Disease Early Warning System -Afghanistan

Surveillance Reporting Form for Morbidity (disease) and Mortality (death)

Province Name/Code: Herat/20 District Name/Code: Koshke-e-Kohna 12th Site
Town/Village/Camp: Koklam CHC Facility Name/Code: Koklam CHC(671) NGO/Donor:BDN
Epidemiological Week:40th from 30/Sept/2018 to Saturday 06/Oct/2018 Submission Date:07/Oct/2018

Contact’s Name & phone #: Dr.Wazir Ahmad(Khalili )0770028080-0795621338-0791831060 Ab.Rahim

Male/less than Female/less Male/ 5 years Female/ 5 years

Events Under Surveillance 5 years old than 5 years old old and over old and over

Cases Deaths Cases Deaths Cases Deaths Cases Deaths

1 ARI- Cough and cold

0 0 0 0 0 0 0 0

2 ARI- Pneumonia
0 0 0 0 0 0 0 0

3 Acute Diarrhoea
0 0 0 0 0 0 0 0

4 Bloody Diarrhoea
0 0 0 0 0 0 0 0

5 AWD w Dehydration
0 0 0 0 0 0 0 0

6 Suspected Meningitis (SIC)

0 0 0 0 0 0 0 0

7 Susp. Acute Viral Hepatitis

0 0 0 0 0 0 0 0

8 Suspected Measles
0 0 0 0 0 0 0 0

9 Suspected Pertussis
0 0 0 0 0 0 0 0

10 Probable Diphtheria
0 0 0 0 0 0 0 0

11 Tetanus/ Neonatal Tetanus

0 0 0 0 0 0 0 0

12 Acute Flaccid Paralysis

0 0 0 0 0 0 0 0

13 Suspected Malaria
0 0 0 0 0 0 0 0

14 Suspected Typhoid Fever

0 0 0 0 0 0 0 0

15 Susp. Hemorrhagic Fever

0 0 0 0 0 0 0 0

16 Pregnancy-related deaths
0 0 0 0 0 0 0 0

0 0 0 0 0 0 0 0
DEWS Disease
0 0 0 0 0 0 0 0
TOTAL New Clients/ Deaths

Newborn Alive
0 Stillbirth 0
 Herat Regional Hospital

S.N Name Age Sex Cause

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
 1 Site

Residence/ Address
 S1-Hrt RH/630
Male/Less than 5 Female/Less than
Male/Less than 5 Female/Less than
years old and 5 years old and
years old 5 years old
over over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths

ARI- Cough and cold 0 0 0 0 0 0 0 0

SARI-( Pneumonia ) 0 0 0 0 0 0 0 0
Acute Diarrhoea 0 0 0 0 0 0 0 0
Bloody Diarrhoea 0 0 0 0 0 0 0 0
AWD w Dehydration 0 0 0 0 0 0 0 0
Suspected Meningitis (SIC) 0 0 0 0 0 0 0 0
Susp. Acute Viral Hepatitis 0 0 0 0 0 0 0 0
Suspected Measles 0 0 0 0 0 0 0 0
Suspected Pertussis 0 0 0 0 0 0 0 0
Probable Diphtheria 0 0 0 0 0 0 0 0
Tetanus/ Neonatal Tetanus 0 0 0 0 0 0 0 0
Acute Flaccid Paralysis 0 0 0 0 0 0 0 0
Suspected Malaria 0 0 0 0 0 0 0 0
Suspected Typhoid Fever 0 0 0 0 0 0 0 0
Susp. Hemorrhagic Fever 0 0 0 0 0 0 0 0
Pregnancy-related deaths 0 0 0 0 0 0 0 0
Total DEWS Diseases 0 0 0 0 0 0 0 0
Total Clients 0 0 0 0 0 0 0 0

Newborn Alive 0
Stillbirth 0

Herat ProvinceMale/Less
Total reports
than 5 Female/Less than
Male/Less than 5 Female/Less than
years old and 5 years old and
years old 5 years old
Cases Deaths Cases Deaths CasesoverDeaths CasesoverDeaths
ARI- Cough and cold 575 0 675 0 547 0 1077 0
SARI-( Pneumonia ) 50 0 44 0 18 0 37 0
Acute Diarrhoea 514 0 519 0 147 0 190 0
Bloody Diarrhoea 35 0 49 0 39 0 54 0
AWD w Dehydration 14 0 13 0 4 0 5 0
Suspected Meningitis (SIC) 0 0 0 0 0 0 0 0
Susp. Acute Viral Hepatitis 0 0 0 0 0 0 0 0
Suspected Measles 0 0 0 0 0 0 0 0
Suspected Pertussis 0 0 0 0 0 0 0 0
Probable Diphtheria 0 0 0 0 0 0 0 0
Tetanus/ Neonatal Tetanus 0 0 0 0 0 0 0 0
Acute Flaccid Paralysis 0 0 0 0 0 0 0 0
Suspected Malaria 0 0 0 0 0 0 0 0
Suspected Typhoid Fever 0 0 0 0 0 0 2 0
Susp. Hemorrhagic Fever 0 0 0 0 0 0 0 0
 Pregnancy-related deaths 0 0 0 0 0 0 0 0
Total DEWS Diseases 1183 0 1296 0 750 0 1354 0
Total Clients 1988 1 2140 0 2434 0 9510 0

Newborn Alive 402

Stillbirth 1

Badghis Province Total reports

Male/Less than 5 Female/Less than
Male/Less than 5 Female/Less than
years old and 5 years old and
years old 5 years old
Cases Deaths Cases Deaths CasesoverDeaths CasesoverDeaths
ARI- Cough and cold 158 0 151 0 126 0 304 0
SARI-( Pneumonia ) 21 0 14 0 13 0 19 0
Acute Diarrhoea 119 0 106 0 42 0 46 0
Bloody Diarrhoea 12 0 7 0 15 0 18 0
AWD w Dehydration 0 0 1 0 0 0 1 0
Suspected Meningitis (SIC) 0 0 0 0 0 0 0 0
Susp. Acute Viral Hepatitis 0 0 0 0 0 0 0 0
Suspected Measles 0 0 0 0 0 0 0 0
Suspected Pertussis 0 0 0 0 0 0 0 0
Probable Diphtheria 0 0 0 0 0 0 0 0
Tetanus/ Neonatal Tetanus 0 0 0 0 0 0 0 0
Acute Flaccid Paralysis 0 0 0 0 0 0 0 0
Suspected Malaria 0 0 0 0 0 0 0 0
Suspected Typhoid Fever 0 0 0 0 0 0 0 0
Susp. Hemorrhagic Fever 0 0 0 0 0 0 0 0
Pregnancy-related deaths 0 0 0 0 0 0 0 0
Total DEWS Diseases 310 0 279 0 196 0 388 0
Total Clients 706 0 663 0 523 0 2695 0

Newborn Alive 1988

Stillbirth 0

Farah ProvinceMale/Less
Total reports
than 5 Female/Less than
Male/Less than 5 Female/Less than
years old and 5 years old and
years old 5 years old
Cases Deaths Cases Deaths CasesoverDeaths CasesoverDeaths
ARI- Cough and cold 135 0 109 0 93 0 154 0
SARI-( Pneumonia ) 13 0 8 0 4 0 4 0
Acute Diarrhoea 58 0 56 0 38 0 56 0
Bloody Diarrhoea 6 0 15 0 12 0 14 0
AWD w Dehydration 0 0 0 0 0 0 0 0
Suspected Meningitis (SIC) 0 0 1 0 1 0 1 0
Susp. Acute Viral Hepatitis 1 0 1 0 0 0 0 0
Suspected Measles 0 0 1 0 0 0 0 0
Suspected Pertussis 0 0 0 0 0 0 0 0
Probable Diphtheria 0 0 0 0 0 0 0 0
Tetanus/ Neonatal Tetanus 0 0 0 0 0 0 0 0
Acute Flaccid Paralysis 0 0 0 0 0 0 0 0
 Suspected Malaria 0 0 0 0 0 0 0 0
Suspected Typhoid Fever 0 0 0 0 0 0 2 0
Susp. Hemorrhagic Fever 0 0 0 0 0 0 0 0
Pregnancy-related deaths 0 0 0 0 0 0 0 0
Total DEWS Diseases 213 0 191 0 148 0 231 0
Total Clients 461 0 436 0 502 0 2070 0

Newborn Alive 0
Stillbirth 1988

Ghor ProvinceMale/Less
Total reports
than 5 Female/Less than
Male/Less than 5 Female/Less than
years old and 5 years old and
years old 5 years old
Cases Deaths Cases Deaths CasesoverDeaths CasesoverDeaths
ARI- Cough and cold 83 0 74 0 109 0 193 0
SARI-( Pneumonia ) 28 0 26 0 18 0 22 0
Acute Diarrhoea 38 0 31 0 40 0 58 0
Bloody Diarrhoea 3 0 3 0 3 0 6 0
AWD w Dehydration 25 0 27 0 19 0 16 0
Suspected Meningitis (SIC) 0 0 0 0 0 0 0 0
Susp. Acute Viral Hepatitis 0 0 0 0 0 0 0 0
Suspected Measles 0 0 0 0 0 0 0 0
Suspected Pertussis 0 0 0 0 0 0 0 0
Probable Diphtheria 0 0 0 0 0 0 0 0
Tetanus/ Neonatal Tetanus 0 0 0 0 0 0 0 0
Acute Flaccid Paralysis 0 0 0 0 0 0 0 0
Suspected Malaria 0 0 0 0 0 0 0 0
Suspected Typhoid Fever 1 0 1 0 11 0 10 0
Susp. Hemorrhagic Fever 0 0 0 0 0 0 0 0
Pregnancy-related deaths 0 0 0 0 0 0 0 0
Total DEWS Diseases 178 0 162 0 200 0 305 0
Total Clients 220 0 212 0 274 0 635 0

Newborn Alive 0
Stillbirth 0
 S2-Gozara DH/648 S3-Now
Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5 Male/Less than 5
5 years old and
years old 5 years old years old and over years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
83 0 107 0 64 0 83 0 19 0
22 0 16 0 4 0 8 0 10 0
65 0 52 0 11 0 11 0 40 0
1 0 3 0 3 0 4 0 5 0
10 0 7 0 2 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
181 0 185 0 84 0 107 0 74 0
244 0 231 0 197 0 1260 0 84 0

70
1

2874
149
1370
177
36
0
0
0
0
0
0
0
0
2
0
 0
4583
16072
0
402
1

739
67
313
52
2
0
0
0
0
0
0
0
0
0
0
0
1173
4587
0
1988
0

491
29
208
47
0
3
2
1
0
0
0
0
 0
2
0
0
783
3469
0
0
1988

459
94
167
15
87
0
0
0
0
0
0
0
0
23
0
0
845
1341
0
0
0
 S3-Now Abad CHC/632 S4-Ghoryan DH/662
Female/Less than
Female/Less than Male/Less than 5 Male/Less than 5 Female/Less than
5 years old and
5 years old years old and over years old 5 years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
17 0 44 0 68 0 86 0 95 0
4 0 0 0 1 0 0 0 0 0
36 0 6 0 12 0 68 0 75 0
7 0 2 0 2 0 3 0 6 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
64 0 52 0 83 0 157 0 176 0
72 0 118 0 722 0 234 1 249 0

38 45
0 0
S4-Ghoryan DH/662 S5-Shindand DH/1192
Female/Less than
Male/Less than 5 Male/Less than 5 Female/Less than Male/Less than 5
5 years old and
years old and over years old 5 years old years old and over
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
75 0 184 0 115 0 175 0 95 0
0 0 8 0 1 0 2 0 0 0
14 0 20 0 145 0 158 0 35 0
1 0 11 0 1 0 3 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
90 0 223 0 262 0 338 0 131 0
355 0 1560 0 504 0 526 0 321 0

45 42
0 0
192 S6-Gulran DH/658
Female/Less than Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5
5 years old and 5 years old and
years old 5 years old years old and over
over over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
281 0 59 0 71 0 48 0 63 0
0 0 0 0 3 0 1 0 0 0
48 0 36 0 51 0 17 0 24 0
0 0 11 0 9 0 5 0 7 0
0 0 2 0 5 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
329 0 108 0 139 0 71 0 95 0
1247 0 267 0 322 0 211 0 1322 0

16
0
 S7-Obey CHC/666 S8-Roba
Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5 Male/Less than 5
5 years old and
years old 5 years old years old and over years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
19 0 25 0 15 0 30 0 23 0
2 0 3 0 1 0 2 0 7 0
38 0 42 0 25 0 35 0 4 0
3 0 2 0 4 0 5 0 2 0
2 0 1 0 2 0 3 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
64 0 73 0 47 0 75 0 36 0
210 0 295 0 195 0 290 0 87 0

26
0
 S8-Robat Sangi CHC/656 S9-Islam Qala-660
Female/Less than
Female/Less than Male/Less than 5 Male/Less than 5 Female/Less than
5 years old and
5 years old years old and over years old 5 years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
27 0 42 0 15 0 58 0 38 0
9 0 11 0 6 0 2 0 0 0
3 0 7 0 8 0 30 0 12 0
1 0 6 0 4 0 0 0 4 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
40 0 66 0 33 0 90 0 54 0
93 0 311 0 416 0 101 0 76 0

17 18
0 0
S9-Islam Qala-660 S10-Karokh-1737
Female/Less than
Male/Less than 5 Male/Less than 5 Female/Less than Male/Less than 5
5 years old and
years old and over years old 5 years old years old and over
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
26 0 104 0 40 0 31 0 45 0
1 0 0 0 3 0 6 0 0 0
10 0 1 0 27 0 29 0 7 0
2 0 5 0 2 0 4 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
39 0 110 0 72 0 70 0 53 0
131 0 560 0 80 0 74 0 194 0

18 14
0 0
7 S11-Adraskan-665
Female/Less than Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5
5 years old and 5 years old and
years old 5 years old years old and over
over over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
82 0 21 0 34 0 8 0 32 0
2 0 3 0 1 0 0 0 5 0
4 0 26 0 29 0 0 0 5 0
0 0 4 0 6 0 8 0 10 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
90 0 54 0 70 0 16 0 52 0
568 0 64 0 83 0 102 0 357 0

7
0
 S12-Koklam CHC S13-Za
Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5 Male/Less than 5
5 years old and
years old 5 years old years old and over years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
0 0 0 0 0 0 0 0 16 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 11 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 27 0
0 0 0 0 0 0 0 0 43 0

0
0
 S13-Zanda jan C.H.C S 14 Rawashan CHC (1974
Female/Less than
Female/Less than Male/Less than 5 Male/Less than 5 Female/Less than
5 years old and
5 years old years old and over years old 5 years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
19 0 60 0 73 0 31 0 32 0
0 0 0 0 0 0 0 0 0 0
13 0 10 0 7 0 24 0 19 0
2 0 1 0 2 0 3 0 2 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
34 0 71 0 82 0 58 0 53 0
60 0 199 0 488 0 70 0 59 0

9 16
0 0
Rawashan CHC (1974) S15-Poshton Zarghon CHC ( 653 )
Female/Less than
Male/Less than 5 Male/Less than 5 Female/Less than Male/Less than 5
5 years old and
years old and over years old 5 years old years old and over
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
20 0 51 0 0 0 0 0 0 0
0 0 5 0 0 0 0 0 0 0
5 0 15 0 0 0 0 0 0 0
5 0 4 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
30 0 75 0 0 0 0 0 0 0
100 0 720 0 0 0 0 0 0 0

16 0
0 0
C ( 653 ) S16-Farsi CHC ( 653 )
Female/Less than Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5
5 years old and 5 years old and
years old 5 years old years old and over
over over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
0 0 5 0 4 0 5 0 11 0
0 0 2 0 2 0 3 0 0 0
0 0 3 0 4 0 5 0 4 0
0 0 1 0 1 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 2 0 4 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 11 0 11 0 15 0 19 0
0 0 17 0 15 0 51 0 63 0

0
0
 S 17 Campe Ansar ( 1594 ) S18 Cha
Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5 Male/Less than 5
5 years old and
years old 5 years old years old and over years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
0 0 0 0 0 0 0 0 37 0
0 0 0 0 0 0 0 0 10 0
0 0 0 0 0 0 0 0 32 0
0 0 0 0 0 0 0 0 2 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 81 0
0 0 0 0 0 0 0 0 90 0

0
0
 S18 Chasht-e-Sharif 670 S19-Injil CHC -639
Female/Less than
Female/Less than Male/Less than 5 Male/Less than 5 Female/Less than
5 years old and
5 years old years old and over years old 5 years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
31 0 20 0 28 0 26 0 17 0
9 0 0 0 1 0 3 0 2 0
28 0 10 0 15 0 14 0 11 0
1 0 3 0 5 0 2 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
69 0 33 0 49 0 45 0 31 0
77 0 91 0 189 0 189 0 206 0

11 19
0 0
S19-Injil CHC -639 S20 Koshka-E-R.S - 1735
Female/Less than
Male/Less than 5 Male/Less than 5 Female/Less than Male/Less than 5
5 years old and
years old and over years old 5 years old years old and over
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
27 0 64 0 48 0 41 0 41 0
3 0 2 0 6 0 3 0 5 0
9 0 10 0 18 0 20 0 13 0
1 0 2 0 2 0 1 0 5 0
0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
40 0 78 0 74 0 66 0 64 0
82 0 603 0 84 0 81 0 162 0

19 12
0 0
1735 S21-Jabrail BHC (615)
Female/Less than Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5
5 years old and 5 years old and
years old 5 years old years old and over
over over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
108 0 20 0 24 0 8 0 19 0
3 0 2 0 0 0 5 0 13 0
10 0 31 0 27 0 1 0 4 0
9 0 2 0 1 0 2 0 2 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
130 0 55 0 52 0 16 0 38 0
529 0 282 0 235 0 59 0 1004 0

11
0
 S22-Kuhsan 661 S23
Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5 Male/Less than 5
5 years old and
years old 5 years old years old and over years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
27 0 38 0 30 0 85 0 13 0
0 0 0 0 0 0 0 0 0 0
24 0 20 0 9 0 7 0 8 0
4 0 3 0 4 0 0 0 4 0
0 0 0 0 0 0 1 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
55 0 61 0 43 0 93 0 25 0
61 0 64 0 129 0 370 0 58 0

9
0
 S23 Minarat 627 S24 Jaghartan CHC (644)
Female/Less than
Female/Less than Male/Less than 5 Male/Less than 5 Female/Less than
5 years old and
5 years old years old and over years old 5 years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
8 0 8 0 32 0 64 0 38 0
0 0 0 0 0 0 0 0 0 0
8 0 2 0 4 0 1 0 0 0
10 0 2 0 4 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
26 0 12 0 40 0 65 0 38 0
59 0 45 0 589 0 165 0 127 0

13 10
Err:509 0
4 Jaghartan CHC (644) S25 Kahdestan CHC(1592)
Female/Less than
Male/Less than 5 Male/Less than 5 Female/Less than Male/Less than 5
5 years old and
years old and over years old 5 years old years old and over
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
27 0 37 0 11 0 20 0 26 0
0 0 0 0 2 0 1 0 1 0
6 0 12 0 4 0 8 0 0 0
0 0 0 0 1 0 2 0 6 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
33 0 49 0 18 0 31 0 33 0
148 0 547 0 60 0 59 0 118 0

10 11
0 0
(1592) S26 Imam Shir Noor CHC(643)
Female/Less than Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5
5 years old and 5 years old and
years old 5 years old years old and over
over over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
49 0 20 0 14 0 20 0 22 0
1 0 0 0 0 0 0 0 1 0
7 0 7 0 8 0 5 0 10 0
4 0 1 0 1 0 1 0 4 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
63 0 28 0 23 0 26 0 37 0
427 0 78 0 89 0 110 0 382 0
6 0 0 Stillbirth 0 0 0 0
0
0
 S27-Aria Apolo Hospital /5302 S28-Noor
Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5 Male/Less than 5
5 years old and
years old 5 years old years old and over years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
23 0 25 0 10 0 12 0 4 0
11 0 7 0 3 0 2 0 0 0
35 0 30 0 25 0 21 0 3 0
0 0 2 0 3 0 2 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 1 0 1 0 1 0 0 0
1 0 1 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
70 0 67 0 42 0 38 0 7 0
90 0 95 0 68 0 113 0 10 0

0
0
 S28-Noorul Madina /5318 S30-Gazergah CHC/628
Female/Less than
Female/Less than Male/Less than 5 Male/Less than 5 Female/Less than 5
5 years old and
5 years old years old and over years old years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
4 0 2 0 2 0 40 0 29 0
0 0 0 0 0 0 1 0 1 0
2 0 0 0 2 0 25 0 18 0
0 0 0 0 0 0 0 0 3 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
6 0 2 0 4 0 66 0 51 0
7 0 13 0 12 0 85 0 78 0

0 9
0 0
0-Gazergah CHC/628 S31-Omul Mominin Ayesha Seddiqa CHC/
Male/Less than 5 Female/Less than 5 Male/Less than 5 Female/Less than Male/Less than 5
years old and over years old and over years old 5 years old years old and over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
22 0 94 0 8 0 6 0 25 0
0 0 1 0 3 0 4 0 2 0
4 0 13 0 8 0 9 0 32 0
0 0 2 0 1 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 1 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
26 0 111 0 20 0 19 0 60 0
68 0 416 0 25 0 28 0 74 0

9 0
0 0
Seddiqa CHC/ S32-Fayyez Clinic
Female/Less than Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5
5 years old and 5 years old and
years old 5 years old years old and over
over over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
29 0 0 0 0 0 0 0 0 0
3 0 0 0 0 0 0 0 0 0
42 0 0 0 0 0 0 0 0 0
2 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
76 0 0 0 0 0 0 0 0 0
81 0 0 0 0 0 0 0 0 0

0
0
 S33-Mehraban Hospital S34-Afg
Male/less than 5 Female/less than 5 Male/ 5 years old 0+D883:J890 Male/Less than 5
years old years old and over years old
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
35 0 39 0 62 0 70 0 0 0
24 0 21 0 16 0 18 0 0 0
5 0 4 0 4 0 3 0 0 0
2 0 0 0 2 0 2 0 0 0
25 0 27 0 19 0 16 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
1 0 1 0 11 0 9 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
92 0 92 0 114 0 118 0 0 0
110 0 106 0 132 0 138 0 0 0

0
0
 S34-Afghan Aria-5346 S35 Loghman Hakim 5310
Female/Less than
Female/Less than Male/Less than 5 Male/Less than 5 Female/Less than
5 years old and
5 years old years old and over years old 5 years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

0 0
0 0
Loghman Hakim 5310 Baba e Barq 626
Female/Less than
Male/Less than 5 Male/Less than 5 Female/Less than Male/Less than 5
5 years old and
years old and over years old 5 years old years old and over
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

0 0
0 0
6 Dulaine CHC1583
Female/Less than Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5
5 years old and 5 years old and
years old 5 years old years old and over
over over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0

0
0
 Dolatyar 1581 A
Female/Less than
Male/Less than 5 Female/Less than Male/Less than 5 Male/Less than 5
5 years old and
years old 5 years old years old and over years old
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths Cases Deaths
0 0 0 0 0 0 0 0 951 0
0 0 0 0 0 0 0 0 114 0
0 0 0 0 0 0 0 0 732 0
0 0 0 0 0 0 0 0 57 0
0 0 0 0 0 0 0 0 39 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 0 0
0 0 0 0 0 0 0 0 1895 0
0 0 0 0 0 0 0 0 3392 1

0
0
 All Sites All Ages
Female/Less than
Female/Less than Male/Less than 5
5 years old and All Ages all age <5
5 years old years old and over
over
Cases Deaths Cases Deaths Cases Deaths Cases Deaths % %

1009 0 875 0 1728 0 4563 0 17.8 28.6

94 0 56 0 82 0 346 0 1.4 3.0
716 0 272 0 354 0 2074 0 8.1 21.1
75 0 69 0 92 0 293 0 1.1 1.9
41 0 23 0 22 0 125 0 0.5 1.2
1 0 1 0 1 0 3 0 0.0 0.0
1 0 2 0 4 0 8 0 0.0 0.0
1 0 0 0 0 0 1 0 0.0 0.0
0 0 0 0 0 0 0 0 0.0 0.0
0 0 0 0 0 0 0 0 0.0 0.0
0 0 0 0 0 0 0 0 0.0 0.0
0 0 0 0 0 0 0 0 0.0 0.0
0 0 0 0 0 0 0 0 0.0 0.0
1 0 11 0 14 0 27 0 0.1 0.0
0 0 0 0 0 0 0 0 0.0 0.0
0 0 0 0 0 0 0 0 0.0 0.0
1939 0 1309 0 2297 0 7440 0 29.0 55.9
3466 0 3784 0 14973 0 25615 1 100.0 100.0

410 Total Male 7176

1 Total Fema 18439
 5<

13.9 1065 3498

0.7 37 309
3.3 -2090 4164
0.9 -337 630
0.2 -14 139
0.0 -25 28 1 2
0.0 -10 18 2 6
0.0 -2 3 1 0
0.0 0 0 0 0
0.0 0 0 0 0
0.0 0 0 0 0
0.0 0 0 0 0
0.0 0 0 0 0
0.1 -59 86 2 25
0.0 -5 5 0 0
0.0 0 0 0 0
19.2 -1440 8880 3834 3606
100.0 -7415 33030 6858 18757
Disease Early Warning System -Afghanistan
Surveillance Reporting Form for Morbidity (disease) and Mortality (death)
Province Name/Code: Hirat – 20 District Name/Code: Center of the province (2001) 1st Site
Town/Village/Camp: Hirat Facility Name/Code: Hirat RH (630) NGO/Donor: MoPH
Epidemiological Week : 13th from 29/Feb/2014 to Friday 04/Mar/2014 Submission Date:05/Mar/2014 Contact’s
Name & phone #: Dr Akbarian 0799861015 or Dr Amirnajad ( 0700410119)
Male/less than 5 Female/less than Male/ 5 years old Female/ 5 years
Events Under Surveillance years old 5 years old and over old and over
Cases Deaths Cases Deaths Cases Deaths Cases

1 ARI- Cough and cold 0 0 0 0 0 0 0

2 ARI- Pneumonia 0 0 0 0 0 0 0

3 Acute Diarrhoea 0 0 0 0 0 0 0

4 Bloody Diarrhoea 0 0 0 0 0 0 0

5 AWD w Dehydration 0 0 0 0 0 0 0

6 Suspected Meningitis (SIC) 0 0 0 0 0 0 0

7 Susp. Acute Viral Hepatitis 0 0 0 0 0 0 0

8 Suspected Measles 0 0 0 0 0 0 0

9 Suspected Pertussis 0 0 0 0 0 0 0

10 Probable Diphtheria 0 0 0 0 0 0 0

11 Tetanus/ Neonatal Tetanus 0 0 0 0 0 0 0

12 Acute Flaccid Paralysis 0 0 0 0 0 0 0

13 Suspected Malaria 0 0 0 0 0 0 0

14 Suspected Typhoid Fever 0 0 0 0 0 0 0

15 Susp. Hemorrhagic Fever 0 0 0 0 0 0 0

16 Pregnancy-related deaths 0 0 0 0 0 0 0

DEWS Disease 0 0 0 0 0 0 0

TOTAL New Clients/ Deaths 0 0 0 0 0 0 0

Newborn Alive 0 Stillbirth 0

Disease Early Warning System -Afghanistan

Surveillance Reporting Form for Morbidity (disease) and Mortality (death)
Province Name/Code: Hirat – 20 District Name/Code: Center of the province (2001) 1st Site
Town/Village/Camp: Hirat Facility Name/Code: Hirat RH (630) NGO/Donor: MoPH
Epidemiological Week : 13th from 29/Feb/2014 to Friday 04/Mar/2014 Submission Date:05/Mar/2014 Contact’s
Name & phone #: Dr Akbarian 0799861015 or Dr Amirnajad ( 0700410119)
Male/less than 5 Female/less than Male/ 5 years old Female/ 5 years
Events Under Surveillance years old 5 years old and over old and over
Cases Deaths Cases Deaths Cases Deaths Cases
 1 ARI- Cough and cold 0 0 0 0 0 0 0

2 ARI- Pneumonia 0 0 0 0 0 0 0

3 Acute Diarrhoea 0 0 0 0 0 0 0

4 Bloody Diarrhoea 0 0 0 0 0 0 0

5 AWD w Dehydration 0 0 0 0 0 0 0

6 Suspected Meningitis (SIC) 0 0 0 0 0 0 0

7 Susp. Acute Viral Hepatitis 0 0 0 0 0 0 0

8 Suspected Measles 0 0 0 0 0 0 0

9 Suspected Pertussis 0 0 0 0 0 0 0

10 Probable Diphtheria 0 0 0 0 0 0 0

11 Tetanus/ Neonatal Tetanus 0 0 0 0 0 0 0

12 Acute Flaccid Paralysis 0 0 0 0 0 0 0

13 Suspected Malaria 0 0 0 0 0 0 0

14 Suspected Typhoid Fever 0 0 0 0 0 0 0

15 Susp. Hemorrhagic Fever 0 0 0 0 0 0 0

16 Pregnancy-related deaths 0 0 0 0 0 0 0

DEWS Disease 0 0 0 0 0 0 0

TOTAL New Clients/ Deaths 0 0 0 0 0 0 0

Newborn Alive 0 Stillbirth 0

Mother 0

Disease Early Warning System -Afghanistan

Surveillance Reporting Form for Morbidity (disease) and Mortality (death)
Province Name/Code: Hirat – 20 District Name/Code: Center of the province (2001) 1st Site

Town/Village/Camp: Hirat Facility Name/Code: Hirat RH (630) NGO/Donor: MoPH

Epidemiological Week : 13th from 29/Feb/2014 to Friday 04/Mar/2014 Submission Date:05/Mar/2014 Contact’s
Name & phone #: Dr Akbarian 0799861015 or Dr Amirnajad ( 0700410119)
 Male/less than 5 Female/less than Male/ 5 years old Female/ 5 years
Events Under Surveillance years old 5 years old and over old and over
Cases Deaths Cases Deaths Cases Deaths Cases

1 ARI- Cough and cold 0 0 0 0 0 0 0

2 ARI- Pneumonia 0 0 0 0 0 0 0

3 Acute Diarrhoea 0 0 0 0 0 0 0

4 Bloody Diarrhoea 0 0 0 0 0 0 0

5 AWD w Dehydration 0 0 0 0 0 0 0

6 Suspected Meningitis (SIC) 0 0 0 0 0 0 0

7 Susp. Acute Viral Hepatitis 0 0 0 0 0 0 0

8 Suspected Measles 0 0 0 0 0 0 0

9 Suspected Pertussis 0 0 0 0 0 0 0

10 Probable Diphtheria 0 0 0 0 0 0 0

11 Tetanus/ Neonatal Tetanus 0 0 0 0 0 0 0

12 Acute Flaccid Paralysis 0 0 0 0 0 0 0

13 Suspected Malaria 0 0 0 0 0 0 0

14 Suspected Typhoid Fever 0 0 0 0 0 0 0

15 Susp. Hemorrhagic Fever 0 0 0 0 0 0 0

16 Pregnancy-related deaths 0 0 0 0 0 0 0

DEWS Disease 0 0 0 0 0 0 0

TOTAL New Clients/ Deaths 0 0 0 0 0 0 0

Newborn Alive 0 Stillbirth 0

 PH Mostafazada 0790735058

Mar/2014 Contact’s

Female/ 5 years
old and over
Deaths Hirat RH (630) NGO/Donor: MoPH
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0

RH Ass dr Aqil 0794775172

Mar/2014 Contact’s

Female/ 5 years
old and over
Deaths Hirat RH (630) NGO/Donor: MoPH
 0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0 0 0
0 0 0 0
797 45 24 62
Zinat Safdari

MoPH

Mar/2014 Contact’s
Female/ 5 years
old and over
Deaths

0
No Of Site Entered
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25