10 out of the 21 countries in Eastern and Southern Africa Region (ESAR) have reported more than 36,257 cholera / AWD cases and 425 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 28.5 % (10,318) of the total case load reported this year, followed by Somalia at 17.2% (6,225).
Out of the 10 countries with reported cholera/ AWD outbreaks this year in ESAR, 4 (Zimbabwe, Angola, Somalia and Tanzania) have ongoing cholera outbreaks. During the week under review, Zimbabwe reported the highest number of new cases (81 cases). Of the four countries with active transmission, Tanzania has recorded the highest CFR (at 1.9%) in 2018.
Zimbabwe: The weekly number of cases continue to show a downward trend since week 42. During week 46 (week ending 18 November 2018), 81 new cases were reported compared to 94 cases reported in week 45 (week ending 11 November 2018). All new cases emerged from Harare. Cumulatively, a total of 10,318 cases including 61 deaths have been reported in 2018. Majority of these cases (98.3%, 10,141) and deaths (90%. 55) have been reported since the beginning of the new wave of the outbreak on 5 September 2018.
Angola: A new wave of cholera outbreak is hitting Uige, since week 38 (week ending 23 September 2018). From the onset of this outbreak, 139 cases including 2 deaths have been reported, as of epidemiological week 46. Cumulatively, 1,091 cases including 17 deaths (CFR 1.6%) have been reported since the beginning of 2018.
Tanzania: A decline in the epidemic trend has been noted. During week 45, 16 new cases were reported compared to 47 cases reported in week 44 (week ending 4 November 2018). All new cases emerged from Ngorongoro district in Arusha region. Cumulatively a total of 32,996 cases including 548 deaths have been reported in Tanzania mainland, as from August 2015. Of these, a total of 4,365 (13.2%) cases and 82 (15%) deaths have been reported since the beginning of 2018.
Somalia: During week 44, 19 new cases including 1 death (CFR, 5.3%) were reported from Banadir Region compared to 22 cases reported in week 43 (28 October 2018). Cumulatively a total of 6,630 cases including 43 deaths have been reported, as from December 2017. Of these, a total of 6,225 (93.9%) cases and 42 (97.7%) deaths have been reported since the beginning of 2018.
Analysis of Cholera Cases by Residence (As from 1 January 2018)
More cholera cases emerge from urban areas as compared to rural areas. An analysis of cholera cases reported in 2018 from six countries (Angola, Kenya, Mozambique, Malawi, Uganda and Zimbabwe) reveals that overall, urban areas account for 68.6% (14,779 cases) of the total caseload while rural areas account for 31.4% (6,758 cases). Zimbabwe accounts for the highest number of cases (68%, 10,056) reported in urban areas, followed by Uganda (15.6%, 2307). However it’s a contrasting scenario for Kenya and Malawi, reporting higher cases in rural than urban areas, with Kenya reporting the highest number of cases (5525, 81.8%) in rural areas.