Cholera Cases On The Upswing - Director

Staff Writer
Cholera cases have been on the rise since last December. At a press briefing on the update on the cholera situation in Botswana, public health director Shenaaz El-Halabi sid by December 15, 2008, eight suspected cholera cases were reported, three of which were confirmed.

She revealed that since February 24 this year, 55 suspected cases of cholera have been reported in various districts. El-Halabi said of the 55, 15 have been confirmed to be cholera and of the number, two deaths have been reported at Princess Marina and Maun General hospitals. Both fatalities, she added, are a man and woman of Zimbabwean origin.

"All confirmed cases are adults, five males and 10 females. The nationalities of the confirmed cases are two Batswana, a Zambian and 12 Zimbabweans. The first Motswana case is originally from Zimbabwe, married to a Motswana and residing at Jacklas No. 10.

She has no history of having recently left Botswana. The second Motswana is from Palapye and has also reported never being out of the country recently. Contact tracing is ongoing for these cases and steps to trace possible source of infection is also ongoing," she said.

El-Halabi explained that the Ministry of Health is collaborating with the Ministry of Local Government, the World Health Organisation (WHO), United Nations Children's Fund (UNICEF), Water Utilities Corporation (WUC) and other stakeholders to coordinate the national preparedness and response activities.

She also disclosed that the multi-sectoral National Cholera Containment Team (NCCT), chaired by her ministry, continues to meet, monitor and control the activities on cholera.

Between  December 29-30 a team from the NCCT visited the Raamokgwebana border post, Dukwi Refugee Camp and Tutume Sub-district to assess the risk levels, preparedness and provide technical assistance.

The Central Medical Stores (CMS) and the Food Control Laboratory, according to El-Halabi, have determined the required stock levels of supplies. CMS has the required stock of medical supplies to last for nine months.

They have also informed districts to strengthen contact tracing and carry out active surveillance for all suspected cholera cases.

"IEC (Independent Electoral Commission) materials, posters, leaflets and cholera guidelines to health workers were distributed to all districts. The Ministry of Health is also carrying out

a community mobilization campaign through the media and in collaboration with district authorities, communities, NGOs and the private sector," she said.

She added that a draft guide for street vendors has been developed. On the other hand, health workers in districts, El Halabi has said, are being trained on epidemic preparedness and response.

"Integrated Disease Surveillance and Response (IDSR) training is progress. For example in Tutume, health education assistants were trained, whilst in Francistown different health cadres are being trained.

Draft guidelines on how to handle and transport dead cholera victims by private mortuaries have been developed. These are still to be finalised and distributed," she said.

WHO representative Dr Eugene Nyarko said that in the Southern African Development Community (SADC) region   nine countries have been affected. These countries he said, are Botswana, Angola, Malawi, Mozambique, Namibia, South Africa, Swaziland, Zambia and Zimbabwe.

Since the outbreak began in mid-August last year, Dr Nyarko said, a cumulative total of 87, 219 cases and 3, 593 deaths have been reported.

In the SADC region Zimbabwe has the highest statistics, having reported 67, 945 cases and 3, 371 deaths, whilst South Africa has 6, 202 cases with 44 deaths. Mozambique has 4, 132 cases and 52 deaths.

"With support from WHO, UNICEF and other humanitarian partners, countries are closely monitoring the situation and are revising their contingency plans in anticipation that the number of people affected could exceed their planning figures as in the case of Zimbabwe," he said.

He said that though cholera and acute watery diarrhea outbreaks occur usually during the rainy season within the SADC region, it is important to note some of the major determinants of cholera outbreak which include; "inadequate access to water, sanitation, housing, food security, natural and man-made disasters. Insufficient health education, hygiene in the communities and negative behaviour such as handling of faeces, little or no hand-washing, especially after visiting the toilet," he said.



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