Bulletin: Cholera and AWD Outbreaks in Eastern and Southern Africa, Regional Update for 2019 – as of 1 April 2019
Approximately 3,385 cholera / AWD cases including 19 deaths have been reported in 10 out of the 21 countries in Eastern and Southern Africa Region (ESAR); with an average Case Fatality Rate of 0.6%, since the beginning of 2019. These countries include; Angola, Burundi, Kenya, Malawi, Mozambique, Tanzania, Somalia, Uganda, Zambia and Zimbabwe. Kenya accounts for 35.4 % (1,198) of the total case load reported this year, followed by Mozambique at 31% (1,048).
Of the 10 countries with reported cholera / AWD outbreaks in ESAR since week 1 of 2019, 6 (Mozambique, Tanzania, Somalia, Kenya, Zambia and Burundi) have ongoing cholera outbreaks. During the week under review, Mozambique reported the highest number of new cases (1048 cases). Tanzania and Burundi have recorded the highest Case Fatality Rates (CFR) in 2019 at 1.3% and 1% respectively, of the countries with active outbreaks.
Mozambique: Cholera cases in cyclone-hit Mozambique and its associated flooding have risen to 1,048 cases including 1 death (CFR, 0.09%). The Ministry of Health declared an outbreak of cholera on 27 March 2019 with cases reported in Beira and Nhamatanda districts. Recent assessments have shown that health facilities have been destroyed by the cyclone, complicating response efforts. The disease is a major concern for the hundreds of thousands of cyclone survivors in the southern African nation now living in squalid conditions in camps, schools or damaged homes. Some drink from contaminated wells or filthy, stagnant water. The first round of an oral cholera vaccination (OCV) campaign is starting today (on 3 April 2019), with the second round of vaccination planned in three months. The OCV campaign will target Beira, Buzi, Dondo and Nhamatanda.
Tanzania: An increase in the epidemic trend has been noted in the last two weeks. During week 12 (week ending 24 March 2019), 38 new cases were reported compared to 23 cases reported in week 11 (week ending 17 March 2019). This raises the total number of cholera cases reported since the beginning of 2019 to 154, including 2 deaths (CFR, 1.3 %). All new cases emerged from Tanga region in the following areas; Korogwe DC (24), Korogwe TC (11) and Handeni DC (3). Cumulatively a total of 33,475 cases including 552 deaths have been reported since the beginning of the outbreak in August 2015.
Somalia: A slight increase in the epidemic trend has been noted in the last two weeks. During week 11, 34 new cases were reported from Banadir Region compared to 32 cases reported in week 10 (week ending 10 March 2019). Cumulatively a total of 635 cases with no deaths have been reported since the beginning of 2019.
Children under five years bear the brunt of the cholera outbreak, representing 50% of the total case load reported in week 10 and 44% in epidemiological week 11. During the last two weeks, the most affected district in Banadir was Madina accounting for 27.5% (12/32) of the total number of cases reported during week 10; and 26.5% (9/34) of total cases reported in week 11. Overall (from epidemiological week 8 to11) the Banadir districts with the highest case numbers are Madina (36; AR 0.05), followed by Daynile (24; AR 0.04).
Kenya: Since January 2019, cholera outbreaks have been reported in Narok, Kajiado, Nairobi, Garissa and Machakos Counties. As of 1 April 2019, a cumulative total of 1198 cases including 4 deaths (CFR, 0.3%) have been reported in these counties since the beginning of 2019. Nairobi and Machakos are the latest counties to report confirmed cases of cholera. During the week under review (epidemiological week 13), 26 new cases were reported from; Nairobi (16), Garissa (6) and Machakos (4) counties.
Zambia: The latest cholera outbreak notified on 22 March 2019 hit Nsama district in Northern Province. The index case, a 9-year-old child from Chaushi village, developed signs and symptoms on 16 March 2019. As of 31 March 2019, a cumulative total of 88 suspected cases and 4 deaths (CFR, 4.5%) have been reported since the onset of the new outbreak.
Burundi: As of 1 April 2019, 206 cases including 2 deaths (CFR: 0.97%) were recorded since the onset of the Cholera epidemic on 18 December 2018. Of these, a total of 104 cases including 1 death (CFR, 0.96%) have been reported since the beginning of 2019. Cases recorded since the beginning of 2019 emerged from three provinces; Bujumbura (56), Rumonge (45) and Cibitoke (3).
Source: UN Children's Fund