General Context
Fighting in eastern DRC and the humanitarian situation in Zimbabwe continue to focus the attention of the international and humanitarian community. Other Political crises leading to insecurity, displacement of populations in some countries are still on-going. Diseases outbreaks continue to strike several countries.
Countries Situations
Acute Crises
- CAR: High concern over security situation in many areas continues especially in the Northwest in view of the approaching date for the beginning of the Global and Inclusive Peace Dialogue of 5th of December 2008. Five cases of meningitis notified in week 47 from Bossangoa Regional Hospital (1), Kabo (2) and Bouar (2). WHO in partnership with local health authorities and MSF is monitoring the situation.
- Chad: The security situation in the East is still unpredictable with isolated incidents such as the Inter community confrontation between Tama and Zagawa in Toro claiming 5 deaths and tens injured on the 20th November 2008. Measles outbreak with 213 cases reported in eastern Chad in week 47 mainly from health district of Abeche (133 cases 1 death). WHO is supporting the surveillance and case management activities.
- DRC: Fighting continues in eastern DRC. Humanitarian situation continues to worsen with escalation of sexual violence, killing and damages. Many IDPs in North Kivu urgently need healthcare amid an increase in the number of cholera, gunshot injury and malnutrition cases being reported. The cholera outbreak is ongoing, during week 47 a total of 466 new suspected cholera cases including 2 deaths (CFR 0.5%) were reported bringing the total for the whole province since January 2008 to 9,735 cases and 188 deaths (CFR 1.9 %). WHO is supporting the response with other partners.
- Ethiopia: Field reports indicate that prices of basic food commodities declined likely linked to the availability of new harvests but remained much higher as compared to a normal year. In Somali Region, approximately 117, 200 flood affected require emergency assistance. In week 47, no new case of Acute Watery Diarrhea (AWD) has been reported nationally since the past two weeks. Cumulative cases and deaths were 3,804 and 23 respectively reported nationally (Case Fatality Rate: 0.6%) as of 23rd of November 2008.
- Kenya: The military operation following the inter-clan conflict in Mandera and the northeastern parts of the country is on-going. This also led to displacement of people leading to establishment of Internally Displaced persons in temporary camps. There is upsurge of reported acute watery diarrhea cases in the 3 districts of Mandera with 1,046 cases, 12 deaths (CFR: 1.1%) reported between 28th October and 17th November 2008. A Technical team of Ministry of Health, Provincial Health and WHO are assessing the situation.
- Zimbabwe: The Cholera outbreak is not under control. The Government has appealed for International aid to respond to the outbreak. A cumulative of 8,887 cases with 366 deaths was reported as of 26 November 2008. Reports of additional cases from neighboring South Africa indicate an alarming regional dimension. WHO is supporting the national authorities to respond to the outbreak. To date there is still no agreement on the power sharing arrangement since the SADC summit in South Africa.
Countries Under Surveillance
- Angola: The cholera outbreak is of high concern. 4 provinces - Uije, Kwanza Sul, Huila and Zaire - are now affected. In week 47 a total of 86 new cases and 3 deaths were reported. From January to November 23rd 2008, a cumulative total of 9,859 cases and 229 cases (CFR: 2.3%) were reported. WHO is supporting the National and Provincial Cholera Task Force to strengthen coordination and response activities.
- Côte d'Ivoire: November poll officially canceled, new date to be announced. The UN Security Council expressed its deep concern about this delay which could put at risk the peace process. Unidentified gunmen attacked an arms depot in the North, many killed.
- Guinea-Bissau: The trend of cholera outbreak continued to decline. 49 cases were reported in week 48. A cumulative total of 14,180 cases and 222 deaths have been reported since the beginning of the outbreak.
- Mozambique: The cholera outbreak is ongoing. Cumulative total since week 34 is 1,071 cases with 19 deaths. WHO and partners are supporting the control of the outbreak.
- Niger: The cholera outbreak is totally under control. Since the beginning of the year 1,623,677 cases with 2,109 deaths of malnutrition have been reported. WHO is supporting the health authorities to coordinate all health activities.
- Nigeria: An outbreak of un-identified disease of children aged 6-24 months dying of Acute Renal Failure is going on since the last three weeks. As of November 28, a total of 56 with 40 deaths (CFR: 71.4%) have been reported. Blood samples are being collected for toxicology in South Africa. Post election intercommunal violence in Jos appears to have been contained by military intervention.
- South Africa: The cholera outbreak in Zimbabwe has already spread into South Africa, raising fears of a regional crisis. 7 people have died of cholera after leaving Zimbabwe.
- Uganda: The general situation is calm. Influx of refugees from DRC continues however, at a reduced rate. Total number of refugee influx is estimated at around 14,000 people.
For more information please contact: Dr Omar Khatib, Programme Manager, EHA/AFRO email: khatibo@afro.who.int