Cholera cases, deaths soar by 30% in Africa

World Health Organisation (WHO) has said Africa is witnessing an exponential rise in cholera cases amid global surge.

WHO African Region (WHOAFRO), yesterday, during an online press conference, said cases recorded on the continent in January this year alone were 30 per cent higher than the total caseload of 2022.

It noted that an estimated 26,000 cases and 660 deaths have been reported as of January 29 in 10 African countries facing outbreaks since the beginning of the year. In 2022, nearly 80,000 cases and 1,863 deaths were posted from 15 nations.

The apex United Nations health body warned that if the current trend continues, it could surpass the number of cases recorded in 2021, the worst year for the epidemic in Africa in nearly a decade. Average case fatality ratio is currently almost at three per cent, above the 2.3 per cent tally of 2022, and far exceeding the acceptable level of below one per cent.

Health Emergency Officer, Acute Events Management Unit, Dr. Patrick Otim, led the WHO media event. Secretary for Health at the Malawi Ministry of Health, Dr. Charles Mwansambo and Director of the Cholera Elimination and Diarrhoeal Disease Control Programme in Democratic Republic of Congo’s Ministry of Health, Dr. Placide Welo, joined him. Also on hand from WHO Regional Office for Africa was Regional COVID-19 Incident Manager, Dr. Thierno Balde.

According to WHO, the bulk of the new cases and deaths have been recorded in Malawi, which is facing its most horrible cholera outbreak in two decades. The neighbours, Mozambique and Zambia, have also recently reported cases.

In East Africa, Ethiopia, Kenya and Somalia are responding to outbreaks amid a prolonged and harsh drought that has left millions of people in dire need of humanitarian assistance. Burundi, Cameroun, Democratic Republic of the Congo and Nigeria have also reported cases.

WHO Regional Director for Africa, Dr. Matshidiso Moeti, said: “We are witnessing a worrying scenario where conflict and extreme climatic events are worsening the triggers of cholera and increasing its toll on lives.

“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 global agency confirmed that it was working with nations to ramp up disease surveillance, prevention and treatment measures, community engagement, as well as multi-sectoral coordination with partners and agencies to improve sanitation and provide safe water.

WHO said it had deployed 65 experts in five African countries, including 40 to Malawi. In addition, it has also disbursed $6 million to kick-start emergency cholera response in Kenya, Malawi and Mozambique.

It said, so far this year, around 3.3 million doses have been delivered to Democratic Republic of the Congo, Kenya and Mozambique through the International Coordinating Group on Vaccine Provision. The initiative is to manage emergency supplies of vaccines and is a partnership of the International Federation of the Red Cross and Red Crescent Societies, Médecins sans Frontières, United Nations Children’s Fund and WHO.

WHO said the increase in cholera outbreaks globally has put a huge strain on availability of vaccines, prompting the International Coordinating Group on Vaccine Provision to temporarily suspend the standard two-dose vaccination regimen in cholera outbreak response campaigns, using instead a single-dose approach. A further surge in cholera outbreak risks deepening the shortage.

Cholera is an acute, extremely virulent infection that can spread rapidly and dehydration resulting in high morbidity and mortality. However, the disease is easily treatable. Most people can be treated successfully through prompt administration of oral rehydration solution or intravenous fluids.

Moeti added: “Every death due to cholera is preventable. 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.”

Effective control relies on implementing comprehensive measures including enhanced epidemiological and laboratory surveillance to detect, confirm and quickly respond to outbreaks, improving access to treatment, vaccines, safe water and basic sanitation as well as effecting behavioural change and better hygiene practices among communities.

The cholera outbreaks in Africa are occurring in the context of extreme climatic events, conflicts, ongoing outbreaks of other disease such as wild poliovirus as well as limited financial resources and strained health workforce due to the response to the COVID-19 pandemic.