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CHOLERA, DIARRHEA AND DYSENTERY UPDATE 2009 (02): AFRICA
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A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
In this update:
[1] Cholera - Uganda (Kamwenge)
[2] Cholera - Uganda (Kampala)
[3] Cholera - Cameroon (Far North) ex Nigeria
[4] Cholera - DR Congo (Katanga and South Kivu)
[5] Cholera - Kenya (Turkana)
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[1] Cholera - Uganda (Kamwenge)
Date: 8 Oct 2009
Source: The New Vision [edited]
<http://www.newvision.co.ug/D/8/13/697261>
A total of 5 people have died of cholera in Kamwenge district. The
disease broke out a week ago in Mahyoro sub-county. The latest victim
died on Tuesday [06 Oct 2009] on arrival at Ntara Health Centre 4.
Another 75 people have been admitted to Bukurungu Health Centre 2,
Mahyoro Health Centre 3 and Ntara Health Centre 4.
Kamwenge's district health officer, Dr. Vincent Mubangizi, said they
have set up isolation centres at Mahyoro and Bukurungu health centres.
"Some of the wards have been turned into isolation wards to avoid
spreading the disease to the rest of patients," he said. Mubangizi
also said the health centres have run out of drugs, making it
difficult to treat the large number of patients. He said the drugs
are obtained from Nyanbani, Rukunyu and Nkoma, which are 65-80 km
[40-50 miles] away.
Kamwenge is the 2nd district in Western Uganda to be hit by cholera
after Kasese. More cholera cases have been reported in Kampala, Busia
and bugiri recently. The African Field Epidemiology Network warned
that western Uganda may experience diarrhea diseases in the wake of
the El Nino season.
[Byline: Hope Mafaranga]
--
Communicated by:
ProMED-EAFR
<promed-eafr@promedmail.org>
[Kamwenge district is located in Western Uganda and can be located on
the ProMED/Health map of Uganda at
<http://healthmap.org/r/00V6>. - Mod.JFW]
*****
[2] Cholera - Uganda (Kampala)
Date: 9 Oct 2009
Source: Monitor Online [edited]
<http://www.monitor.co.ug/artman/publish/news/Cholera_casualties_reach_26_in_K_la_printer.shtml>
A total of 11 people from Kampala were yesterday [8 Oct 2009]
hospitalised at Mulago Referral Hospital following the recent cholera
epidemic. This brings the total number of cholera casualties in
Kampala alone to 26 with 3 confirmed dead.
According to the District Health Officer, Dr. Joseph Senzoga, these
cases have been reported from various divisions in the district. He
said all areas in the district are equally affected but Namuwongo
suburb has registered the highest number of cases. Dr. Senzoga said
there is even a more likelihood of the numbers infected to escalate
because hygiene is not properly observed in some areas. "This is just
the beginning, I am sure there will be more infections," Dr. Senzoga
said. Cholera is caused by a germ called _vibrio cholera_ and its
symptoms include diarrhoea and vomiting.
The State Minister for Primary Health Care, Mr Henry Kakooza, earlier
said the disease is not a threat to the country as people are already
familiar with it. "Cholera is not new. People simply just do not play
their role in maintaining cleanliness," he said. Mr Kakooza urged
people not to wait for politicians or the ministry to tell them to
clean their homes.
So far the ministry has set up cholera treatment centres in Mulago
Hospital and also embarked on general cleaning of the city to prevent
the disease from spreading. Cholera is reportedly spreading rapidly
around the country with the current rainy season. The other affected
districts are Busia, Bugiri and Kasese.
[Byline: Flavia Lanyero]
--
Communicated by:
ProMED-EAFR
<promed-eafr@promedmail.org>
[Kampala district is located in Central Uganda and can be located on
the ProMED/ Health map of Uganda at <http://healthmap.org/r/00v0>. - Mod JFW]
*****
[3] Cholera - Cameroon (Far North) ex Nigeria
Date: 9 Oct 2009
Source: Africa News [edited]
<http://www.africanews.com/site/Cameroon_Cholera_outbreak_sparks_panic/list_messages/27360>
Panic has gripped the Far North Region of Cameroon after 5 people
died of what has been reported to be cholera. A cholera epidemic was
recently reported in Mayo Tsanaga division in the Far North Region of
the country. The outbreak 1st reported on 2 Sep 2009 has now spread
to Mayor Sawa Division, still in the Far North region.
A total of 85 cases including 5 deaths have already been registered.
In the Boha and Mougude in Mayo Tsanaga division and Kolofata and
Mora in Mayo Sawa division a number of persons were reported vomiting
and having diarrhoea.
Health officials in the district's hospitals have been acquainted
with techniques of emergency intervention on patients. The Far North
Regional Delegation of Public Health have made available free drugs
to meet the demands of the treatment centres. Officials involved in
hygiene and sanitation in the Region are also checking public water
points in order to curb the spread of the epidemic.
The outbreak started in a village in Boha subdivision in Mayo Tsanaga
Division when some persons drank contaminated water from a river that
takes its source from Mobi in Nigeria. Although competent authorities
are currently treating infected persons, they also lay emphasis on
sensitisation as a major way out to contain the epidemic.
They prescribe basic hygienic rules like washing of hands,
consumption of good quality water and proper cooking of food items.
Cholera outbreak is now a frequent occurrence in the Far North Region
of Cameroon, especially during the rainy season.
[Byline: Solomon Tembang Mforgham]
--
Communicated by:
ProMED-EAFR
<promed-eafr@promedmail.org>
[The Far North Region of Cameroon can be located on the ProMED/
Health map of Cameroon at <http://healthmap.org/r/00Eh>. - Mod.JFW]
*****
[4] Cholera - DR Congo (Katanga)
Date: 8 Oct 2009
Source: Relief Web [edited]
<http://www.reliefweb.int/rw/rwb.nsf/db900SID/EDIS-7WNMAA?OpenDocument>
Since January 2009 cases of cholera have been reported in the
province of South Kivu in eastern Democratic Republic of Congo (DRC)
and in Kalemie, in Katanga province, by the provincial Ministry of
Health and the World Health Organization (WHO). In early to mid
September [2009], a total of 1055 cases in Kalemie in the Katanga
province had been confirmed (plus 562 cases in South Kivu) and 7
deaths. Control of these cholera cases has been managed by the
coalition of efforts: the Government with the assistance of national
and international non-governmental organizations (NGOs), including
the Red Cross with the support of its traditional partners, the
International Federation of the Red Cross and Red Crescent Societies
and the International Committee of the Red Cross (ICRC). A peak of
cases was registered in September [2009] and the level has now
reached epidemic proportions. More than 1500 cases were detected in
the Katanga and South Kivu in week 38. The International Federation
is supporting the DRC Red Cross (RC) in Katanga province, while the
ICRC is providing support in the Kivu provinces
According to reports from the World Health Organization (WHO) the
Democratic Republic of Congo (DRC) is among the 5 countries in the
world, that are the most affected by cholera. The various reports of
WHO and the Ministry of Health are confirmed by a recent publication
(ref. Griffiths DC and al, Am, Trop Med Hyg 2006). In the DRC, the
eastern provinces of the country are more affected than the western
ones. In the East, the annual incidence by province is about 2500
cases of cholera. However, Katanga, South Kivu and North Kivu have
the highest incidences.
The epidemiological profile is characterized by the existence of
endemic outbreaks, such as diarrhoea, measles, polio, typhoid fever,
acute respiratory infections (ARI), Protein-energy malnutrition,
tuberculosis, malaria, trypanosomiasis, schistosomiasis, HIV/AIDS and
other sexually transmitted infections (STIs), and monkey pox. The
poverty of the population with an income of less than one dollar a
day is to be added to this situation. People are obliged to use
traditional practices to resolve any health issue; they also resort
to churches and other traditional practitioners.
This situation is worsened by poor access to drinking water, general
insalubrity in the various areas mentioned above and in several areas
in the city of Bukavu and Katana. Many sick people are hidden in
houses under the pretext that the disease is shameful; this leads to
deaths at home. It is to be noted that after the meeting held by the
provincial government in Bukavu, the following recommendations were
given: advocacy and social mobilization of communities, towns and
districts where there are more cases; hygiene promotion of and
sanitation focusing on the on improvement of the availability of
potable water; psychosocial support for people affected by the
epidemic; and disinfection of the patients' homes by Red Cross
volunteers and in the cholera treatment centres led by other partners.
The situation has been aggravated by the fact that medical staff have
been on strike for several months and patients are not adequately
taken in care because of a lack of nursing staff. Hence the
importance of training Red Cross volunteers to strengthen the
awareness and the promotion of hygiene in order to cut the chain of
infection. All humanitarian partners are mobilized to support the
treatment centres by providing inputs and other medical equipments
without strengthening the preventive activities which consist of
sensitizing the community about the risk of disease. For this reason,
the Red Cross of the Democratic Republic of Congo intends to mobilize
volunteers in the selected provinces in order to assist the teams in
the health zones involved in the awareness and other preventive
activities. The objective of all this is to limit the spread of the
epidemic. In late 2008 and early 2009 a similar operation carried out
by the National Society volunteers contributed to containing an
outbreak of cholera in other areas of Katanga province and in Maniema province.
In each province involved, an Interagency Coordination Committee
(ICC) has been created to coordinate the actions of all humanitarian
partners in the field. The Red Cross branches take part in these
meetings with other partners such as MSF, Merlin, WHO and UNICEF. The
Ministry of Health conducted an assessment to have a real situation
of people affected by this epidemic. It was during this assessment
that the ICC realized the gap that has to be filled for this
operation, including support, advocacy and psycho social support for
the affected families.
The DRC RC, the Federation and ICRC coordinate their response to the
epidemic. During a tripartite meeting that was held in Kinshasa on 7
Oct 2009, it was agreed that ICRC will provide DRC RC with financial
and technical support to cover the needs identified in South Kivu
province while the Federation will support the national Society's
response in Katanga province. This DREF allocation is therefore based
on the needs of Katanga branch as well as monitoring of the
activities by both the national Society's headquarters and the
Federation country representation in DRC.
The National Society has planned to reach out through the operation
to not less than 160 000 people in Katanga province (Kalemie) and 250
000 people in South Kivu province (Bukavu and Katana) respectively.
In Katanga province, a total of 150 volunteers will be mobilised to
disinfect water sources (chlorination), conduct household based
sensitization and undertake sanitation activities.
The branches [Red Cross and Red Crescent] play an active role in all
crisis committee meetings organized and chaired by the Provincial
Minister of Health on epidemiological surveillance. The volunteers in
this province are involved in the sensitization, reception and
guidance of patients in the cholera treatment centres. In South Kivu,
the volunteers are involved in the chlorination of water.
The Red Cross volunteers have good experience in responding to
cholera outbreaks. Before the government declared the epidemic, they
were already engaged in activities to promote hygiene practices and
in the treatment of water for the community with the support of the
Federation and the Belgium Red Cross Flemish community. Following the
declaration of the epidemic by the provincial authorities, the DRC RC
seeks to reinforce its response through the deployment of volunteers,
increasing its stock of chlorine to treat drinkable water for the
affected population, and the provision of volunteer equipment for
protection and sanitation.
Taking into account the contributions related to the management of
this epidemic, a gap to take concerted action has been noted. Several
activities are not conducted so far because of either lack of
partners or means. The activities related to the community awareness,
water treatment, disinfection, are not yet implemented because of a
lack of means. To fill this gap, the following requirements are to be
met: training 100 volunteers; providing door-to-door sensitization
material; procurement of strategic stocks to provincial committees to
fight against potential outbreaks before the headquarters intervenes
(pairs of boots, overalls, latex gloves, hard gloves, disposable
breathing masks, sprayers, soap, chlorine cans of 25L, tumblers,
image boxes, folders and jackets)
Other planned activities include: support to the cholera treatment
centres (CTC); active participation in crisis meetings across the
concerned provinces; train and supervise 100 volunteers to sensitize
communities and provide chlorination at various levels; strengthen
awareness in the affected communities of the epidemic through the
distribution of awareness materials; strengthen epidemiological
surveillance; commitment to the care of patients; improve access to
drinking water; encourage the promotion of good hygiene; involvement
in hygiene and environmental sanitation; treatment of drinking water
at drawing points; disinfection of sick persons' houses and other
health centres that have served in the management of the epidemic;
and psychosocial support for people affected by the epidemic.
--
Communicated by:
ProMED-EAFR
<promed-eafr@promedmail.org>
[Katanga and South Kivu Provinces are located in Eastern DR Congo and
can be seen on the ProMED/Health map of DR Congo at
<http://healthmap.org/r/00Ve> and <http://healthmap.org/r/00Vc>
respectively. - Mod JFW]
*****
[5] Cholera - Kenya (Turkana)
Date: 10 Oct 2009
Source: Daily Nation [edited]
<http://www.nation.co.ke/News/-/1056/670576/-/unxw0f/-/index.html>
At least 29 people have died of cholera and hundreds more are being
treated for the disease in the larger Turkana District, say health
officials. According to the Ministry of Public Health and Sanitation,
2 people have died in Garbatulla, 5 in Laisamis, 3 in Turkana North,
one in Turkana South and 18 in Turkana Central.
The areas are not only facing an acute water shortage, due to a
prolonged drought, but also have poor latrine coverage. Residents are
forced to trek long distances to health centres. In the past week
[week of 10 Oct 2009], according to the United Nations Office for the
Coordination of Humanitarian Affairs' Integrated Regional Information
Networks (IRIN), quoting a ministry official, a total of 246 cases
have been reported and are being treated.
Some 42 cases of cholera have been confirmed in the region. The
reports come after a similar outbreak in Mutomo District killed 7
people in the past few days, with more infections being recorded
every day. The 7 died at Mutomo Mission Hospital where they were being treated.
The deaths came as health authorities disclosed that 1134 people had
been diagnosed with the disease in the district. Relatives have been
barred from visiting patients admitted to the hospital in a bid to
contain the outbreak, which has spread to neighbouring Yatta
District, where Medical Officer of Health John Logedi confirmed 180
people were being treated.
David Kasanga, Laisamis medical officer, says that 3 of the deceased
had "died at home before they could reach (the) nearest health
facilities." Mr Kasanga said health workers had been deployed to the
affected areas, and the local Elmolo health centre has been reopened
to deal with the new outbreak. He said tents had been set up to serve
as temporary wards. "We have managed to get drugs but we need more
assistance as (the drugs) might not be enough to handle the rising
number of new cases," he said.
--
Communicated by:
ProMED-EAFR
<promed-eafr@promedmail.org>
[Turkana is located in Eastern Kenya and can be located on the
ProMED/Health map of Kenya at
<http://healthmap.org/r/00Vf>.
The cholera outbreaks in Africa are spreading relentlessly due to the
conditions in most of the affected areas that favour the transmission
of the disease. The main risk factor is a shortage of portable water
due to either contamination of open unprotected water sources by
run-off water following the onset of rains, or complete scarcity of
water due to prolonged droughts in the Turkana area in Eastern Kenya.
The Eastern DR Congo has had cholera cases since the beginning of the
year and the traditional response interventions like rapid
rehydration of cases; active community case search and sensitization;
and setting of treatment centres, haven't so far had much effect on
the course of the epidemic. There is however light at the end of the
tunnel as recent trials of the cholera vaccine have revealed an
efficacy of up to 70 percent. This therefore offers hope of using
vaccination as an adjunct to other interventions for cholera outbreak
prevention and response in these endemic regions of sub-Saharan
Africa. - Mod.JFW]
[see also:
Cholera, diarrhea & dysentery update 2009 (01): Africa 20091009.202994
Cholera - Nigeria (02): (Borno) 20091003.202860
Cholera - Uganda (02): (Kasese) 20091002.202854
Cholera - Nigeria: (Jigawa) 20091002.202850
Cholera - Rwanda: (Western Province) 20091002.202849
Cholera - Tanzania: (Zanzibar West) 20090927.202711
Undiagnosed fatalities - Nigeria: (Adamawa) RFI 20090925.202673
Cholera - Ethiopia (03): Addis Ababa, susp 20090918.202407
Undiagnosed diarrheal illness - DR Congo: (North Kivu), fatal 20090918.202370
Cholera, diarrhea & dysentery: Worldwide 20090914.202068
Cholera - Kenya: Turkana 20090914.202053]
[Additional background information on cholera is available from the
general ProMED-mail list. The postings below can be found at
<http://www.promedmail.org>. - Mod.JFW]
[Cholera, diarrhea & dysentery update 2009 (25) 20091009.3500
Cholera, diarrhea & dysentery update 2009 (24) 20090930.3411
Cholera, diarrhea & dysentery update 2009 (23) 20090921.3319
Cholera, diarrhea & dysentery update 2009 (22) 20090913.3223
Cholera, diarrhea & dysentery update 2009 (21) 20090819.2939
Cholera, diarrhea & dysentery update 2009 (20) 20090724.266
Cholera, diarrhea & dysentery update 2009 (19) 20090720.2575
Cholera, diarrhea & dysentery update 2009 (18) 20090709.2469
Cholera, diarrhea & dysentery update 2009 (17) 20090429.1620
Cholera, diarrhea & dysentery update 2009 (16) 20090310.0991
Cholera, diarrhea & dysentery update 2009 (15) 20090212.0632
Cholera, diarrhea & dysentery update 2009 (14) 20090210.0604]
...................................jfw/ejp/mpp
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