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What happened, where and when?
Ministry of Health declared the Cholera outbreak in Zambia in a Press conference on 26 January (source: https://fb.watch/imqJpL5EZq/?mibextid=NnVzG8). The Minister indicated that the Ministry is doing everything possible to curb the transmissions the Provincial Health offices are supporting the District Rapid Response team to urgently control the spread of the disease.
The first case was reported on 21 January 2023 involving a male aged 22 from Kamtsekelo village under Chikoma Health Centre(HC) and a female patient from Mbande in Vubwi District who presented with Acute Watery Diarrhea (AWD) and dehydration. A female patient has just come back from Mozambique to nurse her sick mother. Both patients tested positive for cholera.
The epidemic count of 21 cases registered from 21st to 30 January 2023 in the Vubwi district. On 27 January, there were 13 suspected cases, 6 confirmed, 12 admitted, 7 discharged, and one death. The Ministry of Health (MoH) has indeed declared the vigilance state to the population at risk (53,080 people) and requested all stakeholders to support the efforts to stop the spread of this outbreak. According to the minister, 719 people have been identified as contact persons in six villages.
Zambia has experienced Cholera since 1977 with Lusaka being one of the highest hotspots of cholera in the Country. However, aside from Lusaka, analysis has shown that additional main hotspot districts all share borders or roads with Zambia’s neighboring countries. This is the case for the Vibwu district located in the Eastern province which lies between the Luangwa River and borders Malawi to the east and Mozambique to the south. The current outbreak is driven by cross-border transmission in addition to ZAMBIA's own socio-community, economic factors, and structural factors. The Lusaka outbreak on 18th April was 16 cases with 8 confirmed and was contained within a short period of time. Lusaka district is more urban than the current affected area and even considering that Lusaka has limited social amenities, Vubwi district as a newly created district is rural with the lowest infrastructure, poor WASH facilities, and new on experiencing cholera. Also, the previous outbreak in Lusaka was not in the context of the severe ongoing outbreaks in others surrounding countries and the current level of regional risk.
Note, the cholera elimination in Zambia National Cholera Eliminating Plan (NCEP) by 2025 and guidance of the Global Task Force on Cholera Control’s (GTFCC) global roadmap by 2030 have all identified the cholera elimination as a regional strategy involving each of the bordering countries will be needed. The elimination of Cholera in Zambia and surrounding countries can only be achieved through a coordinated sub-regional response. Zambia is a landlocked country bordered by five cholera-endemic countries in the Cholera belt in Africa. Malawi and Mozambique to the east, DRC and Tanzania to the north, and Zimbabwe to the south. All experiencing regular cholera outbreaks and some with an ongoing cholera outbreak. The IFRC strategy to support the Zambia Red Cross response plan is aligned with this roadmap as well as current support in Mozambique and Malawi. Other bordering countries are under constant surveillance by National societies. Retrospective cholera case data analysis have been published here https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0008227 and chrome-extension://efaidnbmnnnibpcajpcglclefindmkaj/https://www.gtfcc.org/wp-content/uploads/2021/04/6th-meeting-of-the-gtfcc-working-group-on-wash-2021-webinar-2-fred-kapaya.pdf).