Sudan Situation Report, 11 Sep 2019 [EN/AR]
Sudan's Federal Minister of Health Dr. Akram El Tom confirms 4 cholera cases in Blue Nile State. There are total of 41 suspected cholera cases, with two deaths reported.
On 10 September, the national Cholera Task Force was activated by the Federal Ministry of Health and WHO.
FMoH, WHO and UNICEF provided AWD kits to treat over 300 people. More kits will be delivered shortly.
State Ministry of Health in Blue Nile and UNICEF are supporting the water chlorination activities and hygiene awareness in AWD-affected areas.
Sudan's Federal Ministry of Health Confirms Cholera in Blue Nile State
Sudan's Federal Ministry of Health (FMoH) announced on 10 September that four out of the six samples obtained from patients with acute diarrhoea were positive for Vibreo cholera at the National Public Health Laboratory (NPHL). Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae.
As of 9 September 2019, a total of 41 suspected cholera cases, with two deaths - case fatality rate (CFR) of 3.57 per cent - were reported from Blue Nile State. With proper treatment, the case fatality rate for cholera should remain below 1 per cent. The first documented case was reported on 2 September 2019 from the Ganis Sharig (East) area in El Roseires town in Blue Nile. Four out of seven localities in Blue Nile reported suspected cholera cases, with the majority of cases reported in El Roseires (36 cases), Damazine (3 cases), Wad Almahi and Geissan with a single case each.
WHO commends the new Government of Sudan with regard to transparency and full implementation of the international health security measures and protocols in the country. The world health body also congratulated the Federal Minister of Health Dr. Akram El Tom on agreeing to announce confirmed cholera cases following taking the oath to lead the health sector in Sudan.
AWD and cholera response
On 10 September, the national Cholera Task Force (CTF) was activated by FMoH and WHO. They agreed on standard tools for collection, analysis and sharing surveillance data regarding acute watery diarrhea (AWD). AWD (one of the three clinical types of diarrhoea) lasts for several hours or days, and includes cholera, according to WHO. FMoH and WHO have distributed case definitions, treatment protocols, controlled temperature chain (CTC) infection prevention and control (IPC) guidelines, and other relevant documents. Further support will be provided by WHO for Rapid Response Team (RRT) training, deployment and supervision.
FMoH, WHO and UNICEF have already provided AWD kits (enough to treat 300 people) with three additional kits in the pipeline--one of which will reach Damazine on 11 September. In addition, IV fluids (Ringer lactate) and oral rehydration therapy supplies have already been provided for treatment of the patients. The timely clearance and movement of supplies will be critical to an effective response.
The State Ministry of Health (SMoH) in Blue Nile in partnership with UNICEF is supporting the water chlorination activities and hygiene awareness in AWD-affected areas of Blue Nile at household levels. A total of 604 home visits were carried out in the last three days in the Ganis area. All these houses were covered with awareness sessions and disinfected with chlorine. The 604 households received 6,040 bars of soap.
Water chlorination activities are underway at eight water sources connected with urban water network in both Damazine and Roseries towns. In addition, several open water sources have been chlorinated through volunteers who are working actively at the intake area and other open sources. The volunteers managed to chlorinate 1,340 donkey carts, 5200 jerrycans at water sources. OXFAM has installed two water tanks in the Ganis area of El Roseires town, which clean drinking water to the affected people.
Community Engagement and Prevention
Efforts to implement a communication strategy at the national and locality levels to empower the community are being ramped up. The health promotion department in SMoH and humanitarian partners are carrying out advocacy campaigns to raise awareness and promote prevention activities. Two hundred health promotion and community members (i.e., adolescent and youth groups) have been trained and will lead community engagement activities. These activities will focus on house-to-house visits, drama groups and mobile cinema.
In Blue Nile, four mobile cinema shows reaching 370 people were staged, five theatre shows reaching 1,420 people, and 16 health awareness messages were broadcast through radio. The total number of beneficiaries from radio messages represent 75 per cent of the state population (873,750). In addition, 22 public sessions were conducted reaching 465 people and informational materials were distributed to 51,135 people.
According to WHO, cholera remains a global threat to public health and an indicator of inequity and lack of social development. Researchers have estimated that every year, there are 1.3 to 4.0 million cases, and 21,000 to 143,000 deaths worldwide due to cholera. Cholera is an extremely virulent disease that can cause acute watery diarrhoea with severe dehydration. It takes between 12 hours and 5 days for a person to show symptoms after ingesting contaminated food or water. Cholera affects both children and adults and can kill within hours if untreated. Most people infected with Vibrio cholerae do not develop any symptoms, although the bacteria are present in their faeces for 1-10 days after infection and are shed back into the environment, potentially infecting other people. Cholera is often predictable, preventable and can ultimately be eliminated where access to clean water and sanitation facilities, and satisfactory hygiene conditions are ensured and sustained for the whole population.