rdsru

Directorate General Health Services Sindh @ Hyderabad Provincial & Regional Disease Surveillance and Response Units

EX I & I Depot Rafiqui Shaheed Road near JPMC Karachi Cantt, Phone # 02135167029 Phone No. 022-9240101-6, Fax No. 022-9240100: Email: dghealthsindh@sindhealth.pk

COVID-19 Surveillance in Sindh Province Background: From 25th January 2020, Health Department, Government of Sindh received the report of presence of suspected coronavirus cases by Aga Khan University Hospital (AKUH). On directives of Director General Health Services Sindh (DG Sindh) Technical Support Officer (TSOs) of Provincial and Regional Disease Surveillance and Response Units established a COVID-19 surveillance system in Sindh Province. The objectives are early identification of cases/outbreak and burden of disease and implement control and preventive measures.

Confimred cases: 1326

Based on data received up to 4:00 pm dated 12th April

Death:28 The RDSRU and PDSRU have started collecting data on COVID-19 cases from the different hospitals and laboratories of Sindh.

From 24th January – 12th April 2020 a total

1326 COVID -19 cases were identified (Table 01).

Table 01: District Wise Number of COVID-19 cases in from 24th January 2020 to 12TH April 2020 Division

Karachi

Hyderabad

SBA

District

157 205

12% 15%

K Korangi

60

5%

74 191

6% 14%

K West No Address

85 47

6% 4%

Hyderabad

162

12%

TM Khan Jamshoro

19 2

1% 0%

BADIN SUJAWAL

1 1

0% 0%

DADU

1

0%

Sanghar N FEROZE

2 2

0% 0%

10 272

1% 21%

15

1%

2

K Malir K South

Khairpur Gothki

Larkana

Percentage

K Central K East

SBA Sukkur Sukkkur

Frequency

Larkana

15

0% 1%

Jacobad Others

1 2

0% 0%

1326

TUFAIL AHMED EXPRESS TRIBUNE

Total

819

186

14

289

17

Directorate General Health Services Sindh @ Hyderabad Provincial & Regional Disease Surveillance and Response Units

EX I & I Depot Rafiqui Shaheed Road near JPMC Karachi Cantt, Phone # 02135167029 Phone No. 022-9240101-6, Fax No. 022-9240100: Email: dghealthsindh@sindhealth.pk

Time wise distribution of COVID-19 Cases: Highest number (n=164, 21%) of cases were reported on dated 30th March 2020 followed by 16th March 2020 (n=121, 15%). Figure 1 Figure 01: Date wise number of COVID-19 cases in Sindh from 24th January 2020 to 12th April 2020, Sindh (N=1326)

160

Number of COVID-19 Cases

Hyderabad Noor Masjid Cases

Sukkur Zyreen Cases

180

140 120 100 80 60

40 20

26-Feb 27-Feb 28-Feb 29-Feb 1-Mar 2-Mar 3-Mar 4-Mar 5-Mar 6-Mar 7-Mar 8-Mar 9-Mar 10-Mar 11-Mar 12-Mar 13-Mar 14-Mar 15-Mar 16-Mar 17-Mar 18-Mar 19-Mar 20-Mar 21-Mar 22-Mar 23-Mar 24-Mar 25-Mar 26-Mar 27-Mar 28-Mar 29-Mar 30-Mar 31-Mar 1-Apr 2-Apr 3-Apr 4-Apr 5-Apr 6-Apr 7-Apr 8-Apr 9-Apr 10-Apr 11-Apr

0

Date of Diagnosis

Age wise distribution of cases: The COVID-19 cases were reported mostly among the age group 20-29 years (n=269, 20%) followed by age group 30-39 years (n=267, 20%). Figure 02 Figure 02: Age wise distribution of COVID-19 cases from 24th January 2020 to 12th April 2020, Sindh (N=1326)

Number of COVID-19 Cases

300

269

267

250 191

200

164

150

135

129

60-69Y

70 and Above

103 100

68

50 0 0-9Y

10-19Y

20-29Y

30-39Y

40-49Y

Age Group (Years)

50-59Y

Directorate General Health Services Sindh @ Hyderabad Provincial & Regional Disease Surveillance and Response Units

EX I & I Depot Rafiqui Shaheed Road near JPMC Karachi Cantt, Phone # 02135167029 Phone No. 022-9240101-6, Fax No. 022-9240100: Email: dghealthsindh@sindhealth.pk

Gender wise distribution of cases: Nine hundred and twenty Six (70%) of the COIVD-19 cases were male and 400 (30%) female as shown in Figure 2.

Figure 03: Gender wise distribution of COVID-19 cases from 24th January 2020 to 12th April 2020, Sindh (N=1326)

30%

70%

Female

Male

Age and Gender wise attack rate: The overall attack rate was 2.7/100,000. The age group 70 and above years of age was the most severely affected age group having the highest attack rate of 18.3/100,000 followed by 60-69 years 7.4/100,000 age group. (Table 02). Males have high attack rate 3.4/100,000 as compared to females (Table 03).

Table 02: Attack rates by age group in COVID-19 cases in Karachi from 24th January 2020 to 10th April 2020, Sindh (N=1326) Attack Rate Age Group Proportion Population Number of Cases /100,000 1-9Y 27.9 13,360,208 0.51 68 10-19Y 24.17 11,574,059 0.89 103 20-29Y 16.31 7,810,215 3.44 269 30-39Y 11.46 5,487,741 267 4.87 40-49Y 9.06 4,338,476 191 4.40 50-59Y 5.85 2,801,334 5.85 164 60-69 3.78 1,810,093 7.46 135 70 above 1.47 703,925 18.33 129 Total 47,886,051 2.77 1326

Directorate General Health Services Sindh @ Hyderabad Provincial & Regional Disease Surveillance and Response Units

EX I & I Depot Rafiqui Shaheed Road near JPMC Karachi Cantt, Phone # 02135167029 Phone No. 022-9240101-6, Fax No. 022-9240100: Email: dghealthsindh@sindhealth.pk

Table 02: Attack rates by age group in COVID-19 cases in Karachi from 24th January 2020 to 12th April 2020, Sindh (N=1326) Age Group Female Male

Proportion

Population 49 51

23,464,165 24,421,886

Number of Cases 400 926

Attack Rate /100,000 1.7 3.8

Figure 04: District wise COVID-19 cases in Karachi from 24th January 2020 to 12TH April 2020, Sindh (N=1326) Place wise distribution of the case: The highest number of the cases were reported from the Karachi division and Sukkur. The reason of Sukkur cases is presence of Iran Pilgrim in Quarantine.

Figure 04

Directorate General Health Services Sindh @ Hyderabad Provincial & Regional Disease Surveillance and Response Units

EX I & I Depot Rafiqui Shaheed Road near JPMC Karachi Cantt, Phone # 02135167029 Phone No. 022-9240101-6, Fax No. 022-9240100: Email: dghealthsindh@sindhealth.pk

Karachi:

Time wise distribution of COVID-19 Cases: Highest number of cases were reported on dated 28th March 2020 followed by 30th March 2020. Figure 5 Figure 05: Date wise number of COVID-19 cases in Sindh from 24th January 2020 to 12th April 2020, Karachi (N=819)

Town wise distribution of the COVID-19 case: The highest number of the COVID-19 cases were reported from the Gulshan Iqbal and Saddar Table 05 Table 05: Town wise COVID-19 cases in Karachi from 24th January 2020 to 10th April 2020, Karachi (N=819)

Town 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

No Address Town Baldia Town Bin Qasim Town Gadap Town Gulberg Town Gulshan Town Jamshed Town Kemari Town Korangi Town Landhi Town Liaquatabad Town Lyari Town Malir Town Nazimabad Town North Karachi Town Orangi Town Saddar Town Shah Fasial Town site TOTAL

Frequency 67 4 20 2 21 155 46 12 5 27 16 27 49 85 33 39 166 20 25 819

Percent 8.18% 0.49% 2.44% 0.24% 2.56% 18.93% 5.62% 1.47% 0.61% 3.30% 1.95% 3.30% 5.98% 10.38% 4.03% 4.76% 20.27% 2.44% 3.05% 100.00%

Directorate General Health Services Sindh @ Hyderabad Provincial & Regional Disease Surveillance and Response Units

EX I & I Depot Rafiqui Shaheed Road near JPMC Karachi Cantt, Phone # 02135167029 Phone No. 022-9240101-6, Fax No. 022-9240100: Email: dghealthsindh@sindhealth.pk

Transmission Pattern of COVID-19: Highest number of cases have travel history n=74 (54%) Rest were divided into local transmission with known source and unknown source as shown in Table Table 06: Pattern of disease transmission in Karachi (Based on 136 Data) Frequency Type of Transmission Imported Cases Travel History 74 Local Transmission with Contact History with Confirmed Case 42 Known Source Contact History with Case (HCW) 12 Local Transmission with No Travel or Contact History 6 Unknown Source Riwand 2 Total 136

Percentage 54% 31% 9% 4% 1% 100%