Sudan + 7 more

WHO EMRO Weekly Epidemiological Monitor: Volume 12, Issue 44 (03 November 2019)

Situation Report
Originally published
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Current major event

OCV campaign Sudan

In response to the current cholera outbreak in Sudan, the Federal Ministry of Health (FMoH) of Sudan conducted a reactive vaccination campaign using Oral Cholera Vaccine (OCV) that targeted 1.65 million people (1 year and older) from 8 affected localities of Blue Nile and Sennar states.
The first round of the campaign was conducted from 12 to 16 October 2019 through the partnership with the WHO, UNICEF, GAVI, MSF and other national and international agencies.

Editorial note

Sudan has experienced repeated outbreaks of cholera with 12 major outbreaks occurring since 1996, mostly with limited spread (1-3 states) except the 2016 outbreak. Since then, country capacities for cholera response have been strengthened. Nevertheless, the risk still remains high due to high Case Fatality Rates (CFR), and recurring floods which resulted in damaged infrastructure across the country. Also there gaps in resources, preparedness and response capacities at state and national levels.

On 8th September 2019, FMoH officially reported a cholera outbreak in the country. The aetiology of this outbreak was acknowledged by the FMoH as “cholera”. Initially the outbreak was reported from one of the localities in Blue Nile State and within a few days, it quickly spread to other localities of Blue Nile as well as to Sinner State. Since then it is evident that the disease has been spreading new localities and states with cases now also being reported from Khartoum State.

Till 29th October 2019, a total of 332 cases and 12 deaths (CFR 3.61%) have been reported from 12 localities in 3 states; Blue Nile, Sennar and Khartoum states of Sudan. A total of 44 samples has been collected and 30 of them tested positive for Vibrio cholera through culture.

As part of cholera response, the government of Sudan planned to conduct two-round of reactive oral cholera vaccination campaign in 8 primarily-affected localities of Blue Nile and Sennar States. The general objective of the vaccination campaign was to contribute the ongoing response interventions to control the cholera outbreak in Blue Nile and Sennar states through using Oral Cholera Vaccine (OCV), with specific objectives of (i) containing the outbreak in the affected areas and (ii) preventing further spread of cholera to other states. ICG approved Sudan’s proposal to conduct the OCV campaign targeting 1,648,659 persons and provided doses for the first round of campaign. The first round of the campaign was successfully conducted from 12th to 16th October 2019. The campaign strategy was fixed sites as well as by mobile teams to reach special population of the targeted areas. In some cases, the State Ministries of Health of Blue Nile and Sennar sent vaccination teams in the evening for house-to-house visit to cover the male population who were busy at work during daytime and could not show up at the vaccination centres. Regular monitoring and supervision of the campaign activities were conducted by partners and evening meetings were conducted in each locality during the campaign.

In Blue Nile state, 761,158 (85%) persons were reached with OCV against the targeted population of 895,481; whereas, in Sennar, out of 753,178 targeted population, the campaign covered 734,538 population (97.5%). The overall coverage was therefore more than 90% in the first round of the campaign.

Despite all challenges, especially difficult access to some of the target populations, the OCV campaign achieved its objectives. The FMoH and partners should sustain the collaborative efforts to conduct the second round of the said campaign and as well as for the joint activities to improve the water and sanitation conditions in the hotspot areas in order to prevent morbidity and mortality associated with cholera.