Somali Regional Health Bureau

Weekly Public Health Emergency Situational Update Date: 15th Dec 2023

Key Highlights
 Since, February 2023, the Cholera outbreak is ongoing in Somali region that affected a total of 19 Woredas in Seven zones in which a total of 2,935
Cholera cases including 67 deaths reported with Case Fatality Rate of 2.28%.
 The outbreak is currently active in 13 woredas and 3 town administrations in four zones in which a total of 1,471 cases including 46 deaths reported
with CFR = 3.13% as 10th December 2023. 77.4% (1,139) of the total cases reported in the last four weeks alone.
 The current cholera outbreak is ongoing since in the region since 12th September 2023 when the 1st index cases reported from Mayumuluko woreda
of Erer zone.
 Jijiga city, Kelafo, Lagahida and Gota-Biki woredas are currently reporting the highest cases that contributes 1,160 (75%) of the total cases reported
in the region.
 314 (21.3%) of the cases are under 5 years of age while the remaining 1,157 (78.7%).
 The highest cholera related mortality was reported from Jijiga city (11), Mayumuluko (9), Kalafo (8) and Lagahida (8) woredas.
 55 (3.7%) of the cases were reported from IDP sites in Erer (38), Lagahida (14), Deymed (2) and Gota-Biki (1) woredas.

Cholera Epidemiology Since 3rd February 2023

Zone # of Affected # of Affected # of Active # of controlled # of cases # of Death CFR

woredas kebeles woreda woredas
Liban 1 25 0 1 720 10 1.39
Fafan 8 79 8 0 714 12 1.68
Dawa 1 36 0 1 544 9 1.65
Sitti 3 21 3 0 336 6 1.79
Erer 2 19 2 0 257 17 6.61
Shabelle 2 20 2 0 254 11 4.33
Afdher 2 19 0 2 110 2 1.82
Total 19 219 15 4 2935 67 2.28

# of CTC # of CTU # of ORP Total

Cholera treatment facility 8 8 32 48

Cumulative Cholera Cases Cumulative Cholera Cases Cumulative Cholera with Cumulative Cholera Deaths
since February, 2023 in Cholera Active Woredas Severe Dehydration Patients since September, 2023 CFR
since September 2023
2,935 1,561 67 2.28
1,561
Woredas # of cases # of Death Woreda Status
Dollo Ado 720 10 Controlled
Jigjiga City 630 11 Active
Moyale 544 9 Controlled
Kelafo 241 8 Active
Lagahida 193 8 Active
Gota Biki 167 2 Active
Erer 128 4 Active
Mayumuluko 64 9 Active
Dollo-bay 62 0 Controlled
Cherati 48 2 Controlled
Daymed 41 0 Active
Gursum 24 0 Active
Tuliguled 18 0 Active
Abakarow 13 3 Active
Shabeley 12 0 Active
Kabribayah Woreda 11 0 Active
Tog wajale 8 0 Active
Babili 7 1 Active
Kabribayah City 4 0 Active
 Ongoing Outbreak intervention Activities
 Regularly conducted weekly and daily PHEOC, coordination meeting to guide the response operation, established communication platforms for information
sharing, advocacy and resource mobilization, identify key gaps and develop piler based action plans. Alert letters were shared to the cholera hotspot woreda’s
of the region.
 Distributed 107 cartons of water purifications chemicals to the affected woreda’s (Lagahida and kelafo woredas). 290 aqua tabs were distributed to the HH of
commonly affected kebeles in Gota biki.
 Assessed and monitored the functionality and usage of HTH in six major water sources in kelafo town by using a Pool test. RHB and WHO surveillance team in
collaboration with Jijiga City RRT, have conducted investigations on 73 cases admitted to Ayardaga CTC and Jigjiga Primary Hospital CTU. A detailed analysis of
the cases revealed that: 26% of the cases had a history of contact with confirmed or known cholera cases within the past five days, and 18% of the cases had
attended a funeral ceremony of individuals who were known or suspected to have cholera.
 Woreda Water Office provided water trucking for Kelafo CTU with the assistance of Save the Children.
 All of the households in the affected cases were sprayed by designated IPC teams.
 Conducted case management supportive supervision to CTCs/CTUs of Gursum, Lagahida, and Kelafo woredas, assessed the quality of CTC through ODK platform,
delivered quick-reference job aids and provided refresher orientation to a total of 44 HWs (Male = 21, & Female = 8).
 8 CTCs, 8 CTU ‘s, and 32 ORP were established and equipped which are fully functioning for case management.
 Through Risk Communication and Community Engagement, daily risk communication messages are transmitted throughout the affected woreda by using
megaphones, local radio/TV, and speakers/Vans and reached a total of 531 HHs with a total population of 2,687 in Cholera outbreak-affected areas in the Somali
region whereby disseminated critical messages on prevention and control measures.
 Religious leaders and other key community influential leaders were engaged for transmitting messages to the community leaders.
 Collected 49 drinking water samples of CTCs/CTUs and households in Jijiga city and tested for Free Residual Chlorine (FCR). Only 7 samples were found to have
recommended levels of FRC.
 Emergency medical supplies and WASH Supplies were provided to all affected woredas. Regular inventory and monitoring of supplies on hand were conducted
regularly and gaps in the supplies were identified and shared with the coordination minutes of active woredas.
 The Regulatory team in Jijiga city has reached and inspected 13 sites of pharmacies, low clinics, and 4 drinking juice houses. Also conducting inspections of the
restaurants, Cafeteria, and clinics to assess their adherence to the prevention and control measures of cholera.
 MSF/Holan, Red Cross, WHO, UNICEF, SCI, IOM, and OWDA are currently supporting the technical, provision of supplies and logistics in the outbreak response.

Key Challenges/Gaps Key Priority Action needed

 Logistic transportation gaps for surveillance, IPC&WASH, and RCCE pillars.  More CTUs/ORPs are established in high-risk areas.
 Shortage of cholera investigation kits supplies despite there is a rapid spread of
cholera cases in the region including IDP sites.  Strengthen pillar/based outbreak response operation activities
 Lack of OCV campaign.  Advocate OCV campaign and prepare a micro plan for Somali region.
 Gaps in multi-sectoral engagement and limited partner support to the current cholera  Mobilize resources such as operation costs, WASH supplies, and
outbreak response operation in the region.
 Shortage of operational costs partner engagement.
 Multiple public health emergencies and disease outbreaks (Flash Floods, Dengue  Pre-campaign preparation throughout all cholera affected woreda’s
Fever, Malaria, Measles, and Cutaneous Leishmaniasis) all demanding response.  Regional laboratory needs to be capacitated as soon as possible to
 Shortage of WaSH supplies throughout all active woreda’s and areas selected for CATI
approach implementation. ensure its Cholera diagnostic capacity
 The regional laboratory didn’t have the capacity to test the stool samples for cholera
suspected cases and needs to be equipped in terms of materials and human resource
