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DRC - Cholera outbreaks 2021 - 2023

Translation Google

South Kivu: the cholera epidemic kills two prisoners in Kamituga prison

Monday, December 12, 2022 - 09:41

Two inmates died as a result of the cholera outbreak last week at Kamituga prison in South Kivu, prison authorities have announced.

“There are two deaths. More than 10 other detainees are in hospital. It's cholera that reigns there", confirmed to ACTUALITE.CD Richard Tenge, director of the prison of Kamituga.

The situation has become increasingly worrying. A disinfection team is expected this Monday at Kamituga prison.

“I am waiting for the team led by Doctor Léandre, he said he will come by to disinfect”, indicated the director of the prison.

In view of the evolution of the health situation, the public prosecutor ordered the release of the defendants of the prosecution except those whose files are already fixed.

A gold mining city, Kamituga has been at the center of several disasters in recent months. After the floods, the prison is affected by cholera. Civil society organizations plead for urgent intervention by the authorities.

Justin Mwamba

https://actualite.cd/2022/12/12/sud...ts-parmi-les-detenus-de-la-prison-de-kamituga
 
Translation Google

South Kivu: a dozen detainees die in 7 days in Kamituga prison

Published on Wed, 14/12/2022 - 08:27 | Modified on Wed, 14/12/2022 - 08:27

A dozen detainees died in the space of a week in the central prison of Kamituga, in the territory of Mwenga (South Kivu).

According to sources in the region, these deaths are due to a diarrheal disease which for some would be cholera.

The latest case is that of three prisoners who died last weekend.

“In the central prison of Kamituga, there is an epidemic which has just been observed. There are already two deaths from cholera today and seven others are hospitalized at the Kamituga General Reference Hospital. Please issue this cry of alarm to humanitarians and other responders in this area of ​​disease cases. We insist a lot on the relocation of this prison because every day there are deaths, the day before yesterday also there were two deaths, we do not know what to do in Kamituga. The town hall is overwhelmed,” said a resident of Mwenga.

The head doctor of the Kamituga health zone says he recognizes this situation.

Dr Léandre Mutimbwa indicates that these victims show signs of diarrhea, but that it is difficult for the moment to confirm that it is cholera before the laboratory results.

This Monday, December 12, about fifteen other sick prisoners from the same prison in critical condition should be evacuated to the hospital.

The central prison of Kamituga currently houses more than 100 detainees, including two women.

https://www.radiookapi.net/2022/12/...ne-de-detenus-meurent-en-7-jours-la-prison-de
 
Translation Google

South Kivu: more than 160 cases of cholera recorded in 10 health zones

Published on Fri, 16/12/2022 - 16:33 | Modified on Fri, 16/12/2022 - 16:33

More than 160 cases of cholera have been recorded in ten health zones in the province of South Kivu. According to the head of the health information and communication office at the Provincial Health Division, Justin Bengheya, this cholera epidemic has been raging for a few days in about ten health zones, and this has caused deaths.

The health zones most affected by the disease are those located on the shores of the lakes.

“On the shore of Lake Tanganyika, there is the health zone of Uvira which today has around 53 cases of cholera and which recorded three deaths last week. There is the health zone of Ruzizi, Sange and Kiliba, the first case in Ruzizi came from the Burundian refugee transit camp before spreading in the community. And today, we have around 34 cases of cholera, and we have lost two patients,” counted Justin Bengheya.

He adds that the health areas on the Lake Kivu coast are also affected:

“If we enter the territory of Kabare, there is first the health zone of Katana which is around 50 cases and we have also already lost two patients. Apart from Katana, there is Kabare center which has already recorded nine cases since the start of the epidemic and also one death. You understand that it is in each health zone that we are losing patients. But also in the health zone of Miti-Murhesa in the health area of ​​Kavumu they notified 14 cases in the last two weeks. If we go to the territory of Kalehe, there is the health zone of Minova which is in epidemic, in Kalehe center, they are in epidemic at the time I speak to you ”.

This official of the provincial health division has, moreover, affirmed that the care is in progress and the treatment of cholera is free.

https://www.radiookapi.net/2022/12/...de-cholera-enregistres-dans-10-zones-de-sante

-------------------------------------------

Nyirangongo: 6 dead from cholera in the Kanyaruchinya IDP camp in 2 days

Published on Sat, 17/12/2022 - 23:42 | Modified on Sat, 17/12/2022 - 23:42

Six people died of cholera between Friday December 16 and Saturday December 17, in the Kanyaruchinya IDP camp, Nyirangongo territory (North Kivu).

According to the president of this site, Théo Musekura, these deaths are due, among other things, to the difficult situations that these people are going through.

Mwami Ndeze Katurebe Jean-Baptiste, chief of the Bwisha chieftaincy urged the Congolese State and humanitarian workers to come to the rescue of these displaced persons:

“It's very difficult what they are going through. For several months, sometimes they left, returned to Rugari. Those you have there are mainly those who came only from the Rugari and Kisigari groupements who fled the fighting which came from Rutshuru. This population is suffering. And so we have a job that may not be visible. But we do advocacy with the humanitarian communities, with the ministries of social and humanitarian affairs”.

This traditional authority claimed to be working to put in place a contingency plan to assist these displaced people when peace returns to this region.

The deaths come two days after the Governor of North Kivu, General Constat Ndima, declared the cholera outbreak in Nyiragongo territory.

https://www.radiookapi.net/2022/12/...suites-de-cholera-dans-le-camp-de-deplaces-de
 
Translation Google

North Kivu: 7 people die of Cholera in Nyiragongo

Published on Mon, 26/12/2022 - 11:28 | Modified on Mon, 26/12/2022 - 11:37

The cholera epidemic declared in the territory of Nyiragongo on December 14 has already killed seven people, mainly among displaced children under five years old.

Guest of Radio Okapi this Monday, December 26, the head of the provincial health division in North Kivu, Dr. Janvier Kubuya calls for greater action to control this epidemic.
...
https://www.radiookapi.net/2022/12/...ivu-7-personnes-meurent-de-cholera-nyiragongo

-------------------------------------

DRC-M23: already destitute, the displaced must now face the cholera epidemic

Monday, December 26, 2022 - 10:28

The violence caused by the resurgence of the M23 has caused hundreds of thousands of displaced people. Humanitarian actors quoted by OCHA report that at least 510,000 people have been displaced following clashes in Rutshuru and Nyiragongo territories since March 2022.

These displaced people live in extremely precarious conditions and are forced to face several deprivations. As civil society fears, men, women, children and old people living in IDP sites are now facing an epidemic of cholera officially declared since December 14. About 1000 cases have already been notified.

Humanitarian actors are working to contain this epidemic in the IDP sites of Kanyaruchinya, Kibati, Munigi, Don Bosco, among others. Water, hygiene and sanitation actors (Norwegian Church Aid (NCA), UNICEF, Yme Grand Lac, among others) are stepping up their interventions to reduce transmission and stem its spread.

More than 1,200 m3 of treated water is transported by MSF and made available to the sites per day. Interventions targeted by area of ​​occurrence of cases carried out by UNICEF and the Congolese Red Cross have covered more than 30,000 households which have also been decontaminated, simple cholera kits (soap, jerrycans, basins and buckets) distributed for a period of one month, and raising awareness and promoting hygiene to more than 90,000 people.

https://actualite.cd/2022/12/26/rdc...ent-maintenant-affronter-lepidemie-de-cholera
 
Translation Google

North Kivu: drop in cholera cases in the Kanyaruchinya IDP camp

Published on Wed, 11/01/2023 - 13:02 | Modified on Wed, 01/11/2023 - 13:03

The Nyirangongo health zone has noted a decrease in cholera cases in recent days in the Kanyaruchinya IDP camp, located north of Goma (North Kivu) in Nyiragongo territory. The statistics recorded have gone from 80 to 40 cases per day, according to the focal point in charge of epidemiological surveillance in this health zone.

The latter claims to have notified since the start of this epidemic to date 3,054 (three thousand fifty-four) cases.

However, the focal point calls for more efforts to stabilize this epidemic, which is affecting internally displaced persons who fled the hostilities in the territories of Rutshuru and Nyiragongo.

The coordination in the health zone of Nyiragongo welcomes the involvement of the provincial government with its partners like MSF/Belgium and Holland, Medair, WHO and other international organizations in the fight against this disease of dirty hands.

Mathieu Zabona, focal point in charge of epidemiological surveillance in the health zone of Nyiragongo, says that the situation is tending towards stability:

“Since we started we were even at 80 cases a day. But currently we are slowly going down. We are now at an average of 40 cases per day. We are moving towards stability. It's really a big step. We are always monitoring because this disease is complex. We must carry out all possible means and activate all the devices so that we can reach the end”

Therefore, adequate care had been put in favor of patients. However, "efforts must be made to better control this epidemic in the IDP sites but also to prevent its spread to the Goma households closest to the Nyiragongo territory. This is particularly in the Karisimbi health zone, where we has already notified two cases,” says the focal point.

Since December 14, 2022, the provincial authority of North Kivu had declared the cholera epidemic in the territory of Nyiragongo.

https://www.radiookapi.net/2023/01/1...-kanyaruchinya
 
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 2: 2 to 8 January 2023
Data as reported by: 17:00; 8 January 2023

...
All events currently being monitored by WHO AFRO
...

Democratic Republic of the Congo Cholera Grade 3

Date notified to WCO 16-Jan-15
Start of reporting period 3-Jan-22
End of reporting period 30-Dec-22

Total cases 14 290
Cases Confirmed 1 356
Deaths 262
CFR 1.8%


From epidemiological week 1 to 47 (ending 27 November 2022), 14 290 suspected cholera cases, including 262 deaths (CFR: 1.7%), were recorded in 97 health zones across 17 provinces of the Democratic Republic of the Congo. Suspected cases have mostly been reported from South Kivu (4 519), Haut-Lomami (2 727), Tanganyika (2 840), and North Kivu (2 599). Karisimbi and Nyiragongo health zones are among the cholera hotspot sites in North Kivu province. The number of cholera cases increased in Nyiragongo and Karisimbi health zones from weeks 47 and 50 of 2022, respectively. Since then, there has been a steady weekly increase in the number of new cases in Nyiragongo Health Zone, up to 720 new cases at SE52 in 2022.

https://apps.who.int/iris/bitstream/handle/10665/365578/OEW02-0208012023.pdf?sequence=1&isAllowed=y
 
WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES

Week 4: 16 to 22 January 2023
Data as reported by: 17:00; 22 January 2023

...

Cholera Eastern Democratic Republic of the Congo

3 677 cases
15 Deaths
0.4% CFR


EVENT DESCRIPTION

Although cholera is endemic in the North-Kivu province of
the Democratic Republic of the Congo (DRC), an upsurge in
suspected cases of cholera above the epidemic threshold has
been observed in Nyiragongo and Karisimbi health zones (HZs) of
the same province. The upsurge started respectively from weeks
47 (ending 27 November) and 50 (ending18 December) of 2022.
In particular, the number of suspected cases of cholera in
Nyiragongo HZ increased from 51 cases in week 47 to 556 cases
(990% increase) in week 50 and 683 cases (1 239% increase) in
the last week of December 2022 (week 52).

Consequently, an outbreak of cholera was officially declared on
14 December 2022, after isolation of Vibrio cholerae in stools of
suspected cases of cholera in Nyiragongo HZ.

As of 19 January 2023, 3 677 suspected cases of cholera
including 15 deaths (CFR 0.4%) have been reported, including
3514 cases and 14 deaths (CFR 0.4%) in Nyiragongo HZ, and
163 cases and one death (CFR 0.6%) in Karisimbi HZ.

Since the beginning of the outbreak, an average of 500 and 60
cases are being notified weekly in Nyiragongo and Karisimbi HZs,
respectively. Almost 50% of these cases have been laboratoryconfirmed.
In Nyiragongo HZ, the 5-14 years represent the most affected
age group (33%), followed by the 1-4 years (29%) and the 15-29
years (17%); the under-one constitute almost 7% of cases. More
than 60% of cases present with dehydration, in either moderate
(28.6%) or severe (32.1%) form.

A total of 14 health areas including eight in Nyiragongo
(Kanyaruchinya, Kibati, Kibumba, Kiziba, Mudja, Munigi, Ngangi
III, and Turunga) and six in Karisimbi (Baraka, Bujovu, Kasika,
Katoyi, Methodiste, and Mugunga) have so far been affected. In
Nyiragongo HZ, Kanyaruchinya is the epicentre of the outbreak,
with 73.6% (n=2 586 cases) of cases, followed by Munigi (574
cases; 16.3%) and Kibati (266 cases; 7.6%). In Karisimbi HZ,
almost 60% of cases have been reported from Methodiste health
area.

The cholera outbreak follows a massive influx of internally
displaced populations (IDPs) in Nyiragongo, Karisimbi and other
HZs of North-Kivu province, as a consequence of intense armed
conflicts between DRC security and defence forces and the nonstate armed group.
As a result, more than 450 857 IDPs have abandoned their
homes and livelihood, of whom around 53.4% (240 579 IDPs)
have settled in Nyiragongo, either in IDP camps (235 111 IDPs;
97.7%) or in host communities, as of 6 December 2022.

These IDP sites do not meet the standards and are characterized
by overcrowding, poor hygiene and sanitation conditions,
very limited access to drinking water, latrines and basic health
services. IDPs represent more than 90% of cases in Nyiragongo
HZ, and almost 40% of cases in Karisimbi HZ. However, there is an
extension of the outbreak out of IDP sites within the community,
with almost 10% and 60% of cases which originate from host
communities, respectively in Nyiragongo and Karisimbi HZs.
.
PUBLIC HEALTH ACTIONS

Coordination

The outbreak has been officially declared by the North-Kivu
Governor.

A multi-sectorial coordination mechanism has been set-up
at provincial level and daily coordination meetings are being
held in Kaniyarucinya (Nyiragongo).

An incident management system has been activated at the
Goma WHO sub-office.

A number of partners are actively involved in response
activities including WHO, UNHCR, IOM, MSF, UNICEF, WFP,
GRAM, MEDAIR, JOHANNITER, and Save the Children.

A costed strategic preparedness and respons plan is
available.

A coordination meeting has been put in place at national
level to prepare the reactive oral cholera vaccination (OCV)
campaign planned for end of January 2023.

Surveillance and laboratory

Surveillance activities are ongoing, including field
investigations, active case finding, alert notification and
investigation, and contact tracing and follow-up. On 19
January, 382 alerts were received including three community
deaths; of these, 365 alerts (95.5%) were investigated and
335 alerts (91.8%) were validated as suspected cases of
cholera.

Surveillance kits have been provided to teams on ground.
IT kits have been granted to information management
teams, and support is being provided for data entry and
management.

Community health workers have been briefed on the
community-based surveillance of cholera.

Case management and psychosocial support

A total of 34 rehydration points have been put in place and
are currently operational. In addition, six case management
units are functional including four cholera treatment units
(CTUs), one each in Kibati, Kanyaruchinya, Kahembe, and
Don Bosco, and two cholera treatment centres (CTCs), one
each in Munigi and Kiziba. The total bed capacity is of 205
beds.

Infection, prevention an

IPC interventions are being carried-out both in health care
facilities (HCFs) and in the community.

Twelve priority HCFs have been identified including eight in
Nyiragongo and four in Karisimbi.

Health care workers are being briefed on cholera preventive
measures, and IDPs are educated on the importance and
practice of hand washing.

The grid approach (household decontamination) has been
set-up in IDP sites and grid teams have been deployed on
ground, accordingly.

Water supply is being closely monitored.

Risk communication and community engagement

Community engagement activities are ongoing, targeting
traditional authorities and community leaders.

Mass sensitization, educational talks and household visits
are ongoing in all affected areas.

Messages on the importance of vaccination are under
development.

Operations support and logistics

Case management kits and other materials are being
provided in CTUs/CTCs.

IPC kits are also being made available both in CTUs/CTCs
and other HCFs, and in the community.

The expansion of Don Bosco CTU is ongoing.

Vaccination

A reactive OCV campaign is in preparation, scheduled for 25
January 2023, in 11 health areas of Nyiragongo HZ and one
health area of Karisimbi HZ, targeting both IDPs and host
communities.

Vaccines have already arrived in Kinshasa and are now being
distributed to Goma.

SITUATION INTERPRETATION

The ongoing cholera outbreak has resulted from a massive influx
of IDPs in Nyiragongo and other territories, due to ongoing
armed conflicts opposing DRC security and defence forces. The
likelihood of the situation getting worse is high if the conflict
continues to intensify over time with more people arriving in
IDP camps. Although the CFR remains low, the proportion of
moderate and severe cases is concerning, perhaps inferring late
detection and referral of cases. Additionally, there is a high risk
of further spread of the disease to other HZs and provinces of the
country, given population movements due to the ongoing crisis,
poor WASH conditions and very limited access to health care
services in those areas, and the current rainy season. There is
also a major risk of spread to neighbouring countries considering
population movements between DRC and Rwanda or Uganda.
Cross-border collaboration and surveillance should be enhanced,
accordingly.


https://apps.who.int/iris/bitstream/handle/10665/365707/OEW04-1622012023.pdf
 
250px-Democratic_Republic_of_the_Congo_%2826_provinces%29_-_Tanganyika.svg.png

https://en.wikipedia.org/wiki/Tanganyika_Province
----------------------------------

Translation Google


35 cases of cholera recorded in four Moba territory health areas

January 31, 2023044


Kalemie, January 31, 2023 (ACP).- Thirty-five cases of the cholera epidemic have been recorded since a week of January in four health areas in the territory of Moba, learned the ACP from Dr Baruti Momat , chief physician of this health zone.

These are the health areas of Moba-port, Mulungwisi, Kapakwe and Moliro, all these regions located on the shores of Lake Tanganyika where the population gets its supplies of untreated raw water, indicated the head doctor of the Moba health zone, who went to the field immediately informed to verify these cases of cholera recorded in the aforementioned health areas.

Dr. Baruti Moma says that the health authorities in Kalemie in the capital of the province of Tanganyika have sent some medical supplies to strengthen this health zone in order to fight and take care of all the patients affected by the cholera epidemic which is raging. in these health areas, we recall. ACP/Kayu/SNM

https://acpcongo.com/index.php/2023...ans-quatre-aires-de-sante-territoire-de-moba/
 
Translation Google

Tanganyika: cholera cases recorded in Moba

Published on Wed, 01/02/2023 - 13:35 | Modified on Wed, 02/01/2023 - 13:35

Five cases of cholera and about forty suspected cases are recorded in Moba territory in the fifth week of this year. This was reported on Wednesday, February 1 on Radio Okapi by the head doctor of the Moba health zone, Dr. Barwine Momat.

According to him, the health zone is coping with this situation with on-board resources.

“For the week that is starting, that is to say the fifth week, we are already on the third day today, we have already recorded 5 cases. For week one, through week 4, it was 47 cases and in total it's about 52 cases. All these cases come from an Ntoto village, which is 7 km from Kapakwe”.

Doctor Barwine Momat adds that the origin of this disease of dirty hands is not yet known:

“The origin of this disease is not very well known. All of a sudden, it was found that people were starting to show the symptoms. When we had taken the samples, we found for the people who were tested, 4 were positive and as we had few inputs for the others we sent the samples to Kalemie".

But, most of the affected villages, there are not enough developed wells. "This is why at our level, we still carried out some actions: there are the teams that we have already deployed in Ntoto since we had to act at the source", he continued.

https://www.radiookapi.net/2023/02/01/actualite/sante/tanganyika-des-cas-de-cholera-enregistres-moba
 
Cholera - Democratic Republic of the Congo

10 February 2023

Situation at a glance

Cholera is endemic in the eastern part of the Democratic Republic of the Congo (DRC), including Ituri, North Kivu, South Kivu, and Tanganyika provinces, with cases reported through the year.

On 14 December 2022, a cholera epidemic was officially declared by the Governor of the province of North Kivu, following the isolation of Vibrio cholerae among 140 of the 247 samples collected from suspected cases of Nyiragongo HZ.

As of 4 February 2023, a total of 4386 cholera cases (of which 1009 are laboratory-confirmed) with 16 deaths (CFR 0.4%) have been reported.

A multisectoral community-based response has been implemented, including a cholera vaccination campaign.

Considering the fragile context in which this outbreak is taking place, ongoing armed conflicts with further displacements, concurrent epidemics, inadequate levels of access to health care, poor drinking water, hygienic and sanitary conditions, and population movements between the affected HZs and neighbouring countries (including Rwanda and Uganda), WHO assesses the risk posed by this outbreak as high at the national and regional level, and low at the global level.



Description of the situation

Cholera is endemic in several provinces in the Democratic Republic of the Congo (DRC).

However, from mid-November to the end of 2022, there has been an upsurge in the number of reported cholera cases in the health zones of Nyiragongo and Karisimbi, in the province of North Kivu. Since then, cases have shown a declining trend (Figure 1).

Figure 1. Number of cholera cases (suspected and confirmed) reported in Nyiragongo and Karisimbi health zones. Source: line list of Nyiragongo and Karisimbi Health Zones.



In Nyiragongo, the number of new cholera cases (suspected and confirmed) increased from 51 in week 47 (21-27 November) to 556 cases in week 50 (12-18 December) of the year 2022, and to 683 cases in week 52 (December 26, 2022-January 1, 2023).

On 14 December 2022, a cholera epidemic was officially declared by the Governor of the province of North Kivu, following isolation of Vibrio cholerae in the stool of 140 cases from Nyiragongo HZ at the local laboratory in Goma.

As of 4 February 2023, a total of 4386 cholera cases (1009 laboratory-confirmed; 23%) with 16 deaths (CFR 0.4%) have been reported, of which 4011 (91.5%) are from Nyiragongo and 375 (8.5%) from Karisimbi. In the HZ of Nyiragongo, the most affected age group is 5-14 years (30.1%), followed by 1-4 years (29.7%) and 15 -29 years (16.6%); children under the age of one represent 8% of cases.

In total, 15 health areas including seven in the Nyiragongo HZ (Kanyaruchinya, Kibati, Kiziba, Mudja, Munigi, Ngangi III and Turunga) and eight in Karisimbi HZ (Baraka, Bujovu, Kasika, Katoyi, Majengo, Methodiste Mugunga and Muugano Solidarite) are currently affected by the cholera epidemic.

In the HZ of Nyiragongo, the health area of Kanyaruchinya is the most affected, contributing to 73.3% of all suspected cholera cases reported from Nyiragongo. In Karisimbi HZ, the Methodist health area is the most affected with 59.4% of all cases, followed by Baraka and Lasika health areas (both contributing to 7.3% of cases from Karisimbi HZ).

Figure 2. Cumulative number of cholera cases (suspected and confirmed) by health area in Niyragongo and Karisimbi health zones, as of 4 February 2023. Source: Nord Kivu Provincial Health Division.

The cholera outbreak is principally affecting internally displaced populations (IDPs), with 97% of the cases reported among IDPs in the HZ of Nyiragongo, and 59% of cases among IDPs reported from the Methodist health area of Karisimbi HZ, which houses the Don Bosco IDP camp.

However, the outbreak is also spreading across the surrounding communities with nearly 3% of the cases in the HZ of Nyiragongo and 41% of the cases in the HZ of Karisimbi belonging to the host community.

Epidemiology of cholera

Cholera is an acute enteric infection caused by ingesting the bacteria Vibrio cholerae present in contaminated water or food. It is mainly linked to insufficient access to safe drinking water and inadequate sanitation. It is an extremely virulent disease that can cause severe acute watery diarrhoea resulting in high morbidity and mortality, and can spread rapidly, depending on the frequency of exposure, the exposed population and the setting. Cholera affects both children and adults and can be fatal if untreated.

The incubation period is between 12 hours and five days after ingestion of contaminated food or water. Most people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people. The majority of people who develop symptoms have mild or moderate symptoms, while a minority develop acute watery diarrhoea and vomiting with severe dehydration. Cholera is an easily treatable disease. Most people can be treated successfully through prompt administration of oral rehydration solution (ORS).

The consequences of a humanitarian crisis – such as disruption of water and sanitation systems, or the displacement of populations towards inadequate and overcrowded camps – can increase the risk of cholera transmission, should the bacteria be present or introduced.

A multisectoral approach including a combination of surveillance, water, sanitation and hygiene (WASH), social mobilization, treatment, and oral cholera vaccines is essential to control cholera outbreaks and to reduce deaths.

Public health response


Coordination: multisectoral coordination has been established at the provincial level, and daily coordination meetings are held in Kaniyaruchinya (Nyiragongo HZ). The incident management system (IMS) was activated at the WHO office. A budgeted preparedness and response plan has been developed and several partners are involved in the response, including WHO, which supports the Provincial Health Division (PHD) in the implementation of the health sector response in collaboration with the Ministry of Health and the other partners, such as the United Nations High Commissioner for Refugees (UNHCR), International Organization for Migration (IOM), Médecins Sans Frontières (MSF), UNICEF, World Food Programme (WFP), and Save the Children.

Epidemiological surveillance and laboratory: a surveillance and laboratory commission has been set up by the North Kivu Provincial Health Division with the support of WHO and other partners. Four data managers have been trained and equipped with computers by WHO. Training on case definition has been provided to healthcare workers and community health workers (CHW); investigation teams have also been trained on active case finding. Surveillance activities are ongoing, including active case finding, alert notification and investigation, and contact tracing and follow-up. Data is collected daily from Oral Rehydration Points (ORP), Cholera Treatment Units (CTU) and Cholera Treatment Centers (CTC). Samples are regularly collected also from suspected cases registered outside the outbreak area in order to assess the extent of the epidemic. Data is analyzed on a daily basis and shared with partners for operational decision-making. WHO also supported the National Biological Research Institute in Goma with sample transportation.

Case management: WHO and partners supported the establishment of 56 ORPs in IDP sites, four CTUs (Kibati, Kanyarucinya, Kahembe, and Don Bosco) and two CTCs (Munigi, Kiziba) in the most affected health areas, with a total capacity of 205 beds. WHO and partners also provided support for the free provision of basic health care in functional health structures in the two affected health zones to ensure the maintenance of essential health services for vulnerable populations.

Infection Prevention and Control (IPC)/Water, Hygiene and Sanitation (WASH):an IPC/WASH commission has been set up by the North Kivu PHD and supported by partners including WHO and UNICEF. Systematic decontamination of households and public spaces is implemented by trained teams. Training for safe and dignified burials is also carried out. In IDP sites a total of 1706 latrines, 293 showers, 91 hand-washing stations and 62 well sites have been established. Regular supply of water is made through cisterns. Training for healthcare workers and hygiene workers on IPC practices is also carried out regularly.

Risk communication and community engagement: Several advocacy meetings were held with community leaders and political-administrative authorities. Community workers have been trained to raise awareness about cholera, and preventive measures are communicated door-to-door and during public meetings with the affected population.

Vaccination:At the national level, coordination meetings were organized to ensure the preparation of the vaccination campaign against cholera in the two affected health zones. WHO provided support to the Ministry of Health for the mobilization from the vaccination International Coordination Group (ICG) of 364 137 doses of oral cholera vaccines in the two affected HZs. With the support of The Global Alliance for Vaccines and Immunization (GAVI), after its launch by the Governor of North Kivu province on January 25, 2023, the Oral Cholera Vaccination (OCV) campaign in three HZs of North Kivu PHD (including in IDP sites) took place between 25-30 January 2023 and immunized 351 207 people aged one year and older out of a target of 364 137, i.e. partial coverage of 96.4%.

WHO risk assessment


Cholera is endemic in parts of DRC. In 2022, according to data from the National Integrated Disease Surveillance and Response System, a total of 18 403 suspected cases of cholera, including 302 deaths (CFR 1.6%), were notified in the DRC, in 104 HZs of 19 of the 26 provinces of the country.

However, the current epidemic is showing a rapid upsurge in a fragile context such as IDPs camps.

For years, DRC has been experiencing several armed and community conflicts, particularly in the east, putting the country in a state of unprecedented humanitarian and health crisis.

Due to internal armed clashes, which intensified in 2022, nearly 450 857 new IDPs arrived in North Kivu (which already hosts 1.9 million of IDPs). Of them, 53.4% (240 579) are hosted in the territory of Nyiragongo and particularly 97.7% (235 111) in IDPs sites, which are characterized by overcrowding, poor hygiene and sanitation conditions, very limited access to drinking water, latrines and basic health services. In addition, population movements are regularly observed between the affected HZs and the other HZs in the province of North Kivu as well as the rest of the country, where the populations also have limited access to drinking water, good hygiene and sanitation conditions, as well as to health care facilities.

Moreover, the current rainy season may favor the spread of the epidemic in other HZs.

With the ongoing armed conflicts, displacements are likely to continue, leading to a worsening of the humanitarian context and the vulnerabilities of the populations, including the need for basic social services. All this is evolving in a context of a fragile health system; recurrent attacks on hospital infrastructures and reduced availability of services. Other outbreaks are also ongoing (COVID-19, yellow fever, poliomyelitis, measles, mpox (monkeypox), meningitis, etc.) and there are extremely limited human, material and financial resources.

The risk of cholera spreading to neighboring countries cannot be ruled out. Indeed, there are population movements between the affected health zones and neighboring countries, including Rwanda and Uganda.

The affected HZs border the city of Goma, which has an international airport. Countries in the Great Lakes sub-region (Rwanda, Uganda, Burundi), which are most at risk of cholera importation from the current epidemic hotspots in North Kivu, have inadequate levels of access to health care, poor drinking water, hygienic and sanitary conditions. A cholera epidemic is also ongoing in Burundi with 120 suspected cases and 1 death reported as of 7 February 2023. This epidemic affects the city of Bujumbura, which is located on the shores of Lake Tanganyika on the border with South Kivu, with population movements across the border.

The outbreak is occurring against a backdrop of a surge in cholera outbreaks globally, which has constrained the availability of vaccines, tests, and treatments.

Considering the above-described scenario, WHO assesses the risk posed by this outbreak as high at the national and regional level, and low at the global level.

WHO advice


A multi-pronged approach is essential to combat cholera and reduce mortality. The measures used combine surveillance, improvement of water supply, sanitation and hygiene, social mobilization, treatment of the disease and oral cholera vaccines. Countries affected by cholera are advised to strengthen disease surveillance and national preparedness to rapidly detect and respond to possible outbreaks.

WHO recommends improving access to proper and timely case management of cholera cases, improving access to safe drinking water and sanitation infrastructure, as well as improving infection prevention and control in healthcare facilities. These measures along with the promotion of preventive hygiene practices and food safety in affected communities are the most effective means of controlling cholera. Effective risk communication and community engagement strategies are needed to encourage behavioral change and the adoption of appropriate preventive measures.

Measures aimed at improving environmental conditions include applying long-term sustainable solutions for water supply, sanitation and hygiene in cholera-prone areas. In addition to cholera, these interventions can also prevent a wide range of other water-borne diseases and contribute to achieving goals in education and the fight against poverty and malnutrition. Solutions for water supply, sanitation and hygiene related to cholera are in line with the Sustainable Development Goals.

Rapid access to treatment is essential during a cholera outbreak. Oral rehydration should be available in communities and not just in larger health centers that can offer intravenous infusions and management at any time. With rapid and appropriate care, the case fatality rate should remain below 1%.

Community mobilization must continue as an integral part of the response and should cover information on the symptoms of cholera, on the precautions to take to protect against the disease, and the need to promptly seek care when symptoms appear.

The OCV should be used in conjunction with improvements in water and sanitation to control cholera outbreaks and for prevention in targeted areas known to be at high risk for cholera.

WHO recommends Member States to strengthen and maintain surveillance for cholera, especially at the community level, for the early detection of suspected cases and to provide adequate treatment and prevent its spread. Early and adequate treatment limits the CFR of patients to less than 1%.

WHO does not recommend any travel or trade restrictions to the Democratic Republic of Congo based on the currently available information.


...

https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON441
 
Translation Google

Goma: more than 2,000 cases of cholera recorded in 2 weeks at the Bulengo IDP camp

Published on Wed, 03/22/2023 - 07:32 | Modified on Wed, 03/22/2023 - 11:39

The bar of 2,000 cases of cholera was crossed on Tuesday March 21 in the camp for displaced people in Bulengo, located in the Lac-vert district, west of the city of Goma (North Kivu).

A total of 166 new cases have been recorded, adding to the accumulation established until last Monday, which was 1,958 cases.

Cholera was reported on March 7 in this camp for displaced people.

From March 11, the new cases recorded went beyond the hundred.

It was on Sunday March 19 that the peak of 219 new cases was reached.

Thus, from March 7 to 21, i.e. in 14 days, 2,124 cases were recorded.

On this site, the government is working with several partners to overcome this disease.

Community relays in action

The head doctor of the Goma health zone, Jeanine Muhindo explained that the government and its partners are mobilized to overcome this epidemic.

This Tuesday morning, at the mobile hospital of the Bulengo camp, several dozen community relays received work instructions and equipment, before being distributed among the 350 blocks of this camp.

They work all day to ensure that all shelters, yards and even open spaces are sprayed against cholera.

One of the displaced people from the Bulengo camp, Maombi Bwira, who came from Kitshanga, is reassured because her shelter has just been pulverized:

“Even though we don't have latrines here, there are flies circulating all over the site that can bring us disease. So when they come with chlorine, it helps us a lot. »

For her part, Florence Boyohiki, vice-president of the Bulengo camp, thinks that without the construction of latrines for all the displaced people, cholera will not be eradicated in this camp:

“Really, we notice that this chlorine and taking care of the sick has helped. But if the number of latrines is not increased because their number is very minimal, but so is the water…because at the level of the new blocks there is no water”.

According to Médecins sans frontières (MSF), the lack of latrines and drinking water contributes to the outbreak of cholera cases in this camp for displaced people.

The NGO indicates that, until now, it provides 200,000 liters of drinking water per day, in addition to 200 latrines already built while 200 others are still under construction.

This number remains largely insufficient to meet basic hygienic standards, notes MSF.

https://www.radiookapi.net/2023/03/...cholera-enregistres-en-2-semaines-au-camp-des
 
Translation Google

Haut-Katanga: more than 560 cases of cholera including 23 deaths recorded in the space of 5 months

A total of 563 cases of the cholera epidemic including 23 deaths were recorded in 7 health zones in the province of Haut-Katanga in the space of five months, i.e. from October to early April 2023.

Among the entities that are more affected by cholera, there is the territory of Kasenga with 127 cases and 6 deaths followed by Kashobwe with 93 cases including 2 deaths. In Lubumbashi, it is the municipality of Katuba which is most affected by this epidemic with 71 cases including 2 deaths. Kisanga notified 45 cases including 7 deaths and 7 cases including 1 death to Kenya.

These figures were given by the provincial Minister of Health, on Tuesday April 12, 2023, in Lubumbashi, during a press briefing organized on the occasion of the 75th anniversary of the World Health Organization (WHO). Joseph Nsambi Bulanda specified that sensitization activities are already taken into account to control the epidemic.

"It is since October that there have been cases notified first in Kambove, Likasi. There is still the health zone of Mufunga in the territory of Mitwaba which had to notify cases, then Kasenga, Kashobwe in the Kole axis, then Kilwa. Today from today, we can say that there are at least 8 health zones which are in epidemic but we intervene and the WHO is there. Today "today, for example, we are at 563 cases with 23 deaths. Kasenga, Kashobwe, Pweto, Katuba are affected and we are still obliged to vaccinate. But there is awareness and prevention and also timely interventions", a- he told 7SUR.CD.
...
Patient Lukusa, in Lubumbashi

https://7sur7.cd/2023/04/12/haut-kat...pace-de-5-mois
 
Translation Google

Haut-Katanga: 329 cases of cholera including 11 deaths notified in Lubumbashi

hbbHBB MAY 5, 2023 HEALTH

Lubumbashi, May 05, 2023 (ACP).- 329 cases of cholera including 11 deaths have been notified in two weeks since its appearance in Lubumbashi in the province of Haut-Katanga in the Democratic Republic of Congo, the provincial Minister of Health announced on Thursday of the said province, Dr. Joseph N'sambi Bulanda .

“ The health zones of Katuba and Kisanga are the most affected by this disease which has caused 329 cases of cholera including 11 deaths. Currently, 16 cholera patients are being cared for at the Cholera Treatment Center (CTC) in Kenya ,” said the provincial Minister of Public Health, Hygiene and Prevention, during a visit to the cholera treatment center. of the commune of Kenya.

" The care is free, since the provincial government with the support of the NGO Doctor Without Borders has made supplies available to take care of cholera patients ," he said.

Dr. N'sambi, on this occasion, invited the population and especially the most affected health zones to observe hygiene measures, in particular washing hands with soap and running water, boiling water before drinking, to heat food, not to eat food sold on the side of the street and the like, so as not to get sick.

The Provincial Minister of Public Health, Hygiene and Prevention of Haut-Katanga has recommended that the population go to the hospital in case of diarrhea and vomiting so that the health service can detect if it is a case of cholera or not He specified that the "CTC" is the only structure that supports cholera patients in the city of Lubumbashi. Since October 2022 to the beginning of April 2023, at least 563 cases of cholera including 23 deaths have been notified in 7 health zones of Haut-Katanga in the space of five months.

It is endemic in several provinces of the Democratic Republic of Congo. It identified 3,200 cases of cholera in January 2023, three-quarters of which were among the half-million displaced people in North Kivu.

Cholera is an acute diarrheal infection caused by ingesting food or water contaminated with the bacillus called “Vibrio cholerae”. It remains a global threat to public health and an indicator of inequity and insufficient social development. The World Health Organization (WHO) notes that symptoms appear between 12 hours and 5 days after ingesting contaminated water or food.

CPA/

https://acpcongo.com/index.php/2023...-cholera-dont-11-deces-notifies-a-lubumbashi/

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Cholera in Lubumbashi: the provincial minister of health invites the population to respect hygiene rules

Published on Sat, 06/05/2023 - 08:03 | Modified on Sat, 06/05/2023 - 08:05

The Provincial Minister of Health of Haut-Katanga calls on the entire population of the city of Lubumbashi to observe hygiene rules to prevent the spread of cholera. This so-called dirty hands disease has been raging in several health zones of the copper city for two months. It caused the death of ten people.

The areas most affected by this epidemic are Katuba and Kisanga.

Until Wednesday May 3, 329 cases have been notified since the resurgence of this epidemic two months ago. Eleven of these patients have already lost their lives. Seven of them died at home and the other four died in hospital.

To deal with this epidemic, a cholera treatment center was opened in the commune of Kenya. On Wednesday May 3, 16 people were still being treated at this center when the provincial health minister paid a visit.

Among them, six children, three of whom come from the same family.

The care of all patients is free and without problem because the center has all the inputs.

To prevent any spread of this epidemic, the provincial health minister, Joseph Sambi Bulanda, asks the population "to observe hygiene measures by making our environment clean, boiling water and food, avoiding eating foods we do not know the origin”.

Joseph Sambi Bulanda also recalls the symptoms of the disease:

“ Once you have vomiting and diarrhea of ​​any kind, to go to the hospital first so that the health service can tell if it is cholera or not. Once the characteristics of cholera are suspected the CTC (Cholera Treatment Center) of Kenya is the only one that takes care of all cases of cholera ”.

https://www.radiookapi.net/2023/05/...-le-ministre-provincial-de-la-sante-invite-la
 
Translation Google

DRC: 200 cases of cholera recorded in one week in Bukavu

Posted on Mon, 22/05/2023 - 13:55 | Modified on Mon, 22/05/2023 - 13:55

Over two hundred cases of cholera, including five deaths, were recorded in the space of a week in all three urban health zones of Bukavu. The Provincial Health Division (DPS) / South Kivu calls on the population to observe the rules of health.

...

https://www.radiookapi.net/2023/05/...-de-cholera-enregistres-en-une-semaine-bukavu
 
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Province du Tanganyika​-https://en.wikipedia.org/wiki/Tanganyika_Province​

--------------------------

Translation Google

Tanganyika: 14 deaths in 10 days following acute diarrhea in Kiambi

Published on Thu, 01/06/2023 - 20:42 | Edited on Thu, 06/01/2023 - 20:42

A total of 14 deaths and more than 80 cases of acute diarrhea with severe dehydration have been recorded since May 20 in Kiambi health zone, Manono territory, Tanganyika province, the doctor told Radio Okapi on Wednesday June 1. head of Kiambi health zone.

The curve of cases of diarrhea is ascending, while the health zone lacks time to take care of the sick. Kiambi Health Zone Chief Medical Officer, Gérôme Kyungu, explained:

“The evolution of the disease of acute diarrhea with severe dehydration makes us think of suspected cases of cholera. So far in the area, we have no inputs that can deal with it. even the provincial government has already taken quick precautions (in order to) quickly send us the inputs to deal with this disease".

According to him, the area registers almost every day we have new cases. Three health areas are the most affected so far:
  • Monga
  • Lenge
  • Mpiana.

After receiving the first case, continued Dr. Kyungu, the health zone had dispatched a team for the investigation and sensitization to the population for water treatment:

"We asked the population, as we have no chlorine, to start boiling the water before consuming it. And we gave oral serum against diarrhea in the community; (for) that we start to be given to people as soon as there is diarrhea and vomiting, which has not yet led the person to severe dehydration, to start with oral serum treatment".

https://www.radiookapi.net/2023/06/...-10-jours-la-suite-dune-diarrhee-aigue-kiambi

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South Kivu Province-https://en.wikipedia.org/wiki/South_Kivu

--------------------

South Kivu: 390 cases of cholera including more than 270 recorded in Bukavu in one week

Monday, June 5, 2023 - 5:25 p.m.

A total of 390 cases of cholera have been recorded in the province of South Kivu in one week, i.e. last week.

According to Dr. Claude Bahizire, communication officer at the Provincial Health Division (DPS), the city of Bukavu is the most affected by this epidemic and recorded 279 cases in one week, including 166 cases in the commune of Kadutu.

He asks any patient with diarrhea and vomiting to go to the nearest health center as soon as possible.

" We advise people not to wait at home if there is someone with diarrhea and vomiting. Once at the center, the triage service will confirm or rule out cholera and refer the patient. If it's cholera, treatment is automatic and free ," he said in an address to the press last Saturday.

He points out that the consumption of dirty water, the lack of drinking water and the non-respect of hygienic standards are at the root of this epidemic in Bukavu in particular and in South Kivu in general.

It should be recalled that at least 4 deaths due to cholera have already been recorded in the city of Bukavu.

Déogratias Cubaka, in Bukavu


https://7sur7.cd/index.php/2023/06/...plus-de-270-enregistres-bukavu-en-une-semaine
 
Translation Google

South Kivu: 20 deaths following the cholera epidemic in the city of Bukavu

Published on Mon, 12/06/2023 - 14:18 | Modified on Mon, 06/12/2023 - 14:18


Twenty deaths have been recorded since April 2023, following the cholera epidemic, in three health zones in the city of Bukavu, in the province of South Kivu.

Almost two hundred cases have been recorded every week for two months at the cholera treatment center, located at the general reference hospital in Bukavu, according to medical sources.

According to Dr. Guy Mulinganya, the shortage of drinking water is among the causes of this epidemic:

“It is a situation which has been accentuated by the shortage of water in the city but also the period. It must be said that there has also been a relaxation of the measures used against the Ebola virus and against COVID-19. And with this relaxation of barrier measures, there has been an outbreak of cholera cases and I think we have a big chunk to manage ”.

“Last week alone we had 254 patients and today we already have 34 cholera patients. So more than 200 patients per week, it's still an alarming situation. There were some deaths that were recorded at the CTV level and even other bodies that were brought from the community to the treatment center and yet they were already dead,” adds Dr. Guy Mulinganya.

Medical sources say that cholera has been declared in Bukavu since January 2023. Cases increased from April.


https://www.radiookapi.net/2023/06/...uite-de-lepidemie-de-cholera-dans-la-ville-de
 
Source: https://www.mediacongo.net/article-actualite-124253_tanganyika_resurgence_de_l_epidemie_de_chol era_a_kalemie_pres_de_50_cas_enregistres.html

Tanganyika: resurgence of the cholera epidemic in Kalemie, nearly 50 cases recorded
09.07.2023


Nearly 50 new cases of cholera are recorded in the health zone of Nyemba in the 26th week (last week) in Kalemie, capital of the territory which bears the same name in the province of Tanganyika where no death is reported .

According to Hubert Nkulu, supervisor in charge of water and sanitation in this health zone who confirmed the information this Saturday, July 8, 2023 to the press, the occurrence of this wave began since the end of June.

"For the past week, week 26, we have notified a total of 50 cases of cholera and these cases have come to the different health areas and among the health areas which have notified the cases there are Undubu, Kituku, Lubuye and Tobacco, there is also Wimbi on the lake and Kabango but Undubu alone has reported many cases compared to the others," said this public health expert.

According to him, several parameters explain the resurgence of this epidemic in urban-rural areas.

"As soon as we did the investigations, we saw a lot of cases stemming from the consumption of unclean water and the contact between the infected person and the healthy person. The water coverage is too low starting from Undubu until in Wimbi, the population uses water from Lake Tanganyika because the health zone is next to the lake,” he concluded.

As a reminder, the Nyemba health zone covers a large part of the territory of Kalemie and extends to the Lukunga bridge in the border with the city of Kalemie.


JM Mpandanjila​
 
Translation Google

South Kivu: the town hall of Uvira warns of the persistence of cholera cases

July 14, 2023

Uvira, July 14, 2023 (ACP). – The mayor of the city of Uvira Kiza Muhato, in accordance with the correspondence sent to him by the chief doctor of the Uvira zone, draws the attention of his constituents to the increase in cases of cholera in the city of Uvira province of South Kivu in the Democratic Republic of Congo.

"According to the correspondence written to me on July 7 by the head doctor of Uvira zone Dr. Panzu Nimi, concerning the presence of cholera cases in our town, I remind you that on this day, cholera cases continue to rise proof that people are ignoring advice for its prevention. As such, and after having spoken with my hierarchy and humanitarians, I insistently remind you to strictly respect hygienic measures in order to combat this epidemic” , can we read in this declaration from the mayor of Uvira.

Among the measures on which the mayor insists, there are in particular: " wash your hands regularly before each meal, be reassured of the quality of the water used, drink only clean water or even wash food before cooking. , build good latrines… ”

“During this season, the lack of water seems to have spread to the town of Uvira. To do this, restaurant owners and residents use water from Lake Tanganyika, or other sources that are unfortunately unprotected” , regret other anonymous sources.

CPA/

https://acp.cd/sante/sud-kivu-la-mairie-duvira-alerte-sur-la-persistance-de-cas-de-cholera/
 
Translation Google

Tanganyika: lack of inputs to fight cholera in Kalemie and Nyemba (Doctor)

Posted on Fri, 28/07/2023 - 09:53 | Modified on Fri, 28/07/2023 - 09:53

The health zones of Kalemie and Nyemba (Tanganyika) are facing a lack of inputs to fight the cholera which has been raging in these areas since last January.

According to the head doctor of the Nyemba health zone, Dr Nadège Ramazani who spoke on Thursday July 27 on Radio okapi, chlorination and even disinfection are lacking.

“There are several needs in terms of chlorination and disinfection sites in order to install chlorination sites. The needs for a parasol, a jump, a cup, a chair, a table. The Red Cross supports chlorination sites. But, on the ground, these chlorination sites are not found. We find only a few sites. We are directing people to these chlorination sites, because we have a map of these sites, but they are there, they cannot find them,” she revealed.

For Dr. Nadège Ramazani, treatment centers for cholera patients are overwhelmed due to a lack of inputs needed to fight this epidemic:

“We need disinfection. At the treatment centers for cholera patients, they are overwhelmed. Normally, when a patient affected by cholera arrives, we disinfect the place, the vehicle or the motorcycle that transported him. We need disinfection because we have to disinfect the patient's house, the neighborhood and the latrines. But they are (treatment centers for cholera patients) faced with a logistical problem,” she said.

However, according to Dr. Nadège Ramazani, there has been a slight decrease in cholera cases since Monday, July 24, in the health zones of Kalemie and Nyemba.

Despite this lack of inputs, the number of cases due to cholera is decreasing.

According to the head doctor of the Nyemba health zone, the number of cholera cases has risen from 250 to 200 in one week.

https://www.radiookapi.net/2023/07/...ants-pour-lutter-contre-le-cholera-kalemie-et
 
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