Relief groups report rising cholera in Africa, Haiti

Lisa Schnirring Staff Writer

Oct 11, 2011 (CIDRAP News) – Health groups fighting cholera outbreaks in Africa and Haiti are reporting increasing numbers of cases, prompting calls for more attention and coordination from the global community.

The United Nations Children's Fund (UNICEF) said today in a statement that the cholera epidemic in West and Central Africa is one of the worst the area has ever seen. So far this year more than 85,000 cases have been reported in the region, including 2,466 deaths.

Case-fatality rates (CFRs) are "unacceptably high," ranging from 2.3% to 4.7%, but spiking much higher in places, such as parts of Cameroon, which have reported CFRs as high as 22%, UNICEF said. The group warned that children, especially malnourished ones, are more vulnerable to cholera, because they are more prone to dehydration.

Chad, Cameroon, and the western Democratic Republic of the Congo have experienced the most striking increases in cholera activity this year, according to UNICEF. Three areas of major cross-border cholera activity include the Lake Chad Basin, West Congo Basin, and Lake Tanganyika.

Smaller cholera epidemics are under control in several countries, including Benin, Cote d’Ivoire, Ghana, Guinea, Liberia, and Togo, the agency reported.

UNICEF said it is calling on governments to coordinate preparedness and response activities within their own borders and also to collaborate closely with neighboring countries.

Poor access to water and sanitation is the underlying cause of cholera outbreaks in West and Central Africa, according to UNICEF, which pointed out that none of the 24 countries in the region are on track to reach the UN Millennium Development Goals for sanitation. Though response efforts can help slow the spread of the disease and mounting deaths, a more effective disease-control measure would be to improve access to clean water and sanitation.

Meanwhile in Haiti, Doctors Without Borders is seeing an increase in the numbers of patients treated at four cholera clinics in Port-au-Prince, the group reported on Oct 7. It said that though the world is paying less attention to Haiti's cholera outbreak now, the disease is still common and is far from being under control.

Gaetan Drossart, head of the Doctors Without Borders mission in Haiti, said in the statement that in the past month, treatment center admissions have risen from less than 300 per week to more than 850, which he said is a worrisome sign that the outbreak could worsen over next weeks. The group also has treatment centers in Artibonite, North, and West departments.

Another Doctors Without Borders official, Pascale Zintzen, linked rising cholera cases in Haiti's capital to the year's second rainy season, which causes flooding and the spread of the waterborne disease in the crowded city, which lacks sanitation, the Associated Press (AP) reported yesterday.

The group said the number of new cases is still far less than in the first rainy season in May, when the centers in Port-au-Prince treated about 2,300 patients in a week, according to the AP story. So far the outbreak in Haiti has sickened about 440,000 people and led to more than 6,200 deaths.

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