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UNICEF Chad Humanitarian Situation Report No. 6: (Reporting Period: 1 September to 31 October 2020)

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• During the reporting period, 71,188 malnourished children were admitted and treated in the supported health centres, bringing the year-to-date total to 217,393 in the targeted provinces, representing 73.6% of expected cases, with a cure rate of 94.4 per cent.

• 3,151 children received psychosocial support, including in child-friendly spaces, bringing the year-to-date total to 7,695 children.

• 5,000 people received access to safe clean drinking water using water- purifying sachets for household water treatment and building of 17 new boreholes, bringing the year-to-date total to 49,947 people.

• In support of the National Contingency Plan for Preparedness and Response to the COVID-19 pandemic, UNICEF focused on limiting human- to-human transmission to protect individuals from exposure to COVID-19 and minimising morbidity and mortality due to COVID-19. 30,000 protective face shields along with other PPE items were distributed in September and October to 10 provincial hospitals, 5 district hospitals and 246 health centers supported by UNICEF.

Situation Overview & Humanitarian Needs

Chad is facing multiple humanitarian crises in 2020. According to an analysis conducted in August 2020 by the Nutrition Cluster, with support from UNICEF and the World Food Programme, food insecurity, combined with the impact of COVID-19, has increased the number of children aged 6 to 59 with acute malnutrition from 1,711,090 to 1,893,199 including 526,984 children with severe acute malnutrition. UNICEF is targeting 414,301 of these children aged 6-59 months, as per the revised Chad 2020 Humanitarian Response Plan1.
A measles outbreak has been persisting since April 2018, despite the various response campaigns conducted in epidemic districts. Since the beginning of 2020, as of epidemiological week 43 (25 October), the country has reported 8,601 measles cases including 39 deaths registered. However, a decreasing trend of reported cases has been noted since epidemiological week 14 (5 April), likely due to the onset of the rainy season. 37 children were newly infected in September and 65 in October. As of 25 October, there are no districts suspected of being in epidemic.
As of the same epidemiological period, 432 cases of meningitis were reported in 43 districts, including 43 deaths (10%), with most of the cases in the Mandoul province. Due to seasonality, the number of meningitis cases is decreasing with 14 cases in September and 11 cases in October.
As of 23 October, 38,140 cases of chikungunya including one death have been confirmed in the Eastern part of Chad (30,700 in the Ouaddai province, which accounts for 80% of the total cases and one death; 7,439 in the Wadi Fira province; and 1 case in the Guera Province). With a steep increase marked over several weeks, this outbreak added pressure on an already fragile health system.
The country has also been affected by an outbreak of cVDPV2 (circulating vaccine-derived polioviruses) since 2019. The temporary deferral in the outbreak response due to COVID-19 has seen continued cases of cVDPV2 across the country. Since the end of August, 13 new cases of cVPV2 have been confirmed positive, bringing the total confirmed cases to 83 as of epidemiological week 43 (25 October), which includes 80 Acute Flask Paralysis (AFP) cases with an onset date in 2020 and three environmental cases with collection date in 2020.
Against this backdrop, the March 2020 outbreak of COVID-19 further exacerbated the weakness of the health system. As of 31 October 2020, 1,498 cases were reported in 17 provinces. 186 new cases were reported in September and 295 new cases in October. More than 33,565 people have been quarantined since the beginning of the pandemic, of which 1,817 were still under surveillance as of 31 October 2020. Health personnel represent 10.2% of the total reported cases.
The COVID-19 curve of confirmed cases has accelerated since the beginning of the reporting period, especially in Moyen Chari and Mayo Kebbi Est, bordering areas with entry points, which are the most affected with respectively 160 and 111 reported cases on 31 October.