10 out of the 21 countries in Eastern and Southern Africa Region (ESAR) have reported more than 34,965 cholera / AWD cases and 420 deaths (Case Fatality Rate, 1.2%), since the beginning of 2018. These countries include; Angola, Kenya, Malawi, Mozambique, Rwanda, Somalia, Tanzania, Uganda, Zambia and Zimbabwe. Zimbabwe accounts for 26.9 % (9,395) of the total case load reported this year, followed by Somalia at 17.5% (6,132).
Out of the 10 countries with reported cholera/ AWD outbreaks this year in ESAR, 5 (Zimbabwe, Tanzania, Somalia, Kenya and Uganda) have ongoing cholera outbreaks. During the week under review, Zimbabwe reported the highest number of new cases (386 cases). Of the five countries with active transmission, Tanzania has recorded the highest CFR (at 1.9%) in 2018.
Zimbabwe: The weekly case incidence has been on a downward trend in the past 3 weeks (week 39 to week 41), with an average of 41.5% weekly decline . During week 41 (week ending 14 October 2018), 386 new cases were reported compared to 1,000 cases including 6 deaths (CFR, 0.6%) reported in week 40 (week ending 7 October 2018). These new cases emerged from two provinces: Harare (only from Harare: 348 cases, and Chitungwiza: 6 cases), and Manicaland (only from Buhera: 32 cases). Cumulatively, a total of 9,395 cases including 58 deaths have been reported in 2018. Majority of these cases (98%, 9,218) and deaths (93%. 54) have been reported since the beginning of the new wave of the outbreak on 5 September 2018.
Tanzania: A decline in the epidemic trend has been noted. During week 41, 35 new cases including 1 death (CFR, 2.9%) were reported compared to 98 cases including 3 deaths (CFR, 3.1%) reported in week 40. These new cases are from 4 regions; Ngorongoro district in Arusha region (11 cases), Songwe DC in Songwe region (9 cases including 1 death), Simanjiro district in Manyara region (9 cases), and from Moshi DC in Kilimanjaro region (6 cases). Songwe and Kilimanjaro are new regions where cholera cases have been reported during the week under review. Cumulatively a total of 32,862 cases including 548 deaths have been reported in Tanzania mainland, as from August 2015. Of these, a total of 4,231 cases and 82 deaths have been reported since the beginning of 2018.
Somalia: During week 40, 23 new cases including 1 death (CFR, 4.3%) were reported compared to 29 cases reported in week 39 (week ending 30 September 2018). All new cases emerged from Banadir region. Cumulatively a total of 6,537 cases including 43 deaths have been reported since the beginning of the outbreak in December 2017. Of these, a total of 6,132 cases and 42 deaths have been reported in 2018.
Kenya: 7 new cases were reported from Isiolo County during week 41. Last case was reported in Turkana County on 18 September 2018, while Embu County reported 3 cases during week 40. Cumulatively a total of 26,591 cases including 421 deaths have been reported, as from October 2016. Of these, a total of 5,781 cases and 78 deaths have been reported since the beginning of 2018.
Uganda : A new outbreak was confirmed during week 41. 4 cases which were reported emerged from Kampala (2 cases) and Hoima/Kikuube districts (2 cases). Risk factors linked to this new outbreak include; population movement, poor sanitation and inadequate access to clean water