Abstract
Cholera still remains a significant cause of morbidity and mortality in developing countries, although comprehensive surveillance data to inform policy and strategies are scarce. A desk review of the national cholera database and zonal and districts reports was conducted. Interviews were conducted with district health management teams, health workers, and participants in communities in six districts affected by cholera in 2011/2012 to obtain data on water, sanitation, and sociocultural issues. From 1998 to 2012, cholera outbreaks occurred every year in Malawi, with the highest number of cases and deaths reported in 2001/2002 (33,546 cases, 968 deaths; case fatality rate [CFR] 2.3%). In 2011/2012, cholera outbreak was widespread in the southern region, affecting 10 out of 13 districts, where 1,806 cases and 38 deaths (CFR 2.1%) were reported. Unsafe water sources, lack of maintenance of broken boreholes, frequent breakdown of piped water supply, low coverage of pit latrines (range 40%-60%), lack of hand washing facilities (< 5%), salty borehole water, fishermen staying on Lake Chilwa, cross-border Malawi-Mozambique disease spread, and sociocultural issues were some of the causes of the persistent cholera outbreaks in Malawi. Despite improvements in safe drinking water and sanitation, cholera is still a major public health problem. Introduction of a community-led total sanitation approach, use of social and cultural information in community mobilization strategies, and introduction of an oral cholera vaccine could help to eliminate cholera in Malawi.
Highlights
Cholera still remains a significant cause of morbidity and mortality in developing countries, comprehensive surveillance data to inform policy and strategies are scarce
Cholera is an acute diarrheal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae O1 or O139, which can lead to rapid dehydration and death if left untreated
In 2012, the World Health Organization (WHO) estimated that every year, there are 3–5 million cholera cases and more than 100,000 people die of the disease, with the majority (99%) of the cases and deaths occurring in sub-Saharan Africa and southern Asia [2,3,4]
Summary
Cholera still remains a significant cause of morbidity and mortality in developing countries, comprehensive surveillance data to inform policy and strategies are scarce. Interviews were conducted with district health management teams, health workers, and participants in communities in six districts affected by cholera in 2011/2012 to obtain data on water, sanitation, and sociocultural issues. In 2011/2012, cholera outbreak was widespread in the southern region, affecting 10 out of 13 districts, where 1,806 cases and 38 deaths (CFR 2.1%) were reported. With the potential to cause many deaths, spread quickly and eventually internationally, and seriously affect travel and trade, cholera is one of the global threats to public health [1]. In 2012, the World Health Organization (WHO) estimated that every year, there are 3–5 million cholera cases and more than 100,000 people die of the disease, with the majority (99%) of the cases and deaths occurring in sub-Saharan Africa and southern Asia [2,3,4]. In contrast to the persisting situation in Africa, cholera was largely eliminated from Latin America within a decade [4,5,6,7,8]
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
