Hepatitis E cases surpass 5 000

Poor coordination of the outbreak response at all levels has been identified as a major challenge in curtailing the spread of hepatitis E in Namibia.

13 June 2019 | Health

More than 1 000 new hepatitis E cases have been detected in Namibia since January, while 45 people have died since the first case was detected nearly two years ago in Windhoek's informal settlements.

As of 2 June this year, a total of 5 309 cases had been reported in 11 regions of Namibia, compared to 4 227 cases reported by 6 January 2019.

The first identified case of hepatitis E was reported in mid-October 2017 at a hospital in Windhoek. By 8 January 2018, 237 probable and confirmed cases had been reported in the Khomas Region, while the first death was reported in November 2017.

Since then, the outbreak has spread to almost all regions of Namibia, with the informal settlements most affected because of poor sanitation and inadequate coordination to address the response.

The latest situation report, released by the health ministry yesterday, says the outbreak has “become protracted and has spread to other regions in the country.”

It identifies “suboptimal coordination of the outbreak response at all levels” as a major challenge.

The report nevertheless notes that by the week ending 2 June, a “fair decline was noted over the last 12 weeks.”



Heavy toll

To date, 45 people have died, including 20 pregnant or postnatal women. Most of the dead were adults aged between 20 and 39.

The data shows that 3 020 (57%) of those infected were men, while 2 289 were women.

The outbreak has spread from the Khomas Region to eight other regions - Erongo, Kavango, Ohangwena, Omusati, Oshana, Oshikoto and Omaheke. The Khomas Region remains the most affected area, with a total of 3 469 cases reported, followed by 1 249 cases reported in the Erongo Region.





The remaining 11% of cases, totalling 591, were detected in the other seven regions.

Sporadic cases were detected at Khorixas and Opuwo (6) in the Kunene region, Rehoboth and Mariental (4) in the Hardap Region; Lüderitz (5) in the /Karas Region, and 11 cases were detected in four districts in the Otjozondjupa Region.

The hardest-hit areas are the Havana and Goreangab informal settlements in Windhoek and the DRC informal settlement at Swakopmund, “where access to safe water, sanitation and hygiene is limited.”

Cases from less affected regions “have a travel history” that links them to the Khomas and Erongo informal settlements.

Between 20 May and 2 June, a total of 56 new hepatitis E cases were reported countrywide, showing a decline from the previous two weeks when 96 cases were reported.







Reaction



The latest situation report shows several partners have joined forces to address the prolonged outbreak.



Regional and district health emergency committees have been affected in all the affected regions and districts while partner organisations continue to provide technical assistance, including the World Health Organisation and the US Centers for Disease Control and Prevention (CDC).



The response has included intense health education and sensitisation campaigns while teams on the ground are monitoring the outbreak on a weekly basis.



Operation Sanitizer was launched to strengthen behavioural change to reduce the spread of the disease. Municipalities conduct regular water tests.



Yet challenges remain, with the situation report recommending a number of priority steps that include an intensification of the outbreak response and a “massive scaling up” of activities related to water, sanitation and hygiene (WASH).



Moreover, the report acknowledges inadequate staff to support surveillance and data management at national level and recommends the mobilisation of additional support response activities.

JANA-MARI SMITH

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