Cholera cases surge very fast in Africa, reach a third of 2022 total

Idi Amara in Ethiopia

Despite a global epidemic, cholera cases are rising rapidly in Africa. The number of cases on the continent in the first month of 2023 alone has increased by more than 30% compared to the total number of cases in 2022.

As of January 29, 2023, an estimated 26,000 cases and 660 deaths had been reported in ten African countries that have been experiencing outbreaks since the beginning of the year. From 15 affected nations, nearly 80.000 cases and 1863 deaths were recorded in 2022. It could surpass the number of cases recorded in 2021, the worst year for cholera in Africa in nearly a decade, if the current fast-rising trend continues. The average case fatality ratio is almost 3 percent at the moment, which is much higher than the acceptable level of less than 1 percent, which was reached in 2022.

Malawi, which is currently experiencing its worst cholera outbreak in two decades, has been responsible for the majority of the new cases and deaths. Mozambique and Zambia, two of Malawi’s neighbors, have also recently reported cases. Ethiopia, Kenya, and Somalia in East Africa are responding to outbreaks in the midst of a prolonged and severe drought that has left millions of people in dire need of humanitarian assistance. Cases have also been reported from Nigeria, Cameroon, the Democratic Republic of the Congo, and Burundi.

“We are witnessing a worrying scenario where conflict and extreme climatic events are worsening the triggers of cholera and increasing its toll on lives,” said Dr Matshidiso Moeti, World Health Organization (WHO) Regional Director for Africa. “It’s critical for African countries to scale up readiness to quickly detect cases and mount comprehensive and timely response. We are supporting governments to bolster key control measures to halt these outbreaks as quickly as possible.”

The World Health Organization (WHO) collaborates with nations to increase disease surveillance, preventative and curative measures, community engagement, and multisectoral coordination with partners and agencies to enhance sanitation and supply clean water. The organization has sent 65 specialists to five African nations, 40 of which are in Malawi. In addition, the World Health Organization (WHO) has given Mozambique, Kenya, and Malawi $6 million to start an emergency cholera response.

Through the International Coordinating Group on Vaccine Provision, approximately 3.3 million doses of the cholera vaccine have been delivered to the Democratic Republic of the Congo, Kenya, and Mozambique so far this year. Mozambique will receive the vaccine in the coming days. WHO, Médecins Sans Frontières, the United Nations Children’s Fund, and the International Federation of the Red Cross and Red Crescent Societies are working together on this project, which aims to manage vaccine supplies for emergencies.

The International Coordinating Group on Vaccine Provision decided to use a single-dose vaccination strategy in cholera outbreak response campaigns after temporarily suspending the standard two-dose vaccination protocol due to the rise in global cholera outbreaks. The shortage could get worse if the cholera outbreak gets worse again.

Cholera is an acute, highly contagious infection that can spread quickly and cause severe dehydration, leading to high mortality and morbidity rates. However, the illness is simple to treat. The rapid administration of oral rehydration solution or intravenous fluids can successfully treat most patients.

“Every death due to cholera is preventable,” said Dr Moeti. “This disease is much a health challenge as it is a development one. As such investments in better sanitation and access to safe water formidably complement the public health initiatives to sustainably control and end cholera.”

Improving access to treatment, vaccines, clean water, and basic sanitation, as well as influencing behavioral change and improved hygiene practices among communities, are all essential components of comprehensive control. These components include enhanced epidemiological and laboratory surveillance to quickly identify, confirm, and contain outbreaks.

Due to the response to the COVID-19 pandemic, the cholera outbreaks in Africa are occurring in the context of extreme climatic events, conflicts, ongoing outbreaks of other diseases like wild poliovirus, and limited financial resources.

Today, Dr. Patrick Otim, Health Emergency Officer, Acute Events Management Unit, presided over a WHO press conference. Dr. Charles Mwansambo, Secretary for Health at the Malawi Ministry of Health, was there with him. and Dr. Placide Welo, Director of the Ministry of Health of the Democratic Republic of the Congo’s Cholera Elimination and Diarrhoeal Disease Control Program. Dr. Thierno Balde, Regional COVID-19 Incident Manager, was also present from the WHO Regional Office for Africa.