Weekly EWARS Reporting Form

Facility number

Morbidity

Cases

Acute Watery Diarrhoea

Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Bloody Diarrhea
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Other Diarrhea
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Acute Respiratory Infection

Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Suspected Measles/Rubella
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Suspected Mumps
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Acute Flaccid Paralysis (AFP)

Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Suspected Meningitis
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Acute Jaundice Syndrome

Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Suspected Hemorrhagic fever

Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Neonatal Tetanus
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Adult Tetanus
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Suspected Malaria
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Confirmed Malaria
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases
 Suspected Dengue
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Confirmed Dengue
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Suspected Varicella
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Unexplained Fever > 101 F/38.5 C

Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Severe Malnutrition
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Injuries/Wounds
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

Others
Under 5 male Under 5 female Over 5 male Over 5 female
cases cases cases cases

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