Scribd Logo
Upload

Welcome to Scribd!

  • 2020 PIDSR Annual Report

    Uploaded by

    KiarahFlorendo
    1 views106 pages

    Copyright

    © © All Rights Reserved

    Available Formats

    PDF or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
    1 views106 pages

    2020 PIDSR Annual Report

    Uploaded by

    KiarahFlorendo

    Copyright:

    © All Rights Reserved
    Download as PDF or read online from Scribd
    Flag for inappropriate content
    Download as pdf
    of 106
    PHILIPPINE INTEGRATED DISEASE SURVEILLANCE AND RESPONSE, 2020 ANNUAL REPORT Philippine Integrated Disease Surveillance and Response 2020 Annual Report Published by Public Health Surveillance Division Epidemiology Bureau Department of Health San Lazaro Compound Rizal Avenue, Sta. Cruz Manila 1003, Philippines ‘The PIDSR Annual Report 2020 is published by the Epidemiology Bureau. The data in this report were obtained from the Regional Epidemiology and Surveillance Units (RESUs). This report can only provide information on comparative statistics by sociodemographic category and region of the diseases, syndromes and conditions included in PIDSR. This report may be reproduced in full or in part for non-profit purposes without prior permission, provided proper attribution to the Epidemiology Bureau is made. Furnishing the Epidemiology Bureau, a copy of the reprinted or adapted version will be appreciated. By the Staff of the Epidemiology Bureau the Department of Health, Philippines Editorial Board: Medical Specialist IIT Epidemiology Bureau HerdieL. Hizon fi, Supervising Health Propant Officer Epidemiology Burgi 7 Richelle P. Abellera, RN fon study leave) Nurse V, National Coordinator, Philippine Integrated Disease Surveillance and Response Epidemiology Bureau f™ Jezza Jonah C. Aclan, RN, MPH ‘Nurse Ill, National Coordinator, Vaccine Preventable Disease Surveill Epidemiology Bureau Gretchen M. Esole, Rw Glial” ‘Nurse Il, National Coot r, Philippine Integrated Disease Surveillance and Response Epidemiology Bureau Kris Pauline D. Martinez, RN. 4770497 Senior Henth Program Offcer- Cluster Head, Nor-VPD Philippine integrated Disease Surveillance and Response ‘Van Farrah S. bea, RN Senior Health Program Officer” Head, VPD Philippine Integrated Disease Surveillance and ‘Response Officer - Vaccine Prevgatyble Diseases Edriz Noelle B. Ruezo, RN Nurse Il, Cluster Head- Food and Water Bor Diseases and Other Diseases Philippine Integrated Disease Surveillance and Response Eunice P, Guzman, noknryo~ Nurse Ill- Cluster Head, VPD Philippine integrated Disease Surveillance and Response Joysa D. Lorico, RN. Vise Nurse II- Cluster Head, (yctor-Bomeand Zoonotic Diseases. Philippine ntepfated Disease Surveillance and Response Officer a n ‘Charles Maurice A. Natan, RND/\ Heath Program Oficer I Philippine ptegied Disease Survellance nd Response Officet> CChikungunya, Neonatal Tetanus and Rotavirus Gerardo Nifio B. Alapide, RN Aeafbidge ‘Nuase I, Philippine Integrated Diseaze Sa ‘and Response Officer - AMES and Meningococcal disease Jasmin P. Andoy, RN ‘Health Program Officer I Pé@hional Vane Preventable Disease Surveillance Officer- Diphtheria, Pertussis and Non-Neonatal Tetanus Jessa F. Sayson, RMT X< Health Program Officer I, National “tine Preventable Disease Survill=be Orficer- Measles- Rubella Jenny Rose Prudente, RN ‘Nurse Il, Philippine Integrated Surveillance and Response Officer- Acute Bloody Diarrhea, Acute Viral Hepatitis and Cholera Jewel P, Rodriguez, RND Health Program Officer I, Philippine intepated Disease Surveillance and Response Officer- Typhoid Fever, Rabies and Leptospirosis Karl Paolo L. Candelario, RN ‘Health Program Officer I, Philippine Jategrated ‘Disease Surveillance and Response Officer ~ ILI/SART Nurse I, National Vaccine Ye Disease Surveillance Offices; Acute Flaccid Paralysis Lenneth G. Cruz Administrative Assistant, Disease Surveillance and Response, [ 2020 PIDSR Annual Report Preface Acknowledgement Message from the Office of the Chapter 1. Introduction Goal and Objectives of PIDSR Conceptual Framework of PIDSR How to Use this Annual Report Data Interpretation Limitation of the Data Chapter 2. Vaccine-preventable Diseases 2.1 Acute Flaccid Paralysis 2.2 Diphtheria 2.3 Measles-Rubella 2.4 Neonatal Tetanus 2.5 Non-neonatal Tetanus 2.6 Pertussis Chapter 3. Food and Waterborne Diseases 3.1 Acute Watery Diarrhea 3.2 Cholera 3.3 Acute Viral Hepatitis 3.4 Rotavirus 3.5 Typhoid Fever Chapter 4. Zoonotic and Vector-borne Diseases 4.1 Chikungunya 4.2 Dengue 4.3 Leptospirosis 4.4 Rabies Chapter 5. Other Diseases 5.1 Acute Meningitis-Encephalitis Syndrome (AMES) 5,2 Influenza-like Illness (ILI) 5.3 Meningococcal Disease Annex 1. 2020 PIDSR Morbidity Week Calendar Annex 2, Reported Cases, Deaths and Incidence Rates of PIDSR Notifiable Diseases/Syndromes by Region, Philippines, 2019 vs 2020 Annex 3. Reported Cases of PIDSR Notifiable Diseases/Syndromes by Age and Sex, Philippines, 2020 Annex 4, Reported Cases of PIDSR Notifiable Diseases/Syndromes by Region, Province and Month, Philippines, 2020 wowwene 15 20 30 35 39 45 49 54 65 70 ze 74, 79 83 86 86 91 95 99 100 121 135 | 2020 PIDSR Annual Report Annex 5. Reported Cases of PIDSR Notifiable Diseases/Syndromes by Region, Province and Morbidity Week, Philippines, 2020 Annex 6. Reported Cases of PIDSR Notifiable Diseases/Syndromes by Year, Philippines, 2003 to 2020 ‘Annex 7. Reported Cases, Deaths and Case Fatality Rates (CFR) of PIDSR Notifiable Diseases/Syndromes by Region, Philippines, 2016 to 2020 ‘Annex 8. Reported Cases, Deaths and Case Fatality Rates (CFR) of PIDSR Notifiable Diseases/ Syndromes by Age Groups, Philippines, 2020 177 27 278 298 | 2020 PIDSR Annual Report Preface The Philippine Integrated Disease Surveillance and Response (PIDSR) is the main source of disease surveillance information used by various stakeholders. Data collected provide key health intelligence that assists public health authorities in monitoring disease trends, identifying risk populations and implement effective public health interventions to respond to priority diseases. Other stakeholders include the academe, researchers, and other government organizations. This report is one of the yearly publications of morbidity and mortality statistics of notifiable diseases/syndromes by the Epidemiology Bureau, Department of Health (EB-DOH) reported by Disease Reporting Units (DRUs) and Epidemiology and Surveillance Units (ESUs) across all levels of the health system, The diseases/syndromes were identified as those with epidemic potential. This includes the following: Vaccine Preventable Diseases Food and Water-borne Diseases © Acute Flaccid Paralysis © Acute Bloody Diarrhea ‘© Diphtheria * Cholera * Measles-Rubella Hepatitis A © Neonatal Tetanus + Rotavirus ‘+ Non-Neonatal Tetanus © Typhoid Fever © Pertussis . Zoonotic and Vector-borne Diseases Other Diseases/Syndromes © Chikungunya * Acute Meningitis-Encephalitis © Dengue Syndrome (AMES) © Leptospirosis ‘*Influenza-Like Illness (ILI) © Rabies ‘+ Meningococcal Disease | 2020 PIDSR Annual Report Acknowledgment The Epidemiology Bureau extends its sincerest gratitude to the Centers for Health Development (CHDs), through its Regional Epidemiology and Surveillance Units (RESUs) and all Disease Reporting Units (DRUs) participating in the PIDSR National Network for their unwavering support to generate this PIDSR 2020 Annual Report. The EB appreciates the Research Institute for Tropical Medicine (RITM) for their generous support in laboratory confirmation of diseases under the PIDSR system and for sharing their expertise with the PIDSR unit and RESUs during trainings and workshops held in 2020. We would also like to acknowledge the Disease Prevention and Control Bureau (DPCB) for their guidance in updating the case definition of diseases reportable to PIDSR and the inclusion of variables necessary for policy making and program intervention | 2020 PIDSR Annual Report Message from the Office of the Epidemiology Bureau Director ‘The Epidemiology Bureau of the Department of Health remains committed to deliver and realize its mandate to provide and promote epidemiologic information for evidence-based decision making. With this, it is with great pride and honor to present to you the 2020 Philippine Integrated Disease Surveillance and Response (PIDSR) Annual Report. The year 2020 has been a tough year to us due to COVID-19 pandemic. Amidst this global set back, our dear frontline health workers showed outmost resiliency and dedication to fulfill their ‘sworn duty. Their selflessness and commitment of work in the field of disease detection, control and prevention was far beyond expectation. Also, | would like to extend my heartfelt gratitude and congratulations to all the Epidemiologists and Disease Surveillance Officers at the regional, provincial, city and municipal health offices. | would like to acknowledge too our partners in health from the government and private hospitals, Local Government Units, Non - Government Organizations and other Government and Civil Societies who are supportive of the thrusts of the Department of Health. ‘The teamwork from these various organization and key players in surveillance and in health ‘enables us to reach excellence and continue exemplary performance to serve the Filipino people and making this country-a Healthy Philippines. Congratulations and | salute you, all! ha RODOLFO|ANTONIO M. ALBORNOZ, MD, MDM, MPH, CESE OlC-Directbr IV | 2020 PIDSR Annual Report Chapter 1. Introduction Disease surveillance is recognized as the cornerstone of public health decision-making and practice. The surveillance system generates data that is helpful to the Public Health Officials Understanding the existing and emerging infectious and non-infectious diseases. Surveillance data provide Information which can be used for priority setting, policy decisions, planning, implementation, resource ‘mobilization and allocation, prediction and early detection of epidemics. A surveillance system can also be used for monitoring, evaluation and improvement of disease prevention and control programs. Without these quality data, interventions may become misguided and wasteful. With functional surveillance and proper understanding of health problem, it will not be difficult to ameliorate the health issue, Core functions of public health surveillance, such as case detection, registration, confirmation, reporting, and dissemination, carried out by Epidemiology and Surveillance Units (ESUs) should be ensured to detect and respond to health events that pose immediate public health risks. The Philippine Integrated Disease Surveillance and Response (PIDSR) System was established to serve as the existing indicator-based disease survelllance systems in the Philippines and to comply with ‘the call of the International Health Regulations (2005), or the IHR, for an urgent need to adopt an integrated approach for strengthening the epidemiologic surveillance and response system of each member nation, ‘The 2020 PIDSR Annual Report is a summary of the case-based disease surveillance system. The data in this report were obtained from, compiled and validated by the PIDSR Unit of the Epidemiology Bureau (EB) with the Regional ESUs. This report provides information on disease trends by morbidity week and comparative statistics by time, place and person of notifiable diseases, syndromes and conditions. Goal and Objective of PIDSR Goal To support the health sector in reducing morbidity and mortality from diseases of public health importance through an institutionalized, functional integrated disease surveillance and response system, Objectives 1. To continually improve capacities at the national and regional levels to efficiently and effectively manage national and sub-national surveillance and response systems. 2. To mobilize and empower local government units (LGUs) in the establishment and institutionalization of disease surveillance and response system, 3, To support health sector capacity development for sustainable disease surveillance and response systems. | 2020 PIDSR Annual Report 4. To enhance u tion of disease surveillance data for decision making, policy development, program management, planning, monitoring and evaluation at all levels. Conceptual Framework of PIDSR The PIDSR Framework embodies an integrated functional disease surveillance and response system institutionalized from the national level down to the community level (Figure 1). Each level of the health care delivery system interacts with each other while performing their basic roles and responsibilities. Standard case definitions to detect priority diseases are to be used in all disease reporting units and a comprehensive flow of reporting is adopted. With the PIDSR surveillance data, the LGUs take an active role in disease detection and response in their respective localities, while the regional and national levels provide the necessary support. Figure 1. Conceptual Framework of the PIDSR Pena Wations! Disease Surveillance and Resoonse Module SRST coma ana Savatece Unt G40, ~ Gr en ane io RESU- Rogiosl edocs cra sovchcnce uct RAD ~ mur! Roast ome | 2020 PIDSR Annual Report How to use this Annual Report This PIDSR 2020 Annual Report describes significant epidemiologic information for selected notifiable diseases and gives additional information to support the interpretation of surveillance and disease-trend data. It comprises tables showing reported cases for the nationally notifiable infectious diseases, distributed by time, place and person as well as graphs, maps and other visual displays to facilitate the analysis of surveillance data, ‘The PIDSR Annual 2020 includes the following da © Time: Trend/Epicurve ‘© Place: Demographic characteristics of cases © Person: © Profile of Cases and Deaths © Age group and Sex ‘0 Vaccination status of cases with vaccine preventable diseases © Estimates of case fatality ratios Laboratory Specimens and Results Percent change from 2019 surveillance data Data Interpretation PIDSR 2020 Annual Report must be interpreted with caution. Cases from outbreaks identified and investigated by Disease Reporting Units (DRUs) are not included in the final count, The diagnostic capebilities of the hospital laboratories also affect the completeness of reporting. For diseases with laboratory confirmation, those with positive culture, serology or smear as the case requires, are included. Limitations to the Data Notifiable disease reporting is incomplete for most conditions, and completeness and timeliness of reporting to the jurisdictions and submission of notifications to EB vary by condition and location. Detection and reporting of health conditions to jurisdictions may be influenced by the severity of the illness; patient and public awareness of conditions; patient access to health care; the availability of diagnostic facilites; interests, resources, and priorities of the clinicians, laboratories, hospitals and other health facilities that report to the jurisdictions; jurisdiction reporting requirements and resources; ‘emerging pathogens and conditions; and, priorities of state and local health departments. Reporting delays also occur due to outbreaks, competing priorities, and for other various reasons (e.g., technical problems, changes in staff schedules, vacation periods). Moreover, data may be batched reported during ‘outbreaks and at other times, including at the end-of-year when surveillance staff are finalizing the data, | 2020 PIDSR Annual Report ase counts and rates may also vary over time (e.g. from year to year) based on changes in public ‘and provider awareness; changes in laboratory and diagnostic techniques; and changes in the definition of conditions. ‘These limitations to the data should be considered when comparing counts and rates across conditions and when comparing counts and rates for any condition by person, place, or time. It should not be assumed that differences reflect only variation in the true incidence of the conditions. | 2020 PIDSR Annual Report Chapter 2. Vaccine Preventable Diseases ‘There are six (6) vaccine preventable diseases targeted for eradication, elimination and control in the Philippines namely: acute flaccid paralysis, measles, rubella, diphtheria, pertussis and neonatal tetanus. Different strategies were implemented such as surveillance activities, health promotion and immunization. Various programmatic and surveillance indicators were developed to track risks of ‘transmission and measure quality of case detection and reporting. ‘A clear picture of the country's status of diseases for the whole year compared to the previous or specified period of time will prevent progression or halt unfavorable existing conditions thus, prompt action and appropriate response will be determined. To highlight the prevention of occurrence, they only require a complete vaccination. Once neglected or forgotten, this precipitates the surge of cases that might lead to a possible outbreak. 2.1 Acute Flaccid Paralysis (AFP) Poliomyelitis is one of the vaccine-preventable diseases targeted for eradication. It is a highly contagious disease that mainly affects children less than 5 years of age. The last case of wild polio in the Philippines was in 1993 in Cebu. In October of 2000, the Philippines, along with the other members of the Western Pacific Region, was certified polio-free. However, in September of 2001, a type 1 highly evolved circulating vaccine-derived poliovirus (¢VOPV1) was isolated from three acute flaccid paralysis (AFP) cases, and one healthy contact from three separate communities in the country. Extensive OPV immunization campaigns were conducted from 2001 until 2002. in June 2018, there were reported polio outbreaks in some countries in the Western Pacific Region and subsequently, Philippines reported its frst Vaccine- derived poliovirus (VOPV) last September 14, 2019. AFP Surveillance is an intensive case-based surveillance where a comprehensive set of data is collected for every case of children under 15 years of age with acute onset of paralysis or any case that falls under the AFP differential diagnosis or a person of any age in whom poliomyelitis is suspected by @ physician. The differential diagnosis of AFP includes but is not limited to poliomyelitis, Guillain-Barre ‘Syndrome (GBS), traumatic neuritis, and transverse myelitis. These four diseases represent the most ‘common causes of AFP; however, other differential diagnoses that have numerous etiologies. Hence, any ase that presents AFP, even if diagnosed as the other disease than polio by the physician should be reported and collected with stool specimen. Before the declaration of polio outbreak last September 2019, the Non-Polio AFP Rate target is 1 per 100,000 population of children under 15 years old. After the declaration, it was recommended that the target will be raised from 1 to 3 per 100,000 populations for the outbreak regions (Region 3, CALABARZON, 7, 9, 10, 11, 12, BARMM, Caraga and NCR) and 2 per 100,000 for non-outbreak regions (Region 1, 2, MIMAROPA, 5, 6, 8 and CAR). By end of 2020, the non-polio AFP rate was 2.66 with 895 non- polio AFP cases reported. The non-polio AFP rate is one of the core performance indicators to gauge the sensitivity of AFP surveillance in the country. It aims to provide a timely response if an outbreak occurs. | 2020 PIDSR Annual Report Failure to achieve the target requirement indicates that the existing surveillance system is not sufficient to detect the possible transmission of polio. AFP surveillance is an essential strategy that aims to look for poliovirus circulation in the ‘community by investigating all possible polio cases. Its role is to identify high-risk areas or groups and to recommend measures to prevent, control and declare that a polio outbreak is closed. ‘TREND IN THE PHILIPPINES ‘The graph shows a steady notification of AFP cases from 2011 to 2018. However, a significant ‘surge occurred in 2019 when the Department of Health declared polio outbreak in September of the same ‘year. The sudden increase was due to the enhanced AFP surveillance across the country and the start of records 1 ‘the hospitals. Case finding activities were sustained in 2020 where a slight decline in cases was reported (Figure 2.1.1) jure 2.1.1. Reported Acute Flaccid Paralysis Cases (N=5,468) Philippines, 2011 - 2020 1200 3000 800 600 400 Number of cases 200 201. 2012-2013 201420152016 «201720182019 2020 There were 900 AFP cases nationwide from January 1 to December 31, 2020. Of these, 895 (99%) have been discarded as non-polio AFP, 3 (0.33%) cases were classified as polio compatible while 2 (0.22%) ‘were classified as vaccine-derived poliovirus (VDPV) (Figure 2.1.2). Most AFP cases were reported during the 1* half of 2020 with their highest levels from morbidity weeks 1 to 9. Compared to last year’s data, ‘the number of AFP cases this year (N=900) is lower (10% decrease) than the number reported in 2019 (N=1,003) due to COVID-19 challenges and restrictions in every region, Figure 2.1.2. Acute Flaccid Paralysis Cases Philippines, 2019 vs 2020 sexes 2020 Discarded 25 Non Polio (n=885) === 2020 Polio compatible (n=3) 2020 eVOPV2 (n=) sm 2020 avOPV2 ( —— 2013 (v=1,003) Number of Cases 60 50 : Wail, sali mca 1035 7 9 1243 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49:51:53 | 2020 PIDSR Annual Report For outbreak regions, NCR and CALABARZON reported the highest number of AFP cases nationwide with more than 91 cases. For non-outbreak regions, Region V reported the highest number of AFP cases with 62 cases (Figure. 2.1.3). Figure 2.1.3. Distribution of Acute Flaccid Paralysis Cases by Region (N=900) Philippines, 2020 Number of Cases No case 1-30 31-60 61-99 291 | 2020 PIDSR Annual Report In 2020, the target AFP cases is 659 and at the end of the year, the country has reported 900 AFP. ‘cases. With the outbreak regions, CALABARZON and NCR had the most reported cases while in the non- ‘outbreak regions, regions V and VI had the highest number in the group (Table 2.1.1). ‘Table 2.1.1. AFP Cases by Region and Classification (N=900) Philippines, 2020 ____ siento son roroTarst Reported ete Ce Non al ois _ ‘Afb cases “ees __‘Frding Rate (pisnrded)__ Compatible _VOPV PaUPrNES = 300 ax 5 r z ‘Outbreak Reions uw 103 so = ° a ‘ALABARZON 37 109 108 1 o vi * ss 8 ° ° * 25 ” * ° ° x a 58 5 ° o ” = 2 2 ° ° x 2 ° ° ° ° baa 2 » 2 ° o Grane as 6 2 ° ° nce a 200 7 2 4 Non-Outbreak Refers 1 a * 123% x ° ° 0 n ” 3% Fa ° ° ‘mwanora 2 8 om ry ° o v a a ean @ o ° w “6 a 102% ” ° ° vin « 0 5% o 0 ° on 6 2 75% 2 a ° PROFILE OF REPORTED AFP CASES AND DEATHS The age of cases ranged from less than 1 month to 27 years old with a median of 7 years old. The most affected population belonged to the CT 227% 229% 226% 71% 100% 100% 33% 30% 38% 0% 57% 0% 25% 200% 107% 89% 94% 27 | 2020 PIDSR Annual Report PROFILE OF CONFIRMED RUBELLA CASES (n=403) The age group of 20 - 24 years old (134, 33%) was the most affected among the reported confirmed rubella cases followed by age group of 15 ~ 19 years of age (90, 22%) and 25 -29 years of ‘age (85, 21%). The reported confirmed rubella cases range from less than 1 month to 50 years, with ‘a median of 22 years old. The majority (252, 63%) were females. Out of 403 confirmed rubella cases, only 36 (9%) cases received one dose of measles-containing vaccine and 31 cases (8%) received two (or more doses of measles-containing vaccine. Most (128, 32%) of the cases, were not vaccinated while 107 (27%) have an unknown number of doses, and 101 (25%) cases have unknown vaccination status. PROFILE OF CONFIRMED RUBELLA DEATH (n=1) There was one reported death among confirmed rubella cases. There was no report of confirmed rubella death in 2019. The reported death was a less than 6 months old female and was not vaccinated. PROFILE OF CONFIRMED RUBELLA PREGNANCIES (n=6) There were six pregnancies among the confirmed rubella cases. These cases were from Regions Il, CALABARZON, CAR and NCR. Two (33%) of these cases had unknown vaccination status, ‘two (33%) have an unknown number of doses of measles-containing vaccine, and two (33%) were not vaccinated, ‘SURVEILLANCE PERFORMANCE INDICATORS Surveillance indicators gauge the capacity of the country in gearing towards the measles elimination goal. The Philippines has reached a countrywide incidence rate of 8.72 per 1,000,000 population and is way below the target of <1 per 1,000,000 population (Table 2.3.5). 1, Timeliness and Adequacy of Specimen Collection ‘Adequacy and timeliness rate is defined as the collection of specimens among suspect ‘cases within 0 to 28 days from rash onset. The target is 280%. In 2020, the overall adequacy and timeliness of specimen collection rate was 50%. Only three (18%) out of 17 regions reached the target of this indicator (Table 2.3.5). 2. Timeliness and Adequacy of Case investigation Rate The overall timeliness and adequacy of case investigation rate for 2020 was 26%. None of the regions had met the target. This decreases the specificity of epidemiological surveillance to establish evidences of transmission or to track sources of infection (Table 2.3.5). ‘The suspect measles reporting rate is defined as the reporting rate of all cases detected Using the standard case definition, The target is 22/100,000 population and this has been achieved due to increased reported cases from the outbreaks. The national suspect measles 28 | 2020 PIDSR Annual Report reporting rate was 4.46/100,000 population. The majority of the regions reached the target due to the on-going transmission of measles cases in the country (Table 2.3.5). 4, Non-Measles/ Non-Rubella Reporting Rate The non-measles or non-rubella rate surveillance target has not been attained by most of the regions since most of the cases were either clinically compatible measles or laboratory- confirmed measles or rubella. Only Regions XI and CAR surpassed the target of 22/100,000 population (Table 2.3.5) 5. Measles Compatibitity Measles compatibility is the proportion of suspect cases that do not have specimens collected for laboratory confirmation or suspect cases that were not epidemiclogically - linked to other laboratory-confirmed cases but manifested the clinical signs and symptoms of measles. The target is <10%. In 2020, 57% of the total cases at the national level were classified as measles compatible or clinically confirmed (Table 2.3.5). Table 2.3.5. Measles Surveillance Performance Indicators by Region Philippines, 2019 vs 2020 Lapeer ee ed Reet Sede Bd ‘SPECIMEN. Tort cored Tres Tree: ey ay ee ons eo corer Sane nena eee eter ansaid irs Sew os cowenty 29 | 2020 PIDSR Annual Report 2.4 Neonatal Tetanus Tetanus, also known as lockjaw, is a serious but preventable disease that affects the body's ‘muscles and nerves. It typically arises from a skin wound that becomes contaminated by a bacterium called Clostridium tetani, which is often found in soil. Common first signs of tetanus are headache and muscular stiffness in the jaw, followed by stiffness of the neck, difficulty in swallowing, rigidity of abdominal muscles, spasms, sweating and fever. The Philippines achieved the status as the 44" country to eliminate Maternal and Neonatal Tetanus in November 2017 after the Maternal and Neonatal Tetanus Elimination (MNTE) External Validation, ‘TREND IN THE PHILIPPINES Figure 2.4.1 shows the neonatal tetanus cases reported from 2011 up to 2020. The trend shows a decrease in the reported cases from 2011 up to 2015 and a slight increase in years 2016, 2017 and 2019 then a decrease in the succeeding year. Figure 2.4.1. Reported Neonatal Tetanus Cases (N=1,002) Philippines, 2011 - 2020 250 200 200 162 320 885 a n 69 eo Number of cases 2011 2012 2013-2014 «2015-2016 «2017-2018 2019-2020 30 | 2020 PIDSR Annual Report There were 29 neonatal tetanus cases reported in 2020 nationwide. This is 65% lower when compared to 2019 (N=84) [Figure 2.4.2]. The reporting of cases decreased from 3-7 cases in 2019 to ‘maximum of 3 in 2020. Figure 2.4.2. Reported Neonatal Tetanus Cases by Morbidity Week Philippines, 2019 vs 2020 ‘Number of Cases 019-84) © 2020(N=29) 8 6 4 Wa) Det! a Aion ay nS 3.5 7 9 11 13 45 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 S153 Morbidity Week Table 2.4.1 shows a comparison of the regional data on cases and deaths in 2020 vis- 3-vis 2019. Two regions, Caraga (33%) and NCR (100%) had the highest percentage increase in the reported cases. Table 2.4.1, Neonatal Tetanus Cases, Deaths, and Case Fatality Rates (CFR) by Region Philippines, 2019 vs 2020 Region 2019 2020 ‘% Change in ‘Cases Deaths CFR Cases Deaths CFR Cases PHILIPPINES 84 50% 29S: 52H 65% 1 0 oo 0 - 3 0% 0 3 0 0% 3 3 100% > 0% W a 1 100% = 1 0 0% > 0% CALABARZON 3 3 100% 0 o -¥ 100% MIMAROPA 10 5 50% 2 0 O% L 20% v 4 375% = 2 1 50% L 50% 7 5 5 100% 1 0 0% LY 80% vit ° o - o o - 3 0% vill o Oo o o +> 0% is 3 2 67% 0 o -_y 100% x 2 0 0% 1 0 oO v 50% x! 2 0 0% 2 2 100% > 0% xi 1912 63% 3 1 33% L 84% BARMM 25 9 36% 6 3 50% L 76% CAR 2 0 0% 0 o = 100% Caraga 3 2 6% 4 3 75% 33% NCR 2 Oo o% 4 2 50% 1 100% 31 | 2020 PIDSR Annual Report Nationally, BARMM reported the highest number of cases (6, 21%) followed by Caraga (4, 414%), NCR (4, 14%), Region Il (3, 10%) and Region XI (3, 10%). Regions |, CALABARZON, VI, Vil, IK and CAR have no case reported this year (Figure 24.3). Figure 2.4.3. Distribution of Neonatal Tetanus Cases (N=29) Philippines, 2020 No, of Cases [No case PROFILE OF NEONATAL TETANUS CASES AND DEATHS Neonatal Tetanus cases ranged from ages 3 to 22 days old with a median of 7 days old. The most affected age group was 3-7 days old with 15 (52%) cases. Majority (15, 52%) of the reported cases were males (Figure 2.4.4). Figure 2.4.4, Reported Neonatal Tetanus Cases by Age Group and Sex Philippines, 2020 ‘Age Group Male (n=15) Female (n=14) (Days) 18-22 13-17 8-12 3-7 w 8 6 4 2 O 2 4 6 8 WW Number of Cases 32 | 2020 PIDSR Annual Report Of the 29 neonatal tetanus cases reported in 2020, there were 15 deaths having a CFR of 52%. Regions with the proportion of deaths among cases (CFR) were Region I! with three neonatal tetanus deaths (100% CFR), Region XI with two deaths (100% CFR) and Caraga with 1 death (75% CFR) [Figure 2.45). Figure 2.4.5. Reported Neonatal Tetanus Case Fatality Rate by Region Philippines, 2019 vs 2020 CFR 2019 = 2020 100100 100 100, 100 2020 National crResom Majority (18, 62%) of the cases’ mothers have unknown Tetanus Toxoid (TT) vaccination while 9 (81%) did not receive any dose. There were only two (7%) mothers who received doses of tetanus toxoid vaccine (Figure 2.4.6). Figure 2.4.6. Vaccination Status among Mothers of Neonatal Tetanus Cases (N=29) Philippines, 2020 ‘Number of Cases 20 8 Pr 16 4 2 10 8 8 6 4 2 ° a 1 ° — a Received 117 Received 277 Received 3TT ~—-NoTT Dose Unknown Dose Doses Doses Recewed —Vacenation Status Vaccination Status 33, | 2020 PIDSR Annual Report Majority (22, 766) of the reported neonatal tetanus cases were home deliveries and attended by either traditional birth attendant (10, 34%), hilot (7, 2496) or unknown (7, 24%). The most utilized tool for cutting the cord was scissors (11, 38%) followed by bamboo (7, 24%). The majority (16, 55%) had unknown stump treatment used (Table 2.4.2). Table 2.4.2. Delivery Practices of Reported Neonatal Tetanus Cases (N=29) Philippines, 2020 Place of Cases % Home - 2 (76%) Hospital/Lying/In/clinic 4 (18%) Inknown 3 0%) ry Attendant Traditional Birth Atten 10 (aK) Hilot 7 (24%) Physician 3 (0%) midwife 1 (4%) *Lay Person, 1%) Unknown 7 ax) Cord Cutting Tool Used Scissors i G8%) Bamboo 7 (20%) Blade 6 (as) Wood 1 Bx) “others 1% Unknown 3 (ox) ‘Stump Treatment Used ‘Alcohol 10 (4%) Povidone lodine 1 Gx) ***0thers. 2%) Unknown 16 (55%) * Mother-in-Law; * Palwa (Coconut Par); ** Coconut Husk and None 34 | 2020 PIDSR Annual Report 2.5 Non-neonatal Tetanus ‘An acute disease caused by an exotoxin of the tetanus bacillus, Clostridium tetani, grows anaerobically at the site of an injury. The disease is characterized by painful muscular spasms. The first sign suggestive of tetanus in older children and adults is generalized trismus. Spasms occur, opisthotonus and the facial expression known as “risus sardonicus” is characterized by a forced grin and raised eyebrows. ‘TREND IN THE PHILIPPINES. Figure 2.5.1 shows the non-neonatal tetanus cases reported from 2011 to 2020. The figure shows that there has been a marked drop in reported cases in 2014 and 2020. The highest number of ‘cases was reported in 2011 while the lowest number of reported cases was noted in the year 2020. 469) Figure 2.5.1. Reported Non-Neonatal Tetanus Cases ( Philippines, 2011-2020 1,400 1,200 4,000 00 600 Number of cases 400 200 2olt 2012,-««2013.=«2014 «20152016 ~—«2017-S«2018_~—«« 2019-2020 ‘There were 626 clinically confirmed non-neonatal tetanus cases reported in 2020 nationwide (Figure 2.5.1). This is 32% lower when compared to reported cases in 2019 (N=926). The highest peak was marked in week 6, followed by weeks 2 and 37, while week 53 reported the lowest for the year. By far, cases were irregularly distributed almost throughout the morbidity weeks of 2020, 35 | 2020 PIDSR Annual Report Figure 2.5.1. Reported Non-Neonatal Tetanus Cases by Morbidity Week Philippines, 2019 vs 2020 ‘Number of Cases 2019 (N=926) mmm 2020 (N=626) 126) 35 30 25 h \ 20 \} Ly A ~ 15 1 V a \ Ag / ‘ J AAA tl HuaQEQWARuIONONONOWED dn0VQHOQEVE 1 3.5 7 9 11 13 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 Morbidity Week Table 2.5.1 shows a comparison of the regional cases and deaths in 2020 vis-a-vis 2019. The region with the highest increasing percentage change was Region XI (129%) followed by Regions 4 ‘Caraga (50%), MIMAROPA (14%), IX (11%) and I (2%). On the contrary, BARMM reported the highest decreasing percentage change at 83% while CAR did not exhibit change in the reported cases this year. Table 2.5.1. Non-Neonatal Tetanus Cases, Deaths, and Case Fatality Rates (CFR) by Region Philippines, 2019 vs 2020 uo & oO Region 2019 2020 % Change in Cases Deaths CFR Cases Deaths CFR Cases PHILIPPINES 926 158 (17% = 626 118 19% 32% 60 8 13% 61 10 16% 2% 0 a 3 KOS IH 39% a 1504 KHL 56% CALABARZON = 114 16 14% 60 14 23% 47% MIMAROPA 14 0 0% 16 2 123% > 14% v a 15 16% s7 9 16% 37% vi 72 12° (17% 61 130 (21% 15% vil 7s 26 35% 53 14 26% Lb 29% vil 2 3 2% Ow 3% x 35 9 26% 39 11 28% 11% x 35 4 11% 34 4 1% 3% xi 7 3 mm 397K 129% xi 6 1 4% 23 5 2% 63% BARMM 76 13° (17% 13 2 159% 83% car 7 22% 7 0 % > o% Caraga 2 2 1% «BOS mK 50% NeR 913 e132 36% 36 | 2020 PIDSR Annual Report Six of 17 regions reported the highest number of non-neonatal tetanus cases. Regions |, VI, ‘and NCR reported 61 cases, respectively, followed by CALABARZON (60, 10%), Region V (57, 9%), ‘il (53, 8%), and Ill (46, 7%) [Figure 2.5.2). igure 2.5.2. Distribution of Non-Neonatal Tetanus Cases (N=626) Philippines, 2020 oof Cases Er» ms fe oe PROFILE OF CASES AND DEATHS ‘The reported Non-Neonatal Tetanus cases range from ages less than 1 month to 85 years old with median of 44 years, Of the reported cases, 360 (58%) were from the age group of 40 years-old and above. The majority, 532 (85%) of the affected cases were males while 94 (15%) were females (Figure 2.5.3). Figure 2.5.3. Reported Non-Neonatal Tetanus Cases by Age Group and Sex Philippines, 2020, Age Group = Male (n=532)_ = Female (n=94) (vears) 240 30:34 20.24 10.14 <4 — 350 300 250 200 150 100 50 0 50 100 150 200 250 300 350 Number of Cases 7 | 2020 PIDSR Annual Report There were 118 non-neonatal tetanus deaths reported in 2020. The top three regions with a high proportion of deaths among cases (CFR) were Region IX with 11 reported NNT deaths (28.2% CFR), Caraga with 5 deaths (27.8% CFR), and Region VII with 14 NNT deaths (26.4%) (Figure 2.5.4]. Figure 2.5.4. Reported Non-Neonatal Tetanus Case Fatality Rates by Region Philippines, 2019 vs 2020 KCFR op 2019 = 2020 35.0 * 300 72 x8 . 2s 250 a asa t | ih a3 a3 2070 nation 20.0 Dorion to 1 ror aon 100 5.0 J Lil. 09 0.0 . s va + ees + ra SF SoS ss s RS S ee & Region PROFILE OF NON-NEONATAL TETANUS DEATHS (n=118) There were 118 (CFR=19%) reported NNT deaths in 2020 while 158 deaths in 2019 (CFR=17%). Deaths ranged from age less than 1 month to 84 years old with a median of 46 years. Twenty-nine (25%) are 60 years and above. Majority, 102 (86%) are males and sixty-six (56%) received Tetanus vaccine. 38 | 2020 PIDSR Annual Report 2.6 Pertussis Pertussis or whooping cough is a highly communicable disease of the respiratory tract caused by Bordetella pertussis. The initial stage of the disease has an insidious onset with an irritating cough that gradually becomes paroxysmal, usually within 1-2 weeks, and lasts from 1-2 months or longer. Paroxysms are characterized by a repeated violent cough. Each series of paroxysms has many coughs without intervening inhalation and can be followed by a characteristic crowing or high-pitched inspiratory whoop. Paroxysms frequently end with the expulsion of clear, tenacious mucus, often followed by vomiting. ‘TREND IN THE PHILIPPINES Figure 2.6.1 shows the pertussis cases reported from 2011 to 2020. The trend showed an increasing pattern of reported cases per year from 2012-2013, a decrease of cases in 2014, and a gradual increase in 2015-2018. A sudden decline of reported pertussis cases was observed in 2019 and 2020. Figure 2.6.1. Reported Pertussis Cases (N=1,936) Philippines, 2011-2020 400 372 350 6 8 Number of Cases 8 2011 -2012««-2013.-«-2014« «201520162017, 2018_-2019 39 2020 | 2020 PiDsR Annual Report ‘There were 48 reported pertussis cases in 2020. This is 74% lower than the reported cases in 2019 (N=186) [Figure 2.6.2). Incidence of the disease became sporadic as cases in the current year decreased significantly. A total of 31 (58%) morbidity weeks reported zero case in 2020. Figure 2.6.2. Reported Pertussis Cases by Morbidity Week Philippines, 2019 vs 2020 Number of Cases —2019(N=186) mmm 2020 (N= 9 ORNWaUONG 1 . di wy Vie Ua 1.3 5 7 9 1143 15 17 19 21 23 25 27 29 31 33 35 37 39 41 43 45 47 49 51 53 Morbidity Week ‘The table below presents a comparison of the regional cases, deaths, and CFR in 2020 vis-a-vis. 2019. The regions with the highest percentage change were Regions V (100%) and VIII (100%). BARMM, Caraga and Region VI reported 2 100% decrease in caseload while it was still the same with MIMAROPA with zero case reported for 2020 (Table 2.6.1), Table 2.6.1. Pertussis Cases, Deaths, and Case Fatality Rates (CFR) by Region Philippines, 2019 vs 2020 Region 2019 2020 ‘% Change in Cases Deaths CFR Cases Deaths CFR Cases PHILIPPINES 186 ni 6% «48 2 4% Lb 70% 1 6 0 % 1 0 O% L 83% " 2 41% 1 0 Oe Y 96% um 10 1 10% = 4 0 O% L 60% CALABARZON 33 1 3% 866 0 O% Y 82% MIMAROPA, ° ° - 0 ° - 3 0% v 0 ° 7 1 0 O% % 100% vi 2 0 0% oO 0 ov 100% vil 2 0 O% 6 0 O% L 50% vill Ez 0 0% 2 0 0% % 100% x 2 0 % 1 0 O% L 50% x s 1 20% = 2 0 0% L 60% xl 2 2 10% 3 1 33% Lb 86% xil 4 0 0% 1 0 0% % 75% BARMM, 1 0 0% oO 0 - 100% CAR v7 0 O% 1 0 OY 24% Caraga 1 0 0% 0 ° - 100% NCR a7 24% 19 1 s% 60% 40 | 2020 PIDSR Annual Report Figure 2.6.3 shows that NCR (19, 40%) had the most occurrence of the disease for 2020 followed by CALABARZON with 6 (13%) cases. MIMAROPA, VI, BARMM, and Caraga have no pertussis ‘case for the whole year. Figure 2.6.3. Distribution of Pertussis Cases (N=48) Philippines, 2020 ’ a1 | 2020 PIDSR Annual Report PROFILE OF CASES AND DEATHS ‘The age of reported pertussis cases ranged from less than 1 month to 59 years old with median of 2 months. The majority, (29 or 60%) of the cases were males and among less than one to 4-year-old age group (42, 88%) (Figure 2.6.4). Figure 2.6.4, Reported Pertussis Cases by Age Group and Sex Philippines, 2020 ‘Age Group m= Male (n=29) Female (n=19) (rears) 240 35.39 30.34 25.29 20-24 15-19 10-14 59

    You might also like