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Cholera in the WHO African Region: Weekly Regional Cholera Bulletin: 29 May 2023

The cholera outbreak has affected 14 countries in the WHO African Region. The climate-induced natural disasters such as cyclone and flooding in the southern African region and drought in the Horn of Africa led to increase in cases of cholera in most of the affected countries. With the rainy season commencing in the west African region there is the risk of more cholera outbreaks on the horizon. The trend across the region is being closely monitored and this highlights the need for Member States to enhance readiness, heighten surveillance and institute preventive and control measures in communities and at the ports of entry to prevent and mitigate cross border infection.

Since 1 January 2022, a cumulative number of 194 840 cholera cases has been reported to the WHO Regional Office for Africa, including 3 700 deaths with a case fatality ratio (CFR) of 1.9% as of 28 May 2023 (Table 1). Malawi accounts for 30% (58 785) of the total cases and 48% (1 760) of all deaths reported, and together with Cameroon, Democratic Republic of the Congo, Mozambique, and Nigeria contribute to 88% (171 630) of the overall caseload and 90% (3 321) of cumulative deaths.

The cholera outbreaks in the African Region are occurring in the context of natural disasters such as cyclones (Mozambique, Malawi), flooding (Mozambique, Malawi), drought (Kenya and Ethiopia), conflict (Cameroon, Democratic Republic of the Congo, Nigeria, Ethiopia) and multiple disease outbreaks including Mpox, wild polio, measles, COVID-19, etc. Many countries have limited and strained resources, shortage of medical commodities, including cholera kits and Oral Cholera Vaccine (OCV). Poor sanitation and unreliable water supplies with increased cross-border movements also serve as driving factors for the outbreak across the region.

With the effective response mounted in countries, a few non-endemic countries may soon begin to declare the outbreak over in the coming weeks