Cholera in the WHO African Region: Weekly Regional Cholera Bulletin: 8 March 2023
The cholera outbreaks in the WHO African Region continue to evolve, with 13 countries currently reporting cases. South Sudan is the latest country to confirm a new outbreak during the reporting week. Overall, incidence cholera cases and deaths in the region have been declining in the past five weeks. In week 9 (27 February – 5 March 2023), a total of 3835 suspected cases were reported from 13 countries, reflecting a 12.6% decrease compared to 4389 cases recorded in week 8. Similarly, deaths decreased from 89 in week 8 to 70 in week 9, a 21.3% decrease. Between 1 January and 7 March 2023, 35 324 suspected cholera cases were reported from 13 countries, with 747 deaths (case fatality ratio [CFR] = 2.1%). Malawi accounts for 61% (21 412) of all reported cases in 2023, followed by Mozambique with 14% (4979) and the Democratic Republic of the Congo with 11.8% (4154). Of the deaths reported in 2023, Malawi accounts for 84% (608), followed by Mozambique at 4.7% (35) and Kenya with 4.3% (32). Cumulatively from January 2022, 129 757 cases have been reported, including 3024 deaths (CFR = 2.3%) as of 8 March 2023 (refer to figure 1). Malawi accounts for 39.7% (51 568) of the total cases and 53% (1612) of all deaths reported, and together with Nigeria, Democratic Republic of the Congo, and Cameroon, contribute to 88% (113 809) of the overall case load and for 94% (2835) of cumulative deaths. Cameroon has had an outbreak since October 2021, while Malawi, Democratic Republic of the Congo and Nigeria reported cholera outbreaks in the first quarter of 2022. Kenya, Mozambique, and Ethiopia reported their outbreaks between August and October 2022, while Burundi, Zambia, United Republic of Tanzania, South Africa, Zimbabwe, and South Sudan reported cholera outbreaks between January and March 2023. The Ministry of Health of South Sudan declared cholera outbreak in Malakal, Upper Nile State on 7 March 2023. The cholera outbreaks in the region are happening in the context of natural disasters such as cyclones (Mozambique, Malawi), flooding (Nigeria, 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 pandemic, 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.