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UNICEF reported earlier this month: Cholera doesn’t know borders. Despite being preventable and easily treatable, children continue to suffer from the potentially fatal disease. After years of steady decline, cholera has made a devastating comeback. More than 1.1 billion people in 43 countries are at risk, with children under 5 especially vulnerable.
Researchers conservatively estimate that every year, there are as many as 4 million cholera cases globally and as many as 143,000 deaths. Young children, especially those under the age of 5, bear the brunt of the disease. Furthermore, malnourished children are more vulnerable to experiencing severe symptoms. Cholera is a preventable and easily treatable disease.
The World Health Organization (WHO) and UNICEF say more countries now face outbreaks, increasing numbers of cases are being reported and the outcome for patients is worse than 10 years ago.
In 2022, 30 countries faced cholera outbreaks – an alarming 145 per cent average increase from the previous five-year average. Countries like Lebanon and Syrian Arab Republic reported cholera for the first time in decades, while others like Haiti have experienced a resurgence after more than three years with no reported cholera cases. As of May 2023, at least 24 countries continue to report cholera cases, and outbreaks are spreading across borders.
“Despite advances in the control of the disease made in the previous decades we risk going backwards.”
Cholera’s extraordinarily high mortality ratio is also alarming. Malawi and Nigeria registered case fatality rates as high as three per cent this year, well above the acceptable one per cent.
With most cholera deaths entirely preventable, mortality rates above 1 per cent usually signal problems with the quality, access and speed of treatment.
Southeastern Africa is particularly badly affected, with infections spreading in Malawi, Mozambique, South Africa, Tanzania, Zambia and Zimbabwe. The development follows the destructive passage of Cyclone Freddy in February and March this year, leaving 800,000 people in Malawi and Mozambique internally displaced and disrupting healthcare.
Malawi
On March 31, the UN Office for the Coordination of Humanitarian Affairs (OCHA) reported: Malawi is facing its deadliest cholera outbreak in recorded history and its largest in the last two decades.
The outbreak was officially declared on 3 March 2022, after the first case was reported in Machinga district at the end of February 2022.
A total of 29 districts have reported cholera cases since the confirmation of the first case. As of 29 April 2023, the cumulative confirmed cases and deaths reported since the onset of the outbreak is 58,557 and 1,756 respectively, with Case Fatality Rate at 3.0%.
Mozambique
Cholera outbreak has been reported from Sofala and Zambezia provinces of Mozambique. From 14 September 2022 to 29 April 2023, a total of 29,280 cases and 131 deaths (CFR 0.4%) have been reported from 10 provinces and 58 districts.
Tanzania
The cholera outbreak is ongoing in the regions of Katavi, Kigoma, Rukwa and Ruvuma in Tanzania. From 22 January to 13 Mar 2023, Ruvuma Region reported 13 cases, Katavi Rregion reported 34 cases, Rukwa Region reported 18 cases, and Kigoma Regoin reported 7 cases. Three cases (CFR 4.2%) have been reported as deaths all occuring in Nyasa District of Ruvuma Region. A total of 23 cases have been laboratory-confirmed as positive.
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Zambia
Zambia’s index case was confirmed in Vubwi district on 21 January 2023 and was linked to the Mozambique outbreak. Cumulatively, 468 cases and 11 deaths (CFR = 2.4%) have reported as of 1 May 2023.
Zimbabwe
The number of suspected cholera cases in Zimbabwe has surpassed 1,000, among which 288 were confirmed and six have died since the latest outbreak on Feb. 12, according to a government release.
“As of May 16, 2023, a cumulative total of 1,017 suspected cholera cases, six laboratory-confirmed deaths, 20 suspected cholera deaths, and 288 laboratory-confirmed cases were reported,” the Ministry of Health and Child Care said on Wednesday, May 17.
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