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Description of the Event
What happened, where and when?
Since the last months of 2022, Cameroon was plagued by multiple epidemics. This situation was compounded and exacerbated by the heavy rains and repeated ooding observed since August 2022, as well as by conicts and major population movements in many parts of the country. These factors created an environment conducive to the development of epidemics, and put pressure on the government's response capacity. Cholera and smallpox epidemics were particularly alarming and worrying in the Far North, South-West, North-West and Littoral regions. On October 17, 2022, the Ministry of Health asked the Cameroon Red Cross to increase its support for the response to these epidemics.
Cholera that had been raging in some regions for several months, spread to all regions of the country in 2023. As of April 23, 2023, there were 4 active regions in the epidemiological situation: Littoral, Centre, South and West. There were 16 active health districts, with a total of 15,631 notified cases and 321 recorded deaths, representing a case-fatality rate of 2.05%. Of all cases, 11.7% (1,833) were confirmed by culture. The median age of cases was 27, ranging from 0.2 to 103, and the sex ratio was 2.1, with twice as many men as women affected.
As for the monkeypox epidemic, it was declared in several regions of the country by the health authorities. On October 10, 2022, the South-West regional delegate confirmed cases of monkeypox. Despite the rapid implementation of the surveillance system, the epidemic rapidly spread to 6 regions, 5 of which were active, with a total of 10 active health districts. A total of 92 cases of smallpox were reported, 18 of which were confirmed from 76 samples. The epidemic caused three deaths, with an average case fatality rate of 3.2% for the country as a whole. Monkeypox was feared by the population as the disease is not well known to the general public. 15 cases were reported in 2023, with no confirmed or fatal cases. 8 of the cases were reported in the South-West region and 02 in the Littoral region.
The rainy season in the South-West, West, Centre, Littoral and many southern regions of the country had increased the risk of cholera since the end of February. The actions of the National Society were adjusted accordingly to reduce the risk of floods and help put a check on the deteriorating cholera situation.
Scope and Scale
Monkeypox is a public health emergency of international concern, with an unusually high number of cases and wide geographic spread. Cameroon is an endemic country and has witnessed several epizootic outbreaks in the past. The current epidemic is higher than the monkeypox epidemics observed over the last 60 years. Between January 2022 and April 2023, 9 confirmed cases of human monkeypox were reported. In Cameroon, monkeypox is classified as a priority zoonosis and poses challenges for public health officials and health care personnel. Health workers lacked knowledge and experience in detecting and managing monkeypox cases, and communities were not aware of the disease and how to prevent it. Multi-sectoral coordination of interventions between the human and animal health sectors was also needed. It was important to support the national preparedness and response to the monkeypox epidemic in Cameroon given the human and animal health, socio-cultural, environmental and economic consequences.
Cameroon experienced a rise in cholera cases over the past few years, with 4,500 cases and approximately 250 deaths reported between 2019 and 2021. After a period of latency in October and November 2021, there was a resurgence of the epidemic, with an exponential increase in the number of cases recorded per week. The movement of people between regions, including during the African Cup of Nations, likely contributed to the spread of the disease. Since November 2021, the Littoral and South-West regions reported over 94% of new cases, with the South-West alone reporting nearly 1,600 cumulative cases. As of March 2022, an upsurge of cholera cases was recorded, with the South-West being the most affected region.
As of 23 April, Cholera cases were still rising over the country with more cases in 4 regions (Littoral, Centre, South, and West). A new region (East ) declared a confirmed case on 1 May 2023.
The city of Buea experienced flooding on 18 March in several neighborhoods, including Bonalionga, Buea Town Market, and Muea, due to runoff from a long rainfall season. Material damages included the destruction of buildings and loss of personal belongings and merchandise. 4 people were severely injured and 2 people died, and about 700 people were displaced from their homes. Additional vulnerability conditions that led the NS to prioritize the increase of actions in the South West were floods and landslides were making people homeless and more exposed to cholera factors.