26mars2017

Cholera Platform

Against cholera

UNICEF Cholera factsheet

Guinea-Bissau Cholera Factsheet

OVERVIEW OF CHOLERA

Cholera was first reported in Guinea-Bissau in 1986. Since 1990, there has been a combination of outbreaks with either low numbers or very high numbers of cases, with the largest outbreaks seen in 1994, 1996, 1997, 2005 and 2008. (Fig. 1). Between 1996 and 2013, epidemiological surveillance reported 74,031 cases with 1,684 fatalities (case fatality rate ≈ 2.3%)1. Main outbreaks were reported in the capital Bissau, in Biombo region and in Bolama region known as the Bijagos Islands (Tab. I and Fig 2.). The country is affected by cross-border outbreaks, especially along its borders with Guinea in its coastal areas.

STRATEGIC RECOMMENDATIONS

In sectors regularly affected, preparedness and response plans should be developed and implemented including: (1) strengthening early detection and rapid response systems of which community based sur­veillance and cross-border alert; (2) setting up coordination mechanisms across the sectors and borders; (3) building capacity on outbreak management; (4) targeted pre-positioning of supplies and (5) preparing communications messages and plans (Tab. II, Type 1).

In 2010, a cross-sectional study was conducted to identify clusters of cases of the 2008 outbreak in the most affected neighbourhood of the capital (Bairro Bandim) in order to rationalise means and resources during a response and to target interventions6. The geo-referencing of patient home can provide real time information during an outbreak to response teams at city level. A 2012 study suggests that timely and targeted reactive vaccination with oral cholera vaccine, in particular in the neighbourhood of Bissau, can be a useful tool for controlling cholera outbreak throughout the city7.

Sustainable Water, Sanitation and Hygiene activities should be a priority in units regularly affected and with long outbreaks (Tab. II, Type 1). There is a need for multidisciplinary studies to identify long-term programmatic responses in types I and II hotspots (Tab. II).

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