Saturday, March 24, 2012

Cholera Sweeps Across Western and Central Africa by Catherine Vincent

       A woman cares for her child in Congo, which is battling a cholera epidemic. Photograph: Walter Astrada/AFP/Getty Images

Cameroon, Ghana, Nigeria, Congo and Chad account for most of the cases and fatalities, with deaths rates up to 5%

Western and central Africa are facing one of the biggest cholera epidemics in their history, the World Health Organisation and the United Nations Children's Fund said last month, in reporting that more than 85,000 cases of cholera have been registered since the beginning of the year, with nearly 2,500 deaths.

Unicef has identified three main cholera epidemic outbreaks in the Lake Chad basin, the West Congo basin and Lake Tanganyika. The disease, which is spreading along watercourses, has been made worse by the recent rainy season. Five countries – Cameroon, Ghana, Nigeria, the Democratic Republic of the Congo (RDC) and Chad – account for 90% of the reported cases and fatalities.

Cholera is an acute intestinal infection caused by the Vibrio cholerae bacillus. It is still one of the clearest indicators of social development. The disease spreads through water, which has been in contact with the faecal matter of infected people, reappearing periodically in countries unable to secure access to clean drinking water and adequate sanitation.

Almost all developing countries are plagued by occasional cholera epidemics, facilitated by the short incubation period, which ranges from two hours to five days. But it is a long time since central and western Africa suffered such a serious epidemic.

"The highest rates of contamination are in Chad, Cameroon – where nine out of 10 districts are affected – and western RDC, where the mortality rate is over 5%," Unicef spokeswoman Marixie Mercado said, adding that the rate is over 22% in some regions. These figures are particularly dramatic, given that with appropriate treatment – antibiotics and intravenous rehydration – mortality can be brought down to 1%.

One reason for the high mortality rate is the lack of medical care. A lack of public awareness is also a factor. The current peaks in the epidemic are in areas where the disease is not endemic, according to the UN agencies.

"We have just received reports of a sudden outbreak of cholera in the Central African Republic, where the disease has not been seen for years. That means people are less aware of how to prevent an epidemic and how to react," Mercado said. In Congo the disease reappeared in September in provinces where it had not been reported in the past decade.

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