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Table of Contents   
EDITORIAL COMMENTARY  
Year : 2017  |  Volume : 10  |  Issue : 5  |  Page : 1109-1110
Building an effective mechanism to respond to the repeated outbreaks of cholera in the african region


Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai, Chennai, Tamil Nadu, India

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Date of Web Publication6-Nov-2017
 

How to cite this article:
Shrivastava SR, Shrivastava PS, Ramasamy J. Building an effective mechanism to respond to the repeated outbreaks of cholera in the african region. Ann Trop Med Public Health 2017;10:1109-10

How to cite this URL:
Shrivastava SR, Shrivastava PS, Ramasamy J. Building an effective mechanism to respond to the repeated outbreaks of cholera in the african region. Ann Trop Med Public Health [serial online] 2017 [cited 2018 May 22];10:1109-10. Available from: http://www.atmph.org/text.asp?2017/10/5/1109/217534


Dear Editor,

Cholera is an acute diarrheal disease which is fatal if not treated promptly, and has been acknowledged as a major public health concern in many nations.[1] The global estimates suggest that each year, more than 1.5 million cases and close to 0.1 million deaths have been reported.[1] Over the years, the disease has presented in the form of number of outbreaks across various nations in the African region.[2] However, it has been extremely difficult and challenging for the health authorities to contain the disease as some of the nations are facing humanitarian emergencies while others are facing a threat of a major outbreak of yellow fever due to which the existing resources have been diverted.[2]

In 2015, disease outbreak had been reported in the Democratic Republic of the Congo (DRC), which till date has accounted for more than 9300 cases and in excess of 150 cause-specific deaths.[2] Infact, the outbreak has spread across many regions along the Congo River and a significant burden on the health system has been observed.[2] Another major outbreak has been reported in Tanzania and its neighboring nations, with more than 21,500 cases and in excess of 300 deaths have been reported in Tanzania alone.[1],[2]

To further add to the list, a new outbreak of the disease has been reported in August 2016 in the Central African Republic, which is already facing severe humanitarian crisis.[3] Infact, till date, 46 cases has been confirmed in laboratories, while 13 deaths have been reported across three different areas of the nation.[3] The source of the outbreak has been traced from an individual with a history of travel to the DRC (where the disease is endemic), and the disease is now spreading along the banks of the river.[3] It requires urgent attention from the stakeholders as many of the disease-specific predisposing factors (like human displacement, substandard drinking water, poor sanitation, lack of personal hygiene, limited access to health care services, poor awareness, unimmunized population, poor nutritional status, and so on.) are present in the region.[1],[3],[4]

Acknowledging the concern, the WHO has extended its support by establishing centers within the nation's existing infrastructure and special focus has been given to case management; disease surveillance; water, sanitation and hygiene promotion; risk communication and social mobilization; constant supply of logistics; and appropriate handling of dead bodies.[1],[2] Further, international agencies are engaged in the treatment of water sources and community awareness activities with the help of a mobile team in the affected regions.[3]

At the same time, it is crucial to realize that cholera has been often neglected in comparison with other infectious diseases which also possess an epidemic potential, as it is often considered as someone's destiny and interventions are generally reactive and short term in nature.[2],[4] Moreover, despite the availability of enough evidence-based data and appropriate measures to control the disease, they are not used optimally due to financial or human resource-related constraints.[2],[4] Not only that, it has even been observed that most of the measures implemented are not need-based, or do not meet the local requirements, and often are not directed against high-risk population groups.[1],[2],[4]

Thus, the need of the hour is to adopt a multidisciplinary approach to not only reduce the risk of disease outbreak, but even control the outbreak and minimize fatality.[1] The WHO has earmarked five key strategies to prevent or fast-track the control of disease outbreaks, namely political will and commitment (in terms of identified stakeholders at each level, formulation and implementation of national policies, resource allocation, among others.); improvement in surveillance mechanism (which involves strengthening detection, reporting, and confirmation activities through improved laboratories network); focus on water sanitation and hygiene promotion; improvement in community knowledge about different aspects of disease; and vaccinating people using oral cholera vaccine.[1],[4],[5]

To conclude, the frequency of the cholera outbreaks and the caseload in the African region has significantly increased, and hence it is extremely essential to acknowledge the disease as a public health priority and take targeted measures to minimize the sufferings of the poor population.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
   References Top

1.
World Health Organization. Cholera-Fact sheet N 107. 2015. Available from: http://www.who.int/mediacentre/factsheets/fs107/en/. [Last accessed on 2016 Aug 17].  Back to cited text no. 1
    
2.
World Health Organization. Epidemic focus: Cholera. Wkly Epidemiol Rec 2016;91:297-298.  Back to cited text no. 2
    
3.
World Health Organization. WHO heightens health response to cholera outbreak in CAR. 2016. Available from: http://www.afro.who.int/fr/republique-centrafricaine/press-materials/item/8889-who-heightens-health-response-to-cholera-outbreak-in-car.html. [Last accessed on 2016 Aug 17].  Back to cited text no. 3
    
4.
World Health Organization. New momentum in prevention, control and elimination of cholera in Africa: priority actions identified by affected countries. Wkly Epidemiol Rec 2016;91:305-14.  Back to cited text no. 4
    
5.
Peprah D, Palmer JJ, Rubin GJ, Abubakar A, Costa A, Martin S. et al. Perceptions of oral cholera vaccine and reasons for full, partial and non-acceptance during a humanitarian crisis in South Sudan.. Vaccine 2016;34:3823-827.  Back to cited text no. 5
    

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Correspondence Address:
Saurabh R Shrivastava
3rd Floor, Department of Community Medicine, Shri Sathya Sai Medical College and Research Institute, Ammapettai Village, Thiruporur, Guduvancherry Main Road, Sembakkam Post, Kancheepuram, Tamil Nadu
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1755-6783.217534

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