Hepatitis worries continue
Hepatitis E is giving authorities an uphill battle with the spread seemingly unstoppable.
Namibia's health authorities remain deeply worried about new hepatitis E infections in Namibia's poorest communities.
“It is evident that this outbreak has become protracted; most of the cases are still being detected in areas where water and toilet facilities are limited,” the health ministry said in a statement on Tuesday.
The ministry says the outbreak has spread to most regions, including Erongo, Omusati, Oshana, Ohangwena, Oshikoto and the Kavango regions.
It says a number of problems, including the slow response of some local authorities, are undermining efforts to control the outbreak.
Since the outbreak began more than one year ago, 3 859 cases and 31 deaths have been reported, the authorities announced at the end of October.
The health ministry said this week that site visits between 15 and 21 October found 34 new cases of hepatitis E in the Khomas, Omusati, Erongo and Ohangwena regions.
“Although the public health response has been ongoing for nearly a year, it has not been able to contain the hepatitis E outbreak in the country as yet.
“On the contrary, the outbreak has become protracted and has even spread to other informal settlements and other regions in the country,” it said.
A health ministry team, together with partners from the World Health Organisation (WHO), will visit more regions in the north and attend a cross-border surveillance meeting with a health team from Angola soon.
To date, the Khomas Region has been the hardest hit by the outbreak, with 71% of cases reported.
The Erongo Region is the second most affected with 846 cases, or 23% of the total.
The remaining regions account for 6% of the cases.
The national fatality rate is 0.9% of those infected, with maternal deaths accounting for 14 of the 31 deaths (45%).
A total of 2 729 of those infected to date are between 20 and 39 years old.
Too many gaps
One of the obstacles in the ministry's efforts to halt the spread of the disease is a lack of agreement with municipalities on how to reach communities.
The health ministry says Unicef is negotiating with the City of Windhoek, “who seem to be having an issue as they feel that community-led total sanitation (CLTS) may lower the standards of toilet facilities in the city.”
Community-led total sanitation is described as an approach used mainly in developing countries to improve sanitation and hygiene practices. It focuses on long-lasting behaviour change of an entire community to end open defecation.
According to the health ministry CLTS is recommended to ensure that communities appreciate the need for taking ownership of water supply and sanitation facilities.
Another challenge highlighted by the health ministry is inadequate interventions on water, sanitation and hygiene (WASH).
This entails providing taps for clean water, latrines and hand-washing facilities in informal settlements to control the outbreak.
“More support is also needed to support procurement of chlorine tablets for water treatment and scaling up of the other WASH interventions,” the ministry states.
Another challenge is “inadequate risk communication and social work specialists to engage communities and communicate appropriately the changes in lifestyle and environment needed both for the immediate control of this outbreak and prevention of future outbreaks.”
Additionally, delays by health facilities in reporting cases to the ministry are misleading response efforts by not representing the true number of cases in affected regions.
The ministry also notes the inadequate number of epidemiologists to support the surveillance and data management at the ministry, which is “short staffed due to the current economic down-trend in the country”.
The ministry says there is an urgent need for a “massive scale-up of hygiene and sanitation promotion campaigns, access to safe water or water treatment, promotion of hand washing with soap, dignity kits for pregnant women, and regulation of open-market food selling in the affected areas”, in order to prevent the further spread of the outbreak.
JANA-MARI SMITH
“It is evident that this outbreak has become protracted; most of the cases are still being detected in areas where water and toilet facilities are limited,” the health ministry said in a statement on Tuesday.
The ministry says the outbreak has spread to most regions, including Erongo, Omusati, Oshana, Ohangwena, Oshikoto and the Kavango regions.
It says a number of problems, including the slow response of some local authorities, are undermining efforts to control the outbreak.
Since the outbreak began more than one year ago, 3 859 cases and 31 deaths have been reported, the authorities announced at the end of October.
The health ministry said this week that site visits between 15 and 21 October found 34 new cases of hepatitis E in the Khomas, Omusati, Erongo and Ohangwena regions.
“Although the public health response has been ongoing for nearly a year, it has not been able to contain the hepatitis E outbreak in the country as yet.
“On the contrary, the outbreak has become protracted and has even spread to other informal settlements and other regions in the country,” it said.
A health ministry team, together with partners from the World Health Organisation (WHO), will visit more regions in the north and attend a cross-border surveillance meeting with a health team from Angola soon.
To date, the Khomas Region has been the hardest hit by the outbreak, with 71% of cases reported.
The Erongo Region is the second most affected with 846 cases, or 23% of the total.
The remaining regions account for 6% of the cases.
The national fatality rate is 0.9% of those infected, with maternal deaths accounting for 14 of the 31 deaths (45%).
A total of 2 729 of those infected to date are between 20 and 39 years old.
Too many gaps
One of the obstacles in the ministry's efforts to halt the spread of the disease is a lack of agreement with municipalities on how to reach communities.
The health ministry says Unicef is negotiating with the City of Windhoek, “who seem to be having an issue as they feel that community-led total sanitation (CLTS) may lower the standards of toilet facilities in the city.”
Community-led total sanitation is described as an approach used mainly in developing countries to improve sanitation and hygiene practices. It focuses on long-lasting behaviour change of an entire community to end open defecation.
According to the health ministry CLTS is recommended to ensure that communities appreciate the need for taking ownership of water supply and sanitation facilities.
Another challenge highlighted by the health ministry is inadequate interventions on water, sanitation and hygiene (WASH).
This entails providing taps for clean water, latrines and hand-washing facilities in informal settlements to control the outbreak.
“More support is also needed to support procurement of chlorine tablets for water treatment and scaling up of the other WASH interventions,” the ministry states.
Another challenge is “inadequate risk communication and social work specialists to engage communities and communicate appropriately the changes in lifestyle and environment needed both for the immediate control of this outbreak and prevention of future outbreaks.”
Additionally, delays by health facilities in reporting cases to the ministry are misleading response efforts by not representing the true number of cases in affected regions.
The ministry also notes the inadequate number of epidemiologists to support the surveillance and data management at the ministry, which is “short staffed due to the current economic down-trend in the country”.
The ministry says there is an urgent need for a “massive scale-up of hygiene and sanitation promotion campaigns, access to safe water or water treatment, promotion of hand washing with soap, dignity kits for pregnant women, and regulation of open-market food selling in the affected areas”, in order to prevent the further spread of the outbreak.
JANA-MARI SMITH
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