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Comoros

UNICEF Comoros Humanitarian Situation Report No. 4 (Cholera): 15 April - 31 May 2024

Attachments

Highlights

  • Since the declaration of the cholera epidemic on 2 February 2024, and as of 26 May, Comoros has recorded 7,335 suspected cases of cholera and 121 deaths, representing a 1.6% case mortality rate.
  • All three islands continue to report cholera cases. Anjouan island is the epicentre of the epidemic.
  • Children and adolescents make up over 40% of reported cases.
  • Through a partnership between UNICEF, the Ministry of Health, and the Comorian Red Crescent, 13 Case Area Targeted Interventions (CATI) teams continued to respond across the three islands to prevent further cholera transmission. The teams have reached over 35,000 households with house decontamination and stop cholera kits, and over 135,000 individuals via door-to-door or small group interactions.
  • With the arrival of 872,301 doses of Euvichol Plus oral cholera vaccines (OCV) in Comoros, UNICEF has facilitated the safe transport of the vaccines to Anjouan and Moheli and is actively supporting preparation for the upcoming vaccination campaign.
  • Risk communication and community engagement (RCCE) efforts are ongoing with 71,400 people reached with direct person-to-person communication. UNICEF also trained 18 associations to support RCCE efforts.

Situation Overview & Humanitarian Needs

The cholera epidemic in the Union of the Comoros was officially declared on 2 February 2024. The last outbreak of the disease in the national territory dates back to 2007.

As of 26 May 2024, 7,735 suspected cases have been reported, placing this epidemic as the country's top public health emergency. Deaths have also significantly increased compared with the previous UNICEF situation report, with 121 now reported, of which more than 55% occurred at community level. The case mortality rate (deaths in communities and institutions) is at 1.6%. Continued denial of the epidemic in part of the population has likely played an important role in this high mortality rate.

All three islands of Comoros continued to experience local cholera transmission, with all 17 health districts in the country having reported cases since the start of the epidemic. Transmission has been relatively low in Grande Comore (Ngazidja) and Moheli (Mwali) during the reporting period, but very intense in Anjouan (Ndzuwani).

Since mid-April, Anjouan has been the epicentre of the epidemic. This island had totalled 6,265 suspected cases (85% of all reported cases in the country) as of 26 May. This surge in cases is attributed to the high number of deaths occurring in the community, including at least two in downtown Mutsamudu in mid-April. The burials were not secure and contributed to an exceptional outbreak of cholera less than a week after the burials, starting from Mutsamudu and then spreading to the entire island. Moreover, denial remains entrenched among parts of the population and continues to play a key role in the transmission of the disease.

The cities of Mutsamudu and Domoni have been particularly touched in Anjouan, but a near-generalization of transmission is visible in each of the main villages, such as Tsembehou, Mremani or Pomoni.

The cholera outbreak continues to pose significant risks to the community at large, with the potential for further transmission. Nationally, men account for 55% of all cholera cases, and children and adolescents remain at risk, representing over 40% of all cases.

This imported epidemic in the Union of Comoros has already spread to the neighbouring island of Mayotte, where 120 confirmed cases and 2 deaths have been reported as of 31 May. There is also a risk that the epidemic spreads further in the region, for instance to Madagascar.

In the urgent effort to control the cholera outbreak, UNICEF remains fully committed to supporting the Government of Comoros through close coordination and collaboration, enabling the necessary scaling up of efforts to address the key challenges faced.