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Published Date: 2010-03-04 13:43:09
Subject: PRO/EAFR> Cholera, diarrhea & dysentery update 2010 (16): Africa
Archive Number: 20100304.205930

CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2010 (16): AFRICA
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In this update:
[1] Cholera - Zimbabwe: update
[2] Cholera - Tanzania: update
[3] Cholera - Zambia: (Lusaka)

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[1] Cholera - Zimbabwe: update
Date: Sat 20 Feb 2010
Source: Chronicle (Zimbabwe) [edited]
http://www.chronicle.co.zw/inside.aspx?sectid=6428&cat=1

The Government has managed to contain the cholera epidemic as only 7 cases have been reported this year [2010] compared to the same period last year [2009] when 51 of the country's 62 districts recorded an outbreak, the Ministry of Health and Child Welfare has said. The 7 cases were recorded in 4 districts. Although a comment could not be obtained from Health and Child Welfare minister, Dr Paul Madzorera, a report from his ministry said only 7 cases were reported as of the 1st week of February [week ending 7 Feb 2010] and no deaths were recorded.

"The outbreak started on 4 Feb 2010. In the same week last year [2009], 51 districts were having cholera. The 7 cases were reported by 7 Feb [2010] to the World Health Organization (WHO) through the Ministry of Health and Child Welfare's National Health Information Unit. The cases were reported after a break of 4 weeks. The crude case fatality [rate] is 0 percent by 7 Feb [2010]. In the same week last year [2009], 69 317 cumulative cases and 3397 deaths had been reported since August 2008, with a crude case fatality rate of 4.9 percent," said the ministry.

It reported that out of the 7 cases reported, 4 were confirmed to be cholera positive. "One confirmed case was from Kuwadzana Phase, 3 in Harare, and 3 confirmed cases from Mwenezi in Masvingo. One of the confirmed Mwenezi cases was treated in Beitbridge. The other 2 cases were from Shamva District. In addition, a cholera rumour of one case was received from Ward 16 in Mt Darwin. "The samples from the suspected cholera case in Beitbridge and that from Kuwadzana Phase 3 were characterised as "[_Vibrio cholerae_ O1 serotype Inaba]," it said.

The Ministry of Health and Child Welfare said, "The cholera case that was treated in Beitbridge was linked to a funeral at Lapach Farm, next to Flora Farm in Mwenezi District in Masvingo Province. Joint investigation teams from Matabeleland South and Masvingo Provincial Medical Directorates met at Flora Farm on 5 Feb 2010 in Mwenezi, where the Beitbridge case originated.

"The PMD [provincial medical directorate] Masvingo Investigation Team proceeded to Lapach Farm for more investigations on the deaths that were reported at the farm. There was no evidence to link the deaths to cholera, however, they were related to diarrhoea," said the ministry. It said another case was attributed to having eaten unwashed mangoes in Beitbridge. "According to the reports received, diarrhoea caused by _Shigella_, _Salmonella_, and _E. coli_ has been reported in the area since early January [2010]. From the investigations it was discovered no other cases of diarrhoeal diseases had occurred. Community surveillance was encouraged within the farm and prevention materials were distributed," it said.

"100 percent of the cumulative cases were from rural areas and 0 percent from urban areas compared to last year's [2009] scenario of 66 percent from urban areas and 34 percent in rural areas in the same period," it reported. The Ministry said a number of cholera prevention activities in Beitbridge had been proposed including the repair of the border town's water system, health promotion, waste management, and inspection of food premises.

"The last outbreak was exacerbated by unlicensed food vendors, among others. At the moment Beitbridge has adequate cholera treatment supplies and MSF Spain will set up a treatment centre at Lapach Farm (Mwenezi) should the need arise. The International Organisation for Migration will support the district to ensure proper case management and infection control practices," said the ministry.

Cholera is a highly infectious disease that causes severe diarrhoea and vomiting and spreads fast under unhygienic conditions such as poor sanitation. Its symptoms include continuous vomiting, diarrhoea resulting in dehydration, abdominal pains, and loss of strength (weak joints). In 2008, more than 4000 people died of cholera [in Zimbabwe].

-- Communicated by: ProMED-EAFR <promed-eafr@promedmail.org>

[A map showing the provinces of Zimbabwe can be accessed at http://en.wikipedia.org/wiki/Provinces_of_Zimbabwe, and the HealthMap/ProMED-mail interactive map of the country can be accessed at http://healthmap.org/r/00aK. - Mod.JFW]

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[2]
Cholera - Tanzania: update Date: Mon 1 Mar 2010 Source: Daily News (Tanzania) [edited] http://www.dailynews.co.tz/home/?n=7853

[The 8th weekly health surveillance report, from the Health and Social Welfare ministry indicates that there were] 151 cholera cases in several parts of the country. Most reported cases came from Tanga Region with 40 patients and one death, 50 cases in Manyara Region, and 32 cases in Temeke District in Dar es Salaam Region.

[Byline: Masembe Tambwe]

-- Communicated by: HealthMap Alerts via ProMED-EAFR <promed-eafr@promedmail.org>

A map showing the regions of Tanzania can be accessed at http://en.wikipedia.org/wiki/Regions_of_Tanzania, and the HealthMap/ProMED-mail interactive map of the country can be accessed at http://healthmap.org/r/00aU. - Mod.JFW]

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[3]
Cholera - Zambia: (Lusaka) Date: Wed 3 Mar 2010 Source: Zambia Daily Mail [edited] http://www.daily-mail.co.zm/media/news/viewnews.cgi?category=12&id=1267596920

The Ministry of Health has announced that Lusaka has recorded 108 cases of cholera since the disease broke out in January this year [2010] and that 11 of the cases have resulted in death.

Ministry of Health deputy minister Solomon Musonda made the announcement in Parliament yesterday [2 Mar 2010] in response to Mandevu member of parliament Jean Kapata, who wanted to know how many people have died of cholera in Lusaka this year [2010]. This was said during a session of questions for oral answer.

Dr Musonda said the ministry has instituted a number of interventions in the fight against the disease in the city. These include opening up of more treatment centres and intensifying contact tracing.

"My ministry has put in place a number of interventions to fight cholera such as the opening of treatment centres, mobilising drugs, health education, and intensifying of contact tracing," he said. Dr Musonda also said cholera centres are undergoing disinfection.

He said the ministry has given Lusaka district K90 million [approx USD 19 000] to tackle cholera this year [2010]. Dr Musonda said the ministry has also given K200 million [approx USD 43 000] to Lusaka Province for the prevention of the disease.

He said his ministry has so far not recorded any cases involving medical personnel at cholera centres. Dr Musonda said the ministry has embarked on education programmes for medical personnel to orient them on how to handle the disease. He said the ministry is also not aware that there are any personnel of the ministry that are working at cholera centres without protective clothing. Dr Musonda said this in reaction to Mrs Kapata, who also wanted to know whether the ministry was aware of any medical personnel at the centres working without protective clothing. He said there is plenty of protective clothing at the Medical Stores from which the centres should order their requirements.

And minister of health Kapembwa Simbao said people should maintain hygiene to help the ministry in the fight against the disease. He said those in urban areas should emulate people in villages, who are not suffering from the disease because of the observance of hygiene.

"It is obvious that cholera thrives in certain areas. We have never encountered it in villages but in places like Kanyama and some fishing camps. Cholera is a matter of hygiene. In villages hygiene is up to date and none of them suffer from the disease," Mr Simbao said.

[Byline: Martin Nkolomba]

-- Communicated by: ProMED-EAFR <promed-eafr@promedmail.org>

A map showing the provinces of Zambia can be accessed at http://en.wikipedia.org/wiki/Provinces_of_Zambia, and the HealthMap/ProMED-mail interactive map of the country can be accessed at http://healthmap.org/r/018*. - Mod.JFW]

The current update indicates that the cholera outbreak in Zimbabwe this year (2010) has fewer cases and hence deaths and the geographical spread are limited compared to the same period last year (2009). This is an indication that efforts have been mounted by the authorities to address the underlying risk factors. The efforts however need to be extended to the rural areas since all the cases recorded this year have originated from there. Similarly, efforts need to be taken to contain the outbreaks in the urban areas of Zambia (Lusaka) and in the affected regions in Tanzania. - Mod.JFW]

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