WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 14: 28 March – 3 April 2022
Data as reported by: 17:00; 3 April 2022
...
Cholera Malawi
56 cases
2 Deaths
3.6% CFR
EVENT DESCRIPTION
The Southern region of Malawi was severely affected by the tropical
storm Ana and cyclone Gombe that caused torrential rains and
floods between late January and February 2022. The displaced
populations remained with no access to safe drinking water and
sanitation facilities and thus at risk of widespread disease outbreaks
including cholera.
On 3 March 2022, the Malawi Ministry of Health (MoH) declared a
cholera outbreak in the country, following confirmation of a case in a
57-year-old male from Balaka District in Southern Malawi. The case
was identified in Machinga district hospital with suspect cholera
symptoms on 28 February 2022. The stool sample collected from
the case-patient tested positive for cholera by culture and Vibrio
cholerae Inaba was isolated.
A separate locus of cholera cases linked to Mozambique was
reported in Nsanje district, with two initial cases reported on 14
March 2022. One of the cases was a Malawian who was displaced to
Mozambique after the tropical cyclone Ana but returned to Malawi
after developing cholera-like symptoms on 13 March 2022. The
cases were managed at Ndamera health centre on 14 March 2022.
As of 3 April 2022, there have been 54 cholera cases recorded
including nine confirmed by culture and two deaths, a case fatality
ratio (CFR) of 3.9%. Two districts have so far been affected. Nsanje
district has reported the highest number of cases, accounting for
96% (54 cases) of the national total, with two deaths. Machinga
district has reported 2 cases (4.0%). Males and females have been
equally affected. The ages of the cases range between 2 and 57
years, with the 5-14 years age group most affected.
Although many cases, 28 (55%), are imported from Mozambique,
in Morrumbala, Sofala province, some have been reported from
local areas and are on a rising trend.
Nsanje conducted a pre-emptive campaign targeting 80% of the
district population for individuals aged one year and above in 2020.
This campaign was however limited to localised hotspot locations
at the time.
PUBLIC HEALTH ACTIONS
The MoH declared a cholera outbreak in the country.
There are national and district level EOCs established and
are currently coordinating the response in collaboration with
other sectors and partners.
A costed national cholera response plan is in place and WHO
along with other partners are supporting its implementation.
A joint team of MoH and WHO completed field supportive
supervision including risk and needs assessment. A
comprehensive report is being prepared.
Four data managers and two public health officers were
engaged and deployed to the affected districts for data
management.
WHO has provided cholera kits and other supplies, which are
being distributed to the affected districts.
A request for oral cholera vaccine was submitted to the ICG
and more than 3 000 000 million doses of vaccines targeting
eight high risk districts were approved.
Two cholera treatment centres have been established, one
at Nsanje District Hospital and the other at Ndamera health
centre.
Cross-border surveillance engagements have been initiated
with Mozambique.
SITUATION INTERPRETATION
Cholera was first reported in Malawi in 1973 when the seventh
pandemic wave hit East Africa. From 1998 to date, cholera
cases have been reported every year with significant morbidity
and mortality on affected populations especially in the Southern
region, which is low lying, flat and prone to flooding during
the rainy season. The current cholera outbreak has shown an
increasing trend especially in Nsanje district where most cases
have been reported. A national coordination structure is in
place; however, the weak early warning and community-based
surveillance may increase the risk of a widespread outbreak.
PROPOSED ACTIONS
Hotspot districts should maintain a checklist of key cholera
preparedness items and stocks
WHO and MOH to follow up on cross border engagements
for a joint cholera response with Mozambique
Strengthen routine integrated surveillance and response,
including trend analyses for routine monitoring and early
detection
View/Open
OEW14-280303042022.pdf (1.938Mb)
https://apps.who.int/iris/handle/10665/352849
DF