Abstract
Background: On May 23, 2017, a firefight ensued between government forces and an armed group in Marawi City resulting to mass evacuation of people to Iligan City. On June 2, 2017, a Field Epidemiology Training Program team was sent to Iligan City to establish enhanced diarrhea surveillance in hospitals, identify clustering of diarrhea in evacuation centers and villages, and recommend control and prevention measures. Methods and materials: We selected all hospitals in Iligan City. Eight hospitals were identified. We developed a reporting flow and recording tool. A suspect case was an Internally Displaced Person (IDP) with ≥3 episodes of loose watery stool per day from May 23, 2017 who consulted in a hospital in Iligan City. A confirmed case was suspect case positive for any bacteriological pathogen. Clustering was defined as ≥3 suspect cases in evacuation centers or home-based village in four consecutive weeks. We collected rectal swabs for bacteriologic testing. Results: There were 253 diarrhea cases from May 23–July 31, 2017. None died. Eighty (32%) were aged 1–4 years. Cases stayed in evacuation centers (EC) or houses of relatives. Twelve (5%) were positive for Vibrio cholerae. Six (50%) resided in the community; five (42%) were at ECs. One specimen has no data. Clustering were seen in a village and one evacuation center. Data led to regular water screening and disinfection activities and provision of additional communal toilets at the evacuation centers. No diarrhea outbreak was detected. Conclusion: There were clustering of diarrhea cases among IDPs from Marawi City. Confirmed cases of cholera were staying in different evacuation centers and villages in Iligan City. However, due to immediate implementation of control and prevention measures, no outbreak occurred. Disasters and conflicts threaten public health. Surveillance is a fundamental part of public health practice to detect, control, and prevent the impact of disease, guide immediate and long-term actions, and prioritize the use of public health resources.
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