A. Situation analysis
Description of the disaster
According to WHO Weekly Bulletin on Outbreaks and other Emergencies issued on 7 July 2019, from 25 April to 23 June 2019, 688 cholera cases, 23 confirmed and 15 associated deaths (Cholera case facility rate: 2.30%) have been reported from five regions in Ethiopia, including Addis Ababa administrative city. As of 7th July 2019, the number of regions affected by the cholera outbreak increased to seven (7). Afar and Diredawa regions are new regions to record and report cholera cases with the Afar region totalling 131 cases and one death. The most affected of all seven regions is Oromia (360 cases, 41%), followed by Amhara (202 cases, 23%), Afar (131 cases, 15%), Addis Ababa (125 cases, 14%), Somali (33 cases, 4%) and Tigray (19 cases, 2%). The main affected sub-cities of Addis Ababa are Kality and Addis Katema, which account for more than 50% of the cases reported in Addis Ababa. By 10 July 2019, the total number of deaths recorded was 17. Of these cases, 13 were confirmed by culture (5 in Oromia, 4 in Addis Ababa, 2 in Amhara and 2 in Tigray). The main identified risk factor is said to be the contaminated water sources.
Ethiopia has a low sanitation coverage and has been frequently affected by Acute Watery Diarrhoea and Cholera outbreaks. In Ethiopia, the general population have poor access to safe water and sanitation facilities, and the situation is worse for those in rural areas. The national sanitation coverage in Ethiopia is only 57% which translates to more than 45 million people without access to improved sanitation facilities. Health services records and community-based surveys indicate that diarrhoeal diseases are major causes of morbidity and mortality in Ethiopia because of low access to safe water and adequate sanitation.
Prior to this report from WHO, Ethiopian Public Health Institute (EPHI) confirmed the cholera outbreak in Oromia, Amhara, Somali and Tigray and the cases reported in Addis Ababa on 4th June 2019. As of 3rd July 2019, there were at least 871 cholera cases reported with 17 deaths:1 from Afar, 2 from Oromia and 14 from Amhara region.