All hands on the deck if cholera infections are to be halted
Highlights
● As of January 31, 2024, a total of 21 835 cholera cases, 71 confirmed deaths and 416 suspected deaths have been reported from 61 districts across all 10 provinces.
● Of the cumulative cholera cases, approximately 31% are children aged below 15 years, and 14% are children aged below five years of age.
● The country received ICG approval for 2,3 million oral cholera vaccine (OCV) doses targeting eligible population aged one year and above in 160 wards within 24 high risk districts in seven provinces.
● A total of 465 401 people, including 246 058 children aged below 15 years, have received the OCV single dose reactive vaccine since the campaign was launched on January 29, 2024.
● Unicef and partners have reached 260 437 people with critical hygiene supplies, including 101 405 children.
● An estimated 2 960 361 people have been reached with risk communication and community engagement activities. Situation overview and humanitarian needs
BY January 31, 2024, a total of 21 835 cholera cases and 487 deaths with a case fatality rate of 2,2% had been reported from 60 districts.
An upward trend in weekby-week cholera cases continued being seen from epi-week 50, 2023 to epiweek 3, 2024.
Most cholera cases continue being reported from Harare, Masvingo, Manicaland and Chitungwiza provinces, contributing 84% of the national caseload.
There was a continued increase in cases in Mashonaland Central, Mashonaland West and Mashonaland East provinces from the beginning of 2024 related to the increased mobility of the population during the festive season as well as the rainy season.
Week-by-week cholera case fatality gradually declined from September 2023 to week 3, 2024.
Children, women of child-bearing age, religious decliners, illegal miners and farmers in rural settings continue being high-risk groups, with 52% of the cumulative cholera cases being women, while 14% are children under five years of age.
Key factors driving cholera transmission include the continued low access to safe water, inappropriate sanitation and infection, prevention and control, health system challenges (staff attrition, capacity, access and quality issues), unsafe burial practices, wanning immunity from last OCV campaign in 2019, multiple disease outbreaks (polio, measles), and limited funding among United Nations agencies and partners to scale up response.
The country entered its rainy season late in December 2023, contributing to an increased number of cases.
In addition, subregional population movements and large gatherings for economic, cultural and religious reasons amid ongoing cholera outbreaks across neighbouring countries (Zambia, Malawi, Mozambique) present continued risks for cross-border transmission.
While the rains have increased the risk of floods and water contamination due to sewage runoff and seepage, the El Niño-induced drought will cause further water scarcity with households resorting to unsafe water sources and water rationing, complicating the situation.
Cholera caseloads reported have exceeded the 10 730 cases reported in the 2018/19 cholera outbreak, with fears of a similar situation to the major outbreak of 2008/9.
In the most likely scenario, the World Health Organisation and Unicef estimate an attack rate of 0,3, resulting in 38 763 cases by February 2024, if current interventions do not halt transmission, noting that cholera attack rates are typically higher in urban and peri-urban areas than in rural settings.