Dili Office, East Timor
Infectious Disease Surveillance & Epidemic Preparedness Unit
Important points: measles in Ermera, bloody diarrhoea in Dili, malaria season and World AIDS day.
Formal reports via the surveillance system:
During week 46 of 1999, reports concerning 7,829 patients seen in 24 health facilities (including mobile clinics) were received at the WHO Office in Dili. Six districts were represented in the data reported by 7 agencies among 14 providing health care services. The districts reporting were Dili, Maubisse (Ainaro), Ermera, Liquica, Bobonaro (Maliana) and Manufahi (Same). World Vision started a health care service in Maliana and has reported from 3 different localities.
73% of the consultations reported concerned communicable diseases. The most common were malaria/fever (29% of 5,686 total communicable disease cases reported), then upper respiratory tract infection/TB. Three cases of acute jaundice syndrome were reported each from Maliana, Ermera and Liquica - no further information is available on clinical signs and symptoms.
As expected, measles continues to be reported - 18 cases in Ermera, 4 in Dili and 1 in Liquica. The frequency distribution of bloody diarrhoea cases reported is disproportionately higher in Dili this week. Also in Dili, there were 204 cases of malnutrition, corresponding to 63% of total malnutrition cases reported. There seems to be a need to review source of information and methodology used to assess nutritional status.
1- Informal reports:
The French hospital laboratory has isolated Shigella flexneri and S. sonnei - both these pathogens are less likely to cause major outbreaks than Shigella dysenteriae, which has not been isolated as yet.
December 1 is AWorld AIDS day@. The lack of information on HIV/AIDS prevalence in East Timor is a concern: Since week 39, 151 cases of STD have been reported from all 13 districts. The majority of cases were reported from Dili (57%) and Ermera (21%). Probable malaria fatalities in children were reported in Fatu Berliu (32 hours from Same), and also from Manleuana (Perumnas), in Dili. These are known endemic areas, and the loss of mosquito control programmes and bed nets are already leading to increases in both numbers of cases and fatalities this year. Malaria will be an increasing concern as the wet season continues.
DISTRIBUTION OF CONSULTATIONS AND SPECIFIC DISEASES BY DISTRICT REPORTED IN WEEK - 46
Total Number of Consultations Year-week = 1999-46
District
|
Freq
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
561.0
|
7.2%
|
7.2%
|
Dili
|
4348.0
|
55.5%
|
62.7%
|
Ermera
|
966.0
|
12.3%
|
75.0%
|
Liquica
|
1503.0
|
19.2%
|
94.2%
|
Maliana (Bobonaro)
|
390.0
|
5.0%
|
99.2%
|
Same (Manufahi)
|
61.0
|
0.8%
|
100%
|
Total
|
7829.0
|
100.0%
|
Bloody Diarrhoea - Total Cases Year-week = 1999-46
District
|
Freq.
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
6
|
4.0%
|
4.0%
|
Dili
|
125
|
82.8%
|
86.8
|
Ermera
|
12
|
7.9%
|
94.7%
|
Liquica
|
7
|
4.6%
|
99.3%
|
Maliana (Bobonaro)
|
1
|
0.7%
|
100.0%
|
Same (Manufahi)
|
0.0%
|
100.0%
|
|
Total
|
151
|
100.0%
|
Watery Diarrhoea - Total Cases Year-Week = 1999-46
District
|
Freq.
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
56
|
9.4%
|
9.4%
|
Dili
|
380
|
63.8%
|
73.2%
|
Ermera
|
42
|
7.0%
|
80.2%
|
Liquica
|
65
|
10.9%
|
91.1%
|
Maliana (Bobonaro)
|
51
|
8.6%
|
99.7%
|
Same (Manufahi)
|
2
|
0.3%
|
100.%
|
Total
|
596
|
100.0%
|
Suspected Malaria/FUO B Total Cases Year-week = 1999-46
District
|
Freq
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
10
|
0.6%
|
0.6%
|
Dili
|
869
|
53.1%
|
53.7%
|
Ermera
|
186
|
11.4%
|
65.1%
|
Liquica
|
476
|
29.1%
|
94.1%
|
Maliana (Bobonaro)
|
87
|
5.3%
|
99.5%
|
Same (Manufahi)
|
9
|
0.5%
|
100.0%
|
Total
|
1637
|
100.0%
|
URTI/Suspected TB Total Cases Year-week=1999-46
District
|
Freq
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
81
|
6.6%
|
6.6%
|
Dili
|
681
|
55.3%
|
61.9%
|
Ermera
|
244
|
19.8%
|
81.7%
|
Liquica
|
65
|
5.3%
|
86.9%
|
Maliana (Bobonaro)
|
148
|
12.0%
|
98.9%
|
Same (Manufahi)
|
13
|
1.1%
|
100.0%
|
Total
|
1232
|
100.0%
|
Lower Resp Tract Infection Total Cases Year-week = 1999-46
District
|
Freq
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
30
|
6.7%
|
6.7%
|
Dili
|
393
|
88.3%
|
95.1%
|
Ermera
|
15
|
3.4%
|
98.4%
|
Liquica
|
6
|
1.3%
|
99.8%
|
Maliana (bobonaro)
|
0.0%
|
99.8%
|
|
Same (Manufahi)
|
1
|
0.2%
|
100.0%
|
Total
|
445
|
100.0%
|
Measles Total Cases Year-week = 1999-46
District
|
Freq
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
0.0%
|
0.0%
|
|
Dili
|
4
|
17.4%
|
17.4%
|
Ermera
|
18
|
78.3%
|
95.7%
|
Liquica
|
1
|
4.3%
|
100.0%
|
Maliana (Bobonaro)
|
0.0%
|
100.0%
|
|
Same (Manufahi)
|
0.0%
|
100.0%
|
|
Total
|
23
|
100.0%
|
Scabies Total Cases Year-week = 1999-46
District
|
Freq
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
78
|
51.3%
|
51.3%
|
Dili
|
6
|
4.1%
|
47.1%
|
Ermera
|
17
|
11.6%
|
68.7%
|
Liquica
|
19
|
12.9%
|
81.6%
|
Maliana (Bobonaro)
|
23
|
15.6%
|
97.3%
|
Same (Manufahi)
|
4
|
2.7%
|
100%
|
Total
|
147
|
100%
|
Malnutrition Total Cases Year-week = 1999-46
District
|
Freq.
|
Percent
|
Cum.
|
Ainaro (Maubisse)
|
3
|
1.0%
|
1.0%
|
Dili
|
204
|
67.3%
|
68.3%
|
Ermera
|
57
|
18.8%
|
87.1%
|
Liquica
|
0.0%
|
87.1%
|
|
Maliana (Bobonaro)
|
39
|
12.9%
|
100%
|
Same (Manufahi)
|
0.0%
|
100%
|
|
Total
|
303
|
100%
|
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