This set of fact sheets offers a comprehensive and factual description of cholera epidemiology using an identical and reproducible methodology across countries. These fact sheets were produced by a multidisciplinary team with WASH and Health competencies intended to provide decision-makers of both sectors with adequate information to implement efficient and evidence-based cholera prevention and control activities, as well as feeding advocacy purposes.
Authors/Organizations: UNICEF
Year: 2017
Countries: Bénin, Burkina Faso, Cameroun, Côte d'Ivoire, Ghana, Guinée, Guinea Bissau, Mali, Niger, Nigeria, Togo, Tchad, Sierra Leone
The cholera epidemiology and response fact sheets were produced for 12 countries of West and Central Africa. They gather key information to inform cholera control strategies. Each fact sheet is composed by a general presentation of the epidemics and its distribution over time and space. Cholera hotspots are identified at the health district level (LGA for Nigeria) and classified based on the frequency and the duration of previous outbreaks in order to justify the priority level for the actions to implement. The dynamic of the epidemic propagation is analysed combined with the description of the livelihood and risk practices. Based on that, strategic recommendations are formulated for each country. In case of cross border epidemic, regional dynamics are highlighted.
In most countries, the first cholera cases were notified in the 70’s. In several countries, it appears that the frequency and the intensity of the outbreaks have increased for the last decade. In Nigeria and in Cameroon, it seems that a resistance to ciprofloxacin antibiotic appeared. Outbreaks in most countries are linked to cross-border population migration through the fishermen movement or through trade. In many countries, it appears that the epidemics started during the dry season and spread during the rainy season. The outbreaks with this kind of pattern have a higher amplitude than the one starting during the rainy season.
The analysis of the cholera distribution, between 1970 and 2017, highlighted the areas where regional coordination needs to be reinforced to ensure efficient cholera control. The main areas for surveillance are the Chad lake, the ones along the Niger River, the ones along the Gulf of Guinea and the Nigeria borders.
The strategic recommendations are to reinforce the regional collaboration between the country of a same epidemiological basin, and to develop preparedness and response plans in each country (both at the national and community levels in the cholera hotspots). The community-based surveillance and a rapid response system must be reinforced. The capacity of the outbreaks response management must be strengthened and contingency plans shall be defined with the prepositioning of the materials required. Actions to improve access to WASH services shall also be implemented in the hotspot areas.