Regional Update, as of 31 December 2018,
Cholera continues to represent a major public health concern in Eastern and Southern Africa Region (ESAR). From January to December 2018, approximately 37,565 cases and 443 cholera-related deaths were reported in the region with an average CFR of 1.2%. These cases emerged from 10 out of the 21 countries in Eastern and Southern Africa Region (ESAR).
In 2018, the cholera burden in ESAR was markedly heterogeneous, with Zimbabwe accounting for the highest case load at 28.8% (10,807 cases), followed by Somalia reporting 17.2% of cases (6,447 cases). During the same period; Kenya reported 15.4% (5, 782) of cases, Tanzania reported 4,688 cases, Zambia declared 4,127 cases, Uganda recorded 2,699 cases, Angola reported 1,262 cases, Mozambique declared 863 cholera cases, Malawi registered 785 cases, Rwanda 3 cases and recently Burundi declared 102 cases.
Out of the 10 countries with reported cholera/ AWD outbreaks in 2018, 5 (Burundi, Zimbabwe, Angola, Somalia and Tanzania) have ongoing cholera outbreaks.
Burundi: A new cholera outbreak emerging from Rumonge Health Province in Rumonge District was declared on 28 December 2018. This is attributed to heavy rains that have led to flooding in the coastal areas of Lake Tanganyika. The outbreak continues to evolve with a cumulative total of 102 cases including 1 death (CFR, 1%) notified by 31 December 2018.
Somalia: 30 new cases of AWD/cholera were reported in week 52 (week ending 31 December 2018) compared to 26 cases reported in week 51 (Week ending 23 December 2018). Cumulatively a total of 6,852 cases including 45 deaths have been reported since December 2017 from 5 regions (Banadir, Lower Jubba, Middle Shabelle, Lower Shabelle and Hiraan). The cholera outbreak has been contained in 4 regions, however active transmission is still ongoing in the Banadir region where 30 new cases were reported in week 52. Children under five years bear the brunt of the cholera epidemic, representing 54.5% (3,512 cases) of the total case load reported in 2018 (Epidemiolgical week 1 to 52).
Angola : Since the onset of the latest wave of cholera outbreak in September 2018, a total of 312 cases including 3 deaths (CFR, 1%) were reported by epidemiological week 52. During week 52, 20 new cases were reported from Uige province compared to 10 cases reported in week 51.
Tanzania: A new district (Uvinza district in Kigoma region) reported 13 cases of Cholera in Week 52. Cumulatively a total of 33,319 cases including 550 deaths have been reported in the United Republic of Tanzania since August 2015.
Zimbabwe: The weekly case incidence has been on a downward trend in the past 3 weeks (week 50 to week 52). During week 52, 10 new cases were reported compared to 17 cases including 5 deaths (CFR, 29.4%) reported in week 51. These new cases emerged from Murehwa district in Mashonaland East (2 cases), Gokwe North district in Midlands (7 cases) and Mt. Darwin district in Mashonaland Central (1 case). Cumulatively, a total of 10,630 cases including 65 deaths have been reported since the beginning of the new wave of the outbreak on 5 September 2018.
Below are the Cholera Bulletins for 2018.