Since the beginning of Oct. 2017, Zimbabwe has seen more than 1,000 typhoid fever cases in and around the capital city of Harare.
According to WHO, the initial case of typhoid fever was confirmed on 17 September 2017 and the outbreak was detected in the densely populated Mbare suburb on 1 October 2017. The disease eventually spread to other suburbs in the western, southern and eastern parts of Harare, while the northern part of the city remains largely unaffected. Cases have also been reported outside Harare. The incidence of typhoid fever gradually increased since the beginning of October 2017 and peaked by the end of October 2017. Since then, the disease trend has been steadily declining.
As of 20 November 2017, a cumulative total of 1,065 suspected cases have been reported. Thus far, no deaths have been attributed to the disease. Of the reported suspected cases, 82 were confirmed to have Salmonella typhi infection by culture at the National Microbiology reference laboratory. Fifty-six percent of the reported cases and 61% (50) of the confirmed cases are from Mbare suburb, the epi-centre of the outbreak.
The ongoing typhoid fever outbreak in Harare has been attributed to an acute shortage of potable water in the affected communities. Mbare, the epi-centre of the outbreak, is one of the oldest commercial suburbs with several residential flats. The Mbare Flats, initially designed to accommodate about 2 000 residents, currently house over 23 000 people. Matabi flats in Mbare, where the outbreak originated, reportedly had no water supply 2 weeks prior to onset of the outbreak. Environmental assessment identified burst sewer pipes flowing from Matapi flats, which are believed to have caused contamination of nearby boreholes (the main sources of potable water). Water quality testing done on three boreholes in Matapi and one borehole in Block 9 revealed contamination with Escherichia coli.
The outbreak of typhoid fever in Harare is steadily declining. However, the unresolved water and sanitation challenges, characterized by erratic piped water supplies, sewerage bursts as well as uncollected solid waste, constitute a serious and continuous risk factor for recurrence of the disease.
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