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Bulletin: Cholera and AWD Outbreaks in Eastern and Southern Africa, Regional Update for 2018 - as of 22 April 2018

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Highlights

More than 15,042 cholera / AWD cases and 237 deaths (Case Fatality Rate, 1.6%) have been reported in 10 of 21 countries of Eastern and Southern Africa Region (ESAR) since the beginning of 2018. These countries include; Angola, Kenya, Malawi, Mozambique, Rwanda, Somalia, Tanzania, Uganda, Zambia and Zimbabwe.

Currently, 8 out of the 21 countries in ESAR are reporting active transmission of cholera / AWD (Kenya, Tanzania, Angola, Malawi, Uganda, Somalia, Zambia and Zimbambwe). During the week under review, Zambia reported the highest number of new cases (184 cases including 3 deaths), followed by Somalia (178 cases). Apart from Somalia, all countries with active transmission have recorded CFR above 1% in 2018, with Zimbabwe (CFR, 5.1%) and Malawi (CFR, 2.9%) recording the highest CFR.

Zambia: An increase in the epidemic trend has been noted. During week 15 (week ending 15 April 2018), 184 new cases including 3 deaths (CFR, 1.6%) were reported compared to 168 cases including 3 deaths (CFR, 1.8%) reported in week 14 (week ending 8 April 2018). These new cases emerged from the following districts; Lusaka, Kafue and Chilanga. Cumulatively, 5,706 cases including 113 deaths have been reported, as from October 2017. Of these, a total of 3,898 cases and 53 deaths have been reported since the beginning of 2018.

Somalia: During week 15, 178 new cases were reported compared to 214 cases reported in week 14. New cases emerged from Banadir (40) and Lower Jubba (138) regions. Cumulatively a total of 2,267 cases including 9 deaths have been reported, as from December 2017.

Tanzania: New outbreaks have been recorded in two districts; Longido District in Arusha region and Kigoma district in Kigoma region. Longido district reported 115 cases including 5 deaths (CFR, 4.3%) in week 16 (week ending 22 April 2018) and Kigoma district reported 138 cases including 1 death (CFR, 0.7%) during week 15. The outbreak in Kigoma started on 28 March 2018 in a national service camp.

Kenya: An increase in the epidemic trend has been noted. 87 new cases were reported in week 16 compared to 63 cases reported in week 15. New cases emerged from Garissa (53), Busia (1), Turkana (4) West Pokot (27) and Isiolo (2). The current outbreak is unusual because of its long duration. Cumulatively a total of 23,639 cases including 398 deaths have been reported, as from December 2014. Of these, a total of 2,829 cases and 55 deaths have been reported since the beginning of 2018.

Uganda: A decline in the epidemic trend has been noted. During week 15, 33 new cases were reported compared to 60 cases including 4 deaths (CFR, 6.7%) reported in week 14. These new cases are concentrated in Hoima district located in Western region. Cumulatively a total of 2,224 cases including 47 deaths have been reported since the outbreak started in February 2018. The majority of the affected people are refugees from the Democratic Republic of the Congo.

Zimbabwe: During week 15, 25 new cases including 1 death (CFR, 4%) were reported compared to 3 cases including 2 deaths (CFR, 66.7%) reported in week 14. These new cases emerged from Chitungwiza and Stoneridge (an informal settlement next to Chitungwiza but located in Harare city). Cumulatively, 135 cases including 7 deaths have been reported, as from January 2018, when the outbreak started.

Angola: A slight increase in the epidemic trend has been noted. 17 new cases were reported in week 15 compared to 13 cases reported in week 14. These new cases are concentrated in two provinces, namely Uige (13) and Cabinda (4). Cumulatively, 917 cases including 15 deaths have been reported, as from 15 December 2017. Of these, 814 cases and 9 deaths have been reported since the beginning of 2018.

Malawi: 15 new cases were reported in week 15. These new cases emerged from Lilongwe district.
Cumulatively a total of 904 cases and 30 deaths have been reported, as from November 2017. Of these, 749 cases and 22 deaths have been reported since the beginning of 2018. 60% of the total deaths recorded since November 2017 are facility deaths and the remaining 40% are community deaths.