Cameroon - Cholera outbreak 2021- 2023

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 45: 1 – 7 November 2021
Data as reported by: 17:00; 7 November 2021

...
Cholera Cameroon

67 Cases
5 Death
7.4% CFR

EVENT DESCRIPTION

The ongoing cholera outbreak was declared in week 43 (ending 31
October) by Cameroonian health authorities following confirmation
of cholera in stool samples from health districts of Ekondo Titi in
the South-West region and Biyem-Assi in the Centre region (in the
capital city of Yaoundé). However, suspected cases of cholera have
been reported in five (50%) (Far North, North, Center, Littoral and
Southwest) out of ten regions since the beginning of this year but had
not been confirmed.

As of 2 November 2021, a total of 67 suspected cases including three
confirmed and five deaths (case fatality ratio (CFR 7.4%) had been
reported in Cameroon. Deaths have been reported from the regions
of Sud-Ouest (3 deaths), Center (1 death) and Littoral (1 death). The
outbreak is still active in two regions: Centre and South-West. Males
have been more affected than females. Among the reported cases,
children under 5 years (13 cases, 18%) are the most affected.

For the Centre region, 32 suspected cases of cholera, one confirmed
by culture and one death (CFR 3.1%) have been reported since the
beginning of this year. The urban health district of Biyem-Assi is the
only one affected so far and located in the capital city of Yaoundé. The
index case is a 40-year-old lady living in the health area of Akok-Ndoe.
She is reported to having prepared and served a traditional meal with
water from an unprotected community water point during a meeting
of ten women. These ten members fell ill in turn and many of them
were admitted for severe dehydration as well as several of their close
contacts.

Regarding the South-West region, as of 2 November 2021, a total of
23 suspected cases of cholera, including two confirmed by culture,
three deaths (CFR 13.1%) have been reported. On 27 October 2021,
a nurse working at the Bamusso Integrated Health Center, in the
health district of Ekondo Titi collected two samples from two cholera
suspects. These samples were from two Nigerian fishermen, aged
36-years and 23-years old living in Bamusso city of Ekondo Titi health
district. Ekondo Titi health district is part of the cholera belt in the
South-West region of Cameroon.

PUBLIC HEALTH ACTIONS

Central and regional cholera crisis meetings were organized with
the activation of the incident management systems at each level.

Investigation teams have been deployed in the affected areas

Ministry of health together with its partners are currently
conducting community sensitization on cholera and disinfecting
households of affected families.

The provision of the cholera supplies for case management and
infection prevention and control in the affected districts have
been done

Strengthening of surveillance in all health areas of the affected
health districts and surrounding health districts is ongoing .

SITUATION INTERPRETATION

Cameroon is particularly exposed to cholera due to several
factors: its geographical location in the cholera endemic Lake
Chad and Congo basins, the circulation of the vibrio cholerae in
the country especially in the northern, Littoral, Centre, and SouthWest regions,
and the limited access to drinking water in some
areas including in the capital city of Yaoundé as well as cultural
orientation that promote unsafe practices for cholera spread.
Although the magnitude of the ongoing cholera outbreak seems
to be less than the prior year, the risk of rapid spread throughout
the country is high given the cross-border movements with
countries that are experiencing cholera outbreak as well as the
occurrence of the cholera outbreak in the South-West region
which is characterized by difficult access and insecurity.

PROPOSED ACTIONS

In the affected areas, coordination of all partners involved in
the outbreak response is necessary to ensure the effectiveness
of the response. Appropriate response strategies must be
developed for the difficult-to-reach areas. It is also important to
strengthen cross-border collaboration in order to limit the transborder
transmissions.

Cameroon has mapped at-risk areas for cholera, it is therefore
important to strengthen preparedness in these hotspot areas,
especially to reinforce surveillance, risk communication, the
pre-positioning of cholera supplies and capacity building of
human resources for cholera outbreak management.
...
https://apps.who.int/iris/bitstream/handle/10665/348305/OEW45-0107112021.pdf

 

[Shiloh]

Source: https://www.who.int/emergencies/disease-outbreak-news/item/cholera-cameroon

Cholera – Cameroon
16 December 2021

Since the beginning of 2021, Cameroon has reported sporadic cases of cholera. During week 43 of 2021, ending on 31 October, health authorities declared a cholera outbreak that is currently active in the South-West region, with cases also reported from the Centre and Littoral regions. Between 25 October and 10 December 2021, these three regions reported a cumulative number of 309 suspected and 4 laboratory-confirmed cholera cases, with 19 deaths (case fatality ratio (CFR) of 6.1%).
The South-West region, reported the first two cases on 27 October in Kesse area, Bamusso commune in Ekondo Titi health district. Two stool samples were collected from the cases and tested positive for cholera by culture at the Laquintinie Hospital laboratory in Douala. As of 10 December, a cumulative number of 163 suspected cases with 7 deaths (CFR 4.3%) have been identified in Ekondo Titi health district. Sixty-six percent of cases were male and 16.6% were under the age of five. The outbreak has spread to the neighbouring health district of Bakassi, with 95 suspected cases and 11 deaths (CFR 11.6%).
On 28 October 2021, the Centre region, notified a suspected case of cholera with no epidemiological link to cases reported in the South-West region, from the health area of Akok-Ndoe, Biyem-Assi health district part of the urban community of Yaoundé, the capital of Cameroon. A stool sample tested positive for cholera by Rapid Diagnostic Test, and on 29 October was confirmed positive by PCR and culture for Vibrio cholerae at the Pasteur Centre of Cameroon, Yaounde. A cumulative number of 50 suspected cases and one death (CFR 2%) have been reported from Biyem-Assi health district. Of these 52% were male and 8% were under the age of five. The last case to date in the Centre region was reported on 11 November 2021.
In the Littoral region, a cholera case was confirmed by culture on 21 November 2021 in an eight-year-old boy at the Laquintinie Hospital laboratory in Douala. This has remained an isolated case with no further suspected cases. His family and those in his neighbourhood also reported no history of travel.

Public health response

Coordination

• The incident management systems are activated in affected regions to coordinate the response and support the district’s teams.
• A response plan has been elaborated and the Ministry of Health with health partners including WHO, UNICEF and Médecins sans frontiers (MSF) to support the different areas of the response plan.
• Coordination meetings take place on a twice-weekly basis and situation reports are produced to update the relevant stakeholders on the situation.

Surveillance

• Epidemiological surveillance activities are ongoing including community-based surveillance and active case finding.
• Initial cholera outbreak epidemiological investigations have been completed in the South-West, Centre and Littoral regions.
• Neighbouring health districts and high-risk areas have strengthened surveillance activities.

Laboratory and Case management

• Rapid response teams have been deployed to the South-West (Ekondo Titi) and Centre region.
• Rapid diagnostic test kits and sample transportation media have been deployed to the affected regions.
• A cholera treatment unit (CTU) of 14 beds was set up in Bamusso Health Centre and treatment guidelines have been developed with support from MSF. Cholera case management kits were distributed in health facilities; treatment is free.
• Oral rehydration points (ORP) have been set up by MSF in Bakassi health district in the South West Region.

Water, Sanitation and Hygiene (WASH)

• Community leaders and selected community members have been trained on hand washing, purification of water and disinfection of homes and public spaces.
• Aquatabs have been distributed to the affected areas.
• WASH has been improved in the CTU.
• Community health workers have been trained on safe burial of cholera-related deaths.

Risk Communication and Community Engagement

• The country has developed a request for Oral Cholera Vaccine (OCV) to be sent to the International Coordination Group on Vaccine Provision for Cholera (ICG) for a reactive vaccination campaign.
• Risk communication and community engagement activities are ongoing. Community and faith leaders, together with relevant stakeholders are supporting the team in mobilising the community for vaccination.
• Decontamination in homes of suspected cases coupled with risk communication activities are ongoing inaccessible areas.

WHO risk assessment

Cholera is an acute enteric infection caused by the ingestion of Vibrio cholerae bacteria present in contaminated water or food. In its severe form, it can lead to severe dehydration and death within hours if left untreated. It is primarily linked to insufficient access to safe water and adequate sanitation. It has the potential to spread rapidly, depending on the frequency of exposure, the population exposed, and the context.
Cholera is endemic in Cameroon. Since 2018, cholera outbreaks have been reported annually in various regions of the country including in the currently affected regions (South-West, Centre and Littoral). Several risk factors concur with the circulation of Vibrio cholera in the country, including limited access to safe drinking water and health care facilities in the affected areas of the South-West region and in the capital city of Yaoundé, as well as cultural practices that contribute to unsafe WASH conditions.
The Biyem-Assi health district in the Centre region is a densely populated area with insufficient access to safe drinking water and sanitation, that is located in the heart of the capital city Yaoundè. This may allow a cholera outbreak to spread quickly if swift control measures are not implemented.
The affected health districts in the South-West region (Ekondo Titi, Bakassi and Mobonge) belong to an archipelago in a humanitarian crisis zone with an ongoing armed conflict, and the risk of cholera exportation to other neighbouring districts cannot be excluded. Security constraints, limited geographic accessibility of some areas, and suboptimal communication networks lead to irregular epidemiological updates and potential underreporting of cases. The populations have no or limited access to safe drinking water and latrines, and the overall hygienic conditions are inadequate. There is limited access to health care and patients may have to travel long distances by boat to seek care.
In addition, the affected South-West region borders Nigeria, and there is a frequent and substantial cross-border population movement. In the northern areas, Cameroon is bordered by Adamawa, Borno and Taraba states of Nigeria which are currently affected by a cholera outbreak. There is also a risk of further international spread especially to the Republic of Chad which borders both Nigeria and Cameroon. Therefore, the risk at the national and regional levels is assessed as high. At the global level, the risk is considered low...

 

[Shiloh]

Source: https://www.channelstv.com/2022/02/09/32-dead-in-cameroon-cholera-outbreak/

32 Dead In Cameroon Cholera Outbreak
Channels Television
Updated February 9, 2022

Thirty-two people have died in an outbreak of cholera in the central-western African state of Cameroon, the authorities said Wednesday.

The water-borne disease was first detected in the Southwest and Centre regions in late October and then spread to three other regions.

As of January 1, there were 32 deaths out of 1,102 recorded cases, Health Minister Manaouda Malachie said in a statement.

 

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[Shiloh]

Source: https://reliefweb.int/report/cameroon/cameroon-situation-report-9-march-2022

...The cholera outbreak, first announced in the Ekondo-Titi health district in October 2021, has continued to spread to five health districts. Over 967 cases with 23 deaths have been reported. The response to the outbreak has been limited due to insecurity and limited and often defective road infrastructure. Areas affected by the cholera outbreak in the Ndian division can only be reached by boat...

 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 11: 7 – 13 March 2022
Data as reported by: 17:00; 13 March 2022
...

Cholera Cameroon

1 881 Cases
59 Deaths
3.1% CFR


EVENT DESCRIPTION

Since late October 2021, a cholera outbreak has been ongoing in
Cameroon, with four (40%) of the 10 regions of the country active:
Littoral, North, South and South-West.

A total of 151 cases and six deaths were reported during epi-week
9 (ending on 6 March 2022), from three regions: North (one case),
Littoral (71 cases and 4 deaths), and South-West (79 cases and
4 deaths). Notably, 21 new cases and three deaths in the Littoral
region, and 51 cases and two deaths in the South-West region were
retrospectively reported in week 9. No new cases were notified by
the Southern region during week 9, as well as the Far-North region
where the last case was reported on 23 January 2021.

As of 7 March 2022, 1 881 cases and 59 deaths have cumulatively
been reported since the beginning of the outbreak, a CFR of 3.1%.
The median age of patients is 25 years (range: 2 months to 89
years). Men remain more affected than women, with a sex ratio of
2:1.

Since the beginning of the outbreak in Cameroon, six regions have
reported at least one case of cholera: Centre (50 cases and 1 death;
CFR 2.0%), Far-North (8 cases), Littoral (277 cases and 18 deaths;
CFR 6.5%), North (4 cases), South (179 cases and one death; CFR
1.1%) and South-West (1 363 cases and 38 deaths; CFR 2.8%). In
total, 22 health districts have notified cholera cases, of which 18
are still active. A total of 71 stool samples have tested positive for
cholera by culture.

South-West remains the epicentre of the outbreak with 1 363 cases
(72.5%), while Littoral has the highest CFR of 6.5%.

PUBLIC HEALTH ACTIONS

Coordination activities are ongoing including regular joint
coordination meetings of WHO IMS team with Ministry
of Health authorities and other health partners involved in
cholera response activities, both at national and regional
levels.

A reactive oral cholera vaccination (OCV) campaign
was organized in four health districts of the South-West
region: Bakassi, Ekondo Titi, Mbonge and Mundemba. In
total, 178 632 persons were vaccinated, giving an overall
administrative coverage of 85.5%. The second round of
reactive OCV vaccination campaign is planned.

Surveillance activities including alert verification by focal
points at regional and district levels.

Hygienists are being trained at regional and district levels
on proper disinfection of households, latrines, and water
sources.

Health care professionals have been trained on adequate
sampling and transportation of cholera samples, as well as
diagnosis of cholera through culture.

Community leaders are being engaged in response activities
while home visits are being organized in affected areas during
which communities are sensitized on preventive measures
against the outbreak.

SITUATION INTERPRETATION

The ongoing cholera outbreak in Cameroon is currently showing
a declining trend. However, this should be interpreted with
caution, given the insufficient detection, low data quality and
delays in data reporting. In addition, a dire lack of communication
and sensitization of populations around the disease, low level of
community-based surveillance, reluctance from patients to early
search for adequate care, and insufficient capacity in health care
facilities to properly manage cholera cases remain challenges to
the outbreak response. Improvements in these areas will surely
help to better capture the true dynamic of the outbreak.

PROPOSED ACTIONS

Community-based surveillance should be reinforced for
early detection and referral of cases.

Data flow and reporting must be strengthened to better
capture the real dynamic of the outbreak and respond
adequately. Data managers at regional and district levels
should be trained and regularly supervised, accordingly, and
necessary materials should be prepositioned

Community engagement should be reinforced. As such, all
administrative, traditional and religious authorities as well as
community leaders should actively play a role in educating
their respective communities on preventive measures against
cholera, and break people’s reluctance to rapidly search for
adequate care in health care facilities.

View/Open

OEW11-0713032022.pdf (‎1.846Mb)‎

https://apps.who.int/iris/handle/10665/352474

 

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[Shiloh]

Source: https://actucameroun.com/2022/03/19/cameroun-116-nouveaux-cas-de-cholera-recenses-en-une-semaine/

Cameroon: 116 new cases of cholera identified in one week
Home » News » Cameroon: 116 new cases of cholera identified in one week
Mar 19, 2022 by Martin ATCHA

116 new cases of cholera have been identified in one week in Cameroon.

Over the period from March 11 to 17, 2022, 116 new cases of cholera were identified in three regions of Cameroon. These are 76 cases in the South-West, 38 in the Littoral and 02 in the Center. "The other regions have not notified any cases for 21 days thanks to the reactive vaccination campaign", informed Minister Malachie Manaouda.

A total of five regions of Cameroon are affected by the cholera epidemic. According to the Minsanté, 2,097 cases have been recorded since October 2021 with 62 deaths. Cholera is an acute diarrheal infection caused by ingesting food or water contaminated with the bacillus Vibrio cholerae.

This epidemic remains a global threat to public health and an indicator of inequity and insufficient social development.

 

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[Shiloh]

Source: https://www.voanews.com/a/cameroon-says-hospitals-overwhelmed-with-cholera-patients-/6499128.html


Cameroon Says Hospitals Overwhelmed with Cholera Patients
March 24, 2022 9:18 AM
Moki Edwin Kindzeka

Cameroon's public health ministry says a cholera outbreak is sweeping across the towns of Limbe, Buea and Tiko, near the border with Nigeria.

The government says 12 of the 600 patients rushed to hospitals in those towns died within the past 72 hours.

Nyenti Annereke, director of the Limbe government hospital, said the facility, which has a capacity of 200 beds, has received more than 240 cholera patients.

"We built three tents in Limbe hospital yesterday because patients were at the veranda, in the corridors of the wards," he said. "All the beds were full. The Tiko district hospital, the capacity also is overpowered. The hospital in Bota is another crisis zone."

To cope with the overflow, humanitarian workers are helping to erect tents at the hospitals in Limbe and Buea...

 

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Dr MANAOUDA MALACHIE

@DrManaouda
·
21h
Between March 16 and 22, an outbreak of cholera was observed in the South West region with more than 300 cases, that is, 43 cases and 20 deaths in Kumba, 111 cases and 2 deaths in Buea, 122 cases in Limbe , 68 cases and 05 deaths in Tiko. Also 16 cases and 02 deaths in Yaounde.



Dr MANAOUDA MALACHIE

@DrManaouda
·
1h
Cholera situation (March 21 to 24): 260 new cases including 209 in the South-West (18 in Buea, 143 in Limbe, 1 in Kumba South, 46 in Tiko, 1 in Muyuka); 46 in the Littoral; 2 in the Centre, 3 in the North. The South and the Far North have not recorded cases for more than 21 days

 

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[Shiloh]

Source: https://www.voanews.com/a/cameroon-...ra-outbreak-quarantines-patients/6510981.html


Cameroon Struggling to Contain Cholera Outbreak, Quarantines Patients
April 01, 2022 9:02 AM
Moki Edwin Kindzeka

Yaounde, Cameroon —

Cameroon is struggling to contain a cholera outbreak that has sickened 6,000 people with the bacteria and killed nearly 100 since February. Authorities have dispatched the ministers of health and water to affected areas and have begun quarantining cholera patients to prevent it from spreading.

Cameroon's Public Health Ministry said the number of cholera patients received in hospitals was growing by the day.

In the seaside city of Limbe in the past week alone, 200 of 300 patients were treated and discharged from the government hospital.

Filbert Eko, the highest-ranking official in Cameroon's Southwest region where Limbe is located, said the region was the worst hit by cholera, with more than 800 cases since February, forcing the the quarantining of patients to prevent the disease from spreading...

 

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Translation Google

Douala. Cholera outbreak kills 4 inmates at New Bell prison

dailynews cameroon by dailynews cameroon March 28, 2022 in french

Thirty positive cases have been recorded there since March 21, 2022

New-Bell Central Prison officially recorded its first cholera deaths on Friday March 25, 2022. This is at least what our prison and health sources at Laquintinie Hospital in Douala claim. In detail, three died last Friday and on Saturday 26. This makes a total of four detainees killed by the disease which has been raging in Cameroon for five months. A crisis meeting was held yesterday with the officials of the penitentiary and those of the regional delegation of public health for the Littoral.

According to the latest figures, around thirty positive cases have been declared in this penitentiary. “The first cases were detected on Monday evening (March 21: Editor's note). We immediately referred them to the Laquintinie hospital” , informs our source close to the file within this prison. In fact, “The first cases were mentally ill people who fed on the trash ,” explains this one. It was therefore enough to trigger the epidemic in these places. Since then, our source says that the medical staff of this prison is hard at work to contain the epidemic.

Last Wednesday for example, “The whole prison, that is to say offices and cells, was disinfected with the help of the Regional Delegation of Public Health for the Littoral ”, we learn. Also, “We continue to raise awareness, apply strict hygiene measures and sanitation has been redoubled. Seals and chlorine were hung at all the entrances to the prison , ”lists the aforementioned source.

It should be noted that the central prison of Douala has more than 4,500 detainees for an initial capacity of 800 detainees. If a focus of the epidemic were to settle there, it would be worrying. Of the 5 regions in epidemic in Cameroon, that of the Littoral is the 2nd most affected, after the South-West. Thus, between March 21 and 24, this region recorded 46 new cases, according to official figures.

https://dailynewscameroon.com/douala-lepidemie-de-cholera-tue-4-detenus-a-la-prison-de-new-bell/

 

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WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 15: 4 – 10 April 2022
Data as reported by: 17:00; 10 April 2022
...

Cholera Cameroon

3 407 cases
83 Deaths
2.4% CFR

EVENT DESCRIPTION

Cameroon began experiencing increasing reports of cholera since
2021 and declared an outbreak in the last week of October 2021,
however cases have continued to increase into 2022. Between 29
October 2021 through 27 March 2022, at total of 3 407 cases and
83 deaths (CFR 2.4%) have been reported from South-West (2 570,
75.4%), Littoral (551, 16.2%), South (184, 5.4%), Centre (87, 2.6%),
Far North (8, 0.2%), and North (7, 0.2%) regions. The national attack
rate during the reporting period is 1.7 cases per 10 000 population in
a country estimated to have 20.5 million people in 2022.

Currently, there are five regions with active outbreaks including
Centre, Littoral, North, South, and South-West. During the reporting
period, at least 531 samples have been tested and 168 cultures are
positive with Vibrio cholerae O1 Ogawa as the dominant strain.
In South-West, the most affected region, Limbe district has reported
the highest number of cases during the reporting period accounting
for 48.2% (1 238) of all cases in the region. However, Bakassi district
has reported the highest case fatality rates at 3.5% and attack rates
at 94.1 cases per 10 000 people. Limbe is relatively close to the
commercial area of Douala and could pose a threat to spread in the
city, while Bakassi district is located along the Nigerian border which
is characterised by frequent cross-border movement.

In 2021, only sporadic cases were reported for the majority of the
year, but cases increased at the end of October (week 43 of 2021)
primarily affecting the South-West, Centre, and Littoral regions.
Regarding Centre region, the cholera outbreak seemed to have been
contained by November 2021 only to flare up again in week 9 2022
(ending 6 March) and since week 12 (ending 27 March), 31 cases
have been reported in the capital of Yaounde. In Littoral region,
notable outbreaks associated with a known water source occurred
in Njombé district affecting more than 100 people as well as in New
Bell prison during week 12 (ending 27 March 2022) affecting more
than 100 prisoners in the facility.

Poor healthcare seeking remains a challenge as many people
prefer to get treatment from traditional healers due to the lack of
transportation. More than 30% of all cases in Littoral and SouthWest
regions have been classified as severe, potentially meaning that there
is delayed detection or poor case management in these regions.

There have also been problems with communicating awareness
about cholera in the communities affected. Certain regions have low
capacity for cholera case management in their facilities due to the
lack of resources for medical care which increases the risk of poor
health outcomes for cholera patients.

Additionally, Cameroon continues to experience conflict and
movement of internally displaced persons (IDPs) predominantly in
the affected region of South-West, but also in other regions that have
not been substantially affected by the current cholera outbreak such
as in Far North and North regions.

PUBLIC HEALTH ACTIONS

The national incident management system holds regular
coordination meetings with its partners to support district
teams.

A costed response plan was created by the Ministry of Health
and includes response partners.

An international order for cholera kits was launched to aid the
response.

Advocacy meetings are held with local and international
partners for their continued support with the response including
humanitarian actors working in areas of conflict.

The first round of cholera vaccination campaign was completed
and the second round has been planned for April 2022.

Response teams were deployed to major outbreak sites to
supplement the response and conduct investigations.

Decontamination of outbreak sites such as prison facilities and
households of confirmed cases have been conducted.

Surveillance activities have been strengthened for active case
searching and patient referrals in affected districts.

Community members and leaders were trained on hand
washing, purification of water and disinfection of homes and
public spaces.

SITUATION INTERPRETATION

The cholera outbreak in Cameroon that began surging in late October
2021 has deteriorated to even higher levels in March 2022. The
regions have faced challenges of insecurity in some areas, high
population movement of IDPs, as well as health system problems to
combat the outbreak such as low diagnostic capacity, rejections of
patients at health facilities, and low risk communication for cholera.
The country is conducting cholera vaccination which should aid in
the decreasing of cases but will need to be supplemented by more
successful interventions in order to control the outbreak.

PROPOSED ACTIONS

Further develop a case management strategy for cholera in the
country to improve health services at various levels. Severe
health outcomes and deaths can be prevented if access to
healthcare is improved.

Enhance risk communication methods to increase awareness on
cholera and prevent delayed healthcare seeking.

Improve access to safe water and sanitation, conduct proper
waste management, promote food safety and hygiene practices.

Build laboratory capacitation and logistical facilitation networks
at lower levels to shorten diagnostic turnaround times.

View/Open

OEW15-0410042022.pdf (‎2.192Mb)‎

https://apps.who.int/iris/handle/10665/353065

 

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[Shiloh]

Source: https://www.plenglish.com/news/2022...-region-of-cameroon-suffers-cholera-epidemic/


English-speaking region of Cameroon suffers cholera epidemic
April 17, 2022
CDT10:57 (GMT) -0400
Published by: Alina Ramos Martin

Malachie informed that so far 4,627 cholera cases with 105 deaths have been reported throughout the country, with the greatest impact in the English-speaking regions of Bamenda and Buea.

Cholera was accentuated by the spread of Covid-19. It is a shocking situation in a disturbed state like ours. Cameroon should review its national health policy in case of crisis, he said.

The disease aggravates the situation in the area, which since 2017 has been experiencing a deadly conflict rooted in colonization by the French and British governments, and the two languages that came with it, French and English...