Monthly Regional Cholera Bulletin, July 2024
The cholera outbreak in the WHO African Region in 2024 has affected 14 countries (Burundi, Cameroon, Comoros, Democratic Republic of the Congo, Ethiopia, Kenya, Malawi, Mozambique, Nigeria, South Africa, United Republic of Tanzania, Uganda, Zambia and Zimbabwe). However, the situation is particularly severe in three countries – Democratic Republic of the Congo, Ethiopia, Nigeria – which are currently categorized as being in acute crisis.
The Western and Eastern subregions of the continent, now in the rainy season, are experiencing resurging outbreaks. The El Nino phenomenon has caused both droughts in (Zambia and Zimbabwe) and an increase in rainfall levels, causing floods and landslides in some communities (Kenya and Tanzania). This may exacerbate the increase in cholera cases and raise the risk of outbreaks in districts and countries that have not reported new confirmed cases or previously controlled cholera outbreaks. The seasonality of cholera outbreaks continues to be an issue for countries to consider. There is a need for member states to improve cholera preparedness and readiness, heightened surveillance, and scale up preventive and control measures in communities and around border crossings. This will prevent outbreaks, engender early response, and reduce cross-border transmission. Since the beginning of the year 2024, the number of cholera cases and deaths reported to the WHO Regional Office for Africa (AFRO) as of 31 July was 112 301 and 1 900 respectively, with a case fatality ratio of 1.7%. Comoros, The Democratic Republic of the Congo (DRC), Ethiopia, Zambia, and Zimbabwe account for 83.4% (93 628) of the total cases and 86.4% (1 641) of total deaths reported this year. In 2024, Comoros confirmed an outbreak linked to importation from a passenger aboard a boat that arrived in Moroni on January 31, 2024.
In July 2024, nine countries – Burundi, Comoros, Democratic Republic of the Congo, Ethiopia, Kenya, Mozambique, Nigeria, United Republic of Tanzania, and Zimbabwe – reported a total of 6 092 new cases and 99 deaths (CFR = 1.6%).
As of 31 July 2024, a cumulative total of 399 508 cholera cases, including 7 023 deaths (CFR: 1.8%), have been reported since 1 January 2022. The Democratic Republic of the Congo, Ethiopia, Malawi, Mozambique, and Zimbabwe account for 72.2% (288 570) of all cumulative cases and 62.3% (4 375) deaths reported. Transmission is currently active in nine countries.
The number of cases in 2024 has decreased compared to 2023. From January to July, the cases decreased by 16.5%, from 134 483 in 2023 to 112 301 in 2024. However, there was only a slight decrease (-0.2%) in the number of deaths, with 1 903 deaths in 2023 and 1 900 in 2024. This was due to a large number of deaths reported from the Southern subregion, mainly (Zambia and Zimbabwe) in the early part of the current year. Nevertheless, the number of deaths reported in 2024 was lower than in 2023 from epi weeks 17 to 23 before an increase in epi week 24. The outbreak has, however, been controlled in these countries (Zambia and Zimbabwe). This calls for prompt identification of cases and institution of management from the communities to establish oral rehydration points (ORPs) and referral to cholera treatment centres/units (CTCs/CTUs). The average case fatality ratio from January to July was 1.4% in 2023 compared to 1.7% in 2024.