WEEKLY BULLETIN ON OUTBREAKS
AND OTHER EMERGENCIES
Week 5: 23 to 29 January 2023
Data as reported by: 17:00; 29 January 2023
...
Cholera Mozambique
1 934 cases
18 Deaths
0.9% CFR
EVENT DESCRIPTION
The current cholera outbreak in Mozambique has been ongoing
since 14 September 2022, when a case was reported from Lago
district, Niassa province, in the northern region of the country,
bordering Malawi and Tanzania.
As of 21 January 2023, a cumulative total of 1 934 suspected
cases and 18 deaths (CFR 0.9%) have been reported in nine
districts from five of the country’s 11 provinces. Of the 66 cases
tested, 45 cases were laboratory confirmed as cholera by culture.
The number of districts reporting cases has increased over the
past 30 days. Niassa is by far the most affected province, with 1
376 suspected cases (71%) and 13 deaths (CFR 0.9%) reported
from the districts of Lago, Lichinga, Mecanhlas and Sanga.
In the central region, two districts (Caia and Marromeu) in Sofala
province reported 497 cases and one death (CFR 0.2%), while
one district (Tete City) in Tete province reported 11 cases and
no deaths. Milange district in Zambezia province, which borders
Malawi, reported 14 cases and no deaths. In the southern part of
the country, one district (Xai-Xai) in Gaza province reported 36
cases and four deaths (CFR 11%).
Notably, cases of acute watery diarrhoea (AWD) have been
reported in nine districts from four provinces: two districts
in Maputo City Province, five districts in Tete Province, one
district in Sofala Province and one district in Zambezia Province.
Samples from these cases have tested positive for cholera by
rapid diagnostic test (RDT) and culture results are pending.
Since 2017, cholera outbreaks have been reported annually in
Mozambique during the hot and rainy seasons (January to April
and October to December), mainly in the provinces of Nampula,
Cabo Delgado, Sofala, and Tete. Prior to the current outbreak,
cholera outbreaks unrelated to the current one occurred in the first
two quarters of 2022, with a total of 3 480 cases and 15 deaths
(CFR 0.4%) reported in eight districts from three provinces that
were declared controlled.
The current outbreak is more geographically widespread than
the outbreaks reported in 2019-2022, when no more than three
provinces were affected during the year. In addition, while some
central and northern provinces report cases every year, the
currently affected provinces of Gaza and Maputo in the south of
the country had not reported cases for more than five years.
PUBLIC HEALTH ACTIONS
The Ministry of Health issued a cholera alert to provinces,
districts, and health facilities on December 28, 2022,
emphasizing the importance of early detection, confirmation,
reporting, and management of suspected cases and the
establishment of multisectoral coordination in provinces and
districts.
At the national level, a cholera task force has been activated
under the leadership of the National Public Health Directorate.
Response activities are underway, including field
investigations, enhanced surveillance, laboratory testing,
case management, risk communication and community
engagement (RCCE), and Water, Sanitation and Hygiene
(WASH) activities to prevent and control the spread of the
disease.
Public messages about cholera and the current situation
are being disseminated through media and digital platforms
to raise awareness of cholera prevention measures and
encourage early treatment seeking.
SITUATION INTERPRETATION
Currently, nine districts from five provinces are reporting cholera
cases, and nine additional districts from four provinces including
the capital, Maputo are reporting AWD cases with positive
cholera RDT results. If an outbreak of cholera is confirmed in
Maputo, this could lead to a large outbreak and increase the risk
of transmission in the country and to surrounding countries due
to the high level of population movement through Maputo. There
is a need to build the capacity of healthcare workers in case
management and other response pillars, as most of the affected
districts, particularly in Niassa Province, have not reported a
cholera case for more than five years.
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https://apps.who.int/iris/bitstream/handle/10665/365810/OEW05-232901.pdf