414 in MMC, 318 in Magumeri, 29 in Kaga, 81 in Konduga, 119 in Chibok, 11 in Shani, 32 in Damboa and 455 in Ngala LGAs. No additional case reported from Kaga, Shani and Damboa LGAs.

Out of the 102 samples collected and tested in the state using RDTs, 72 (70%) were positive while 11 (25%) of 44 samples were culture positive.

Table 1: Number of cases reported as of 22nd September 2018.

Jere MMC Magumeri Kaga Konduga Chibok Shani Damboa Ngala TOTAL

Cases

New cholera suspected cases 45 21 1 0 1 1 0 0

27 96

Cumulative cholera suspected cases 937 414 318 29 81 119 11 32 452 2,396

Deaths

New deaths 1 0 0 0 0 1 0 0 0 2

Cumulative deaths 10 6 5 1 3 5 0 3 9 42

Laboratory

Number of specimen Tested

15 23 12 10 7 20 3 5 7 102

Specimen Positive RDT 11 17 9 8 5 11 1 3 7 72

Specimen Positive Culture

4 4 0 0 0 2 0 0 1 11

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Figure 1: Map of Borno state showing affected LGAs in Borno State.

96 additional suspected cholera case were reported from 6 LGAs, Jere, MMC, Magumeri, Konduga, Chibok and Ngala LGAs on the 22nd of September 2018. The total number of suspected cases reported in the state so far is 2,396. Jere LGA has reported a total of 937 suspected cases, MMC 414 and Magumeri 318 (see Table).

Figure 2a: Daily Epi-curve of suspected cholera cases in Jere LGA Figure 2b: Weekly Epi-curve of suspected cholera cases in Jere LGA

**NB: The last bar on the weekly epidemiological curves above are not complete data for week 38**

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Figure 3a: Daily Epi-curve of suspected cholera cases in MMC Figure 3b: Weekly Epi-curve of suspected cholera cases in MMC

Figure 4a: Daily Epi-curve of suspected cholera cases in Magumeri LGA Figure 4b: Weekly Epi-curve of suspected cholera cases in Magumeri LGA

Figure 5a: Daily Epi-curve of suspected cholera cases in Borno State Figure 5b: Weekly Epi-curve of suspected cholera cases in Borno State

**NB: The last bar on the weekly epidemiological curves above are not complete data for week 38**

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Response

1. Surveillance

Active Case Search intensified and ongoing in all affected locations

WHO supported volunteers conducting House to House case search covered 3,425 Households in

Maisandari, Bakassi IDP camp, Garba Buzzu, in Bolori I; Seven Up area, Jajeri and behind UBA in Bolori

II, identified 62 suspected cases and referred 59 to CTC/ORP

WHO supported House to House active case search teams continues data capture in the field using ODK

for accurate, timely aggregation and analysis of data to guide response activities only, same to

commence in Ngala by LGA team

WHO HTR teams still supporting Active Case Search in Benisheik, in Kaga, Chibok and Gajigana in

Magumeri LGAs

Sharing of priority locations to WASH and risk communication teams is ongoing for targeted interventions. Wards with ongoing transmission are: Dusuman, Gongulong and Old Maiduguri in Jere LGA while in MMC priority locations Limanti, Bolori 1&2, Bulabulin, Gwange 1 and Lamisula. Gajigana still reporting cases in Magumeri LGA.

Response activities have been intensified in Ngala, as cases are being reported in IDP camp.

Fig 6. Map of Borno state showing households visited during ACS in Jere and MMC

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2. Case management

CTC Dala ORP EL-Miskin PHC Gajigana

Total

Admissions

New admissions Number on Admission New Discharges

43 59 56

23 20 3

1 0 1

67 79 60

The number of intervention site are 5 at present. 1 CTC, 2CTU and 3 ORPs; CTC Dala in Jere LGA (MSF

Belgium). 1 CTU in Model PHC Gajigana, Magumeri (supported by WHO, IRC and INTERSOS), ORP in El-

miskin, Jere LGA (Supported by MDM).

WHO and SMOH continues to support partners managing CTCs/CTU with medical supplies

3. WASH

Continued hygiene promotion and education on hand washing, dangers of open defecation ongoing in identified priority locations by WaSH sector partners and Community Health Volunteers supported by WHO.

In Jere LGA, CIDAR/UNICEF Sensitized 594 households on hygiene promotion /cholera through a Door to Door approach and 778 people through a Focus Group Discussion approach in Muna Garage El Badawe, Custom House, Custom House 2, El-Miskin Center, El-Miskin Transit camp.

Door to Door for Cholera/AWD Active case finding/Search in the same 594 households in the same locations

Covered 241 people through environmental cleaning campaign and refilled 26 washing stations in the same locations

Disinfected 120 latrines and 641 shelters in the same locations

Posted 346 water points care takers, chlorinated 328 water points and distributed 351 cubic meter of water from borehole equipped in the same locations+ Bale Galtimari primary school and Jere host communities

4. Social Mobilization

Volunteers continue to deliver lifesaving messages on how to prepare ORT as a first aid therapy,

personal/environmental hygiene and early health seeking behaviour. They visited 3,425 households

and sensitized 21,110 persons in Maidinatu, Elmiskin, Customs, shuwari, Bolori

Mobile health campaign has continued in host communities and IDPs camps around Jere, MMC and

Konduga

Islamiyya and Tsangaya school pupils are being sensitized in Jere and MMC, conducting in 47 schools

Distribution of Cholera IEC materials is ongoing in identified hotspots

Radio messages ongoing in 3 languages (Hausa, Kanuri and English Languages) in 3 media houses within

Borno

Regular mosques announcement by Jumaat and Daily Prayer Imams are ongoing in Gongolong ward

(Mallam Kolo, Goni Kolo and mallam Abatcha mosques) and Madinatu mosques in Jere LGA and also

in Biu, Bayo and Ngala

5. Coordination

Public Health EOC resolved to start holding daily coordination meetings of the cholera outbreak to close

up response gaps and ensure a robust and effective coordination of the response activities