CBS News & Updates
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The detection of Mumps in Buulo-Ba’ley IDP camp – Mudug region, Puntland State of Somalia
Buulo-Ba’ley IDP camp in Puntland State, Mudug region hosts about one thousand households for people affected by drought and conflict. Between the 15th and 23rd of June the Somali Red Crescent (SRCS) volunteers reported unusual illnesses of 12 children between the ages of 1 and 10. The children had swelling in one parotid gland, leading to puffed cheeks, and high fever.
The first child was identified by a volunteer on the 15thof June. Other children in the same school showed the same signs a few days after and were reported to the CBS platform Nyss on the 23rd of July.
After verifying the report on cluster of unusual illnesses with the volunteers, an SRCS supervisor notified theMoH in Puntland State on the alert only a few minutes later. The surveillance unit visited the site on the 25th of June for further investigation. They clinically diagnosed Mumps after visiting the children.
The respective community in the IDP camps have been living in very poor conditions with limited access to hygiene facilities which makes them more vulnerable to the onset of such infections. Hence, SRCS encouraged the volunteers to enhance community awareness on hygiene and sanitation and to practice physical distancing. SRCS volunteers encouraged those practices with school children, their parents and teachers, and advised on isolation of the infected children from others. Volunteers also referred the sick children to the near health facility for treatment. Since then, no more cases have been reported. SRCS is supporting Ministry of Health with the advocacy on acquiring the respective vaccine and diagnostic tests.
Measles Detected by SRCS Volunteers Using CBS at an IDP Camp in Puntland State
In the Mudag region of Puntland, 119 Somali Red Crescent (SRCS) volunteers have been trained in CBS. These volunteers cover 54 locations in the region. The CBS volunteer training consists of how to report real-time on health risks identified to be a priority in the area from the CBS pre-assessment. One of the locations covered by SRCR volunteers is the Duyah IDP camp in Mudag region. As this camp is far away from the Galkayo District and there is no other close health facility, the community is not reached by routine vaccination services.
On February 18, 2022, eighteen reports of the health risk fever and rash were reported by SRCS volunteers in Dayah IDP Camp using the Nyss platform. After receiving these alerts, the CBS Officer confirmed the alert from volunteers, and escalated it to the Ministry of Health to respond all in the same day. Critical cases were referred to Mudug General Hospital, while others received health education by volunteers. After being admitted to the Mudug General Hospital, samples were collected from the children with suspected measles.
Even before the confirmation of positive measles cases, the SRCS, in collaboration with the MoH visited the camp and allocated a health mobile clinic team to carry out a measles vaccination campaign and case management. The diagram below shows the flow of information which facilitates real-time reporting and quick action.
Nyss Presented at the Geneva Health Forum
The Norwegian Red Cross presented the NYSS platform at the Geneva Health Forum this May. The Geneva Health Forum is hosted by Geneva University Hospitals and the University of Geneva with the goal of bringing together actors from all sectors of health.
NYSS was presented as a health innovation next to other innovations from all over the world looking to find solutions to global health challenges.
As NYSS facilitates community-based surveillance by providing real-time detection, reporting, aggregating and analysis of information on health risks, it works to extend existing surveillance systems into the community, it helps to promote early detection and response to outbreaks.
You can read more about the Geneva Health Forum here.
Abstract Published: Analysing effectivness of Using the Nyss platform for CBS
The abstract Community Based Surveillance in Somaliland: Analysis of the Functionality and Effectiveness using the CBS Platform Nyss has been published in the International Journal of Infectious Disease. The analysis is based in Somaliland, where CBS was implemented in 2018. Data from CBS activities of the Togdheer region were used to evaluative completeness and accuracy of reporting, data quality, timeliness of verification and effectives. The results were promising, showing an average of 90% of the targeted villages being covered by active SRCS volunteers. The authors include employees of the Norwegian Red Cross and the Somali Red Crescent Society. Have a look at the full abstract to see more results and the authors recommendations.
SRCS Volunteers in Puntland State Detected Measles Through CBS in an IDP Camp
Somali Red Crescent (SRCS) has implemented a community health project in 2020 in an internally displaced people (IDP) camp 15km from Galkayo District. This camp was established in 2017 due to severe droughts in the region. A population of about 6000 people has been forced to move to the area to find better condition for themselves and their livestock. Together with the leaders, three volunteers were identified from the community of the IDPs and trained in community health services, including community-based surveillance (CBS).
Beginning of December 2021, these volunteers reported on several children with fever and rash which are related to measles. Members of the Ministry of Health (MoH) in Puntland State went together with SRCS to investigate the situation. They could identify ten children with the respective symptoms, of whom the families had previously refused to vaccinate their children. Health awareness activities were conducted, and infected children referred to the hospital where they were confirmed positive for measles. The detection of those measles cases come just after a recently declared Measles outbreak in the same region in August 2021. Puntland State MoH is currently planning another measles campaign in all Puntland regions together with SRCS to end this outbreak.
SRCS together with support of the Norwegian Red Cross has established a community health project in 2021 in the region, which includes epidemic preparedness activities.
where Measles cases were detected.
CBS Presentations at International Conferences in 2021:
MSF Scientific Days, Imed International Conference, and ICRC Analysis and Evidence Week
In May 2021, Norwegian Red Cross participated in the MSF Scientific Days, presenting Nyss as part of an innovation demonstration. It was fantastic to be part of international discussion and to share learnings and experience with other humanitarian actors.
In November 2021, Norwegian Red Cross presented a poster at the iMed international conference. The conference is an international meeting on emerging diseases and surveillance run by the International Society for Infectious Diseases. The poster presentation gave an overview of an analysis of the functionality and effectiveness of CBS and the Nyss platform in Somaliland. A copy of the poster can be found here.
In December 2021, Norwegian Red Cross presented a session at the ICRC Analysis and Evidence Week focusing on Community Based Surveillance using the Nyss platform, with examples from experience in Somaliland. The overall theme of the week was data and it was a great opportunity to be part of the forum, bringing together humanitarian actors, academics, UN agencies, NGOs and donor agencies for shared learning and discussion.
SRCS Volunteers in Puntland State Support MoH With the Detection of People Suspected of Having COVID-19 and Strategizing the Vaccination Campaign
In 2021, the Somali Red Crescent (SRCS) in Puntland State, together with support of the Norwegian Red Cross, has implemented a community health project providing different services including community-based surveillance (CBS) to the population.
More than 100 volunteers were trained in detecting signs and symptoms of epidemic diseases enabling early reporting and rapid response to prevent large scale outbreaks. Along with acute watery diarrhoea, fever and rash, unusual illnesses and deaths, the volunteers were also trained in signs and symptoms of Covid -19.
Based on their reports to the Nyssplatform, MoH could overcome the challenge of limited reach of people at community level with health education and referrals for testing for Covid-19. It also provided MoH with a better understanding of the high prevalence areas and supported prioritising of Covid-19 vaccination campaigns. MoH with SRCS were analysing the data from the Nyss platform to select locations which were at highest need to start mobile vaccination at community level.
Measles Outbreak Detected by SRCS Volunteers in Togdheer Region
Community Based Surveillance (CBS) is an active process of community participation in detecting, reporting, responding to and monitoring of events of public health significance within a community-by-community members. With technical and financial support from the Norwegian Red Cross (NorCross), CBS was first implemented in Somaliland during May 2018, and is currently functioning in 129 sites, 10 districts, and 3 regions, namely Togdheer, Awdal, and most recently, Sool. A total of 315 volunteers have been trained to submit reports via coded SMS to a platform called “Nyss” on selected health risks at community level. Nyss allows SRCS to collect, analyze, and interpret information on health risks andproduce alerts to enable early action by the health authorities and thus save lives.
Between the 14th and 16th of August 2021, SRCS Community Based Volunteers reported 5 cases of fever and rash symptoms in a village in Oodweine District of Togdheer region in Somaliland. The SRCS CBS officer in Togdheer region, upon receiving the alerts through Nyss, followed up with the volunteers and verified them according to the community case definition. The alert was then escalated to Somaliland's Ministry of Health Development (MoHD) in Togdheer region. A team comprising of MoHD, SRCS, and WHO representatives were sent to the area to collect blood samples and conduct clinical investigations.
The collected samples were sent to the National Medical Lab in Hargeisa for further investigation and on the 21st of August, 2 out of the 5 samples came back positive. Immediately after the confirmation of the measles cases, SRCS in Somaliland deployed a mobile medical team close to the area to conduct immunization campaigns, and health and hygiene promotion activities. In addition, the CBS team in Togdheer region informed volunteers in the surrounding villages on the identification of measles cases in Qalo'ato village and to step-up surveillance of suspected fever and rash cases or any other symptoms in their respective villages and to communicate to the communities on preventative measures.
The MoH declared a measles outbreak and called for a meeting to coordinate the response. The ministry requested SRCS to support with 3 additional mobile teams to be mobilized in communities surrounding the village to conduct vaccination and health promotion campaigns. SRCS, with the financial support from NorCross, accepted the ministry’s request and deployed the mobile clinics for 9 days. The MoHD provided SRCS with the vaccines and data collection tools. As a result, a total of 2,637 children aged between 9 months and 9 years were vaccinated against measles and 1,774 children aged between 6 to 59 months were provided with Vitamin A supplements. In addition, 5,568 people were reached with community mobilization, awareness raising and health education against measles. The outbreak of measles in Odweine district, Togdheer region in Somaliland was prevented from spreading due to early detection by community volunteers, using the Nyss platform, and early action. No other new cases were reported.
