Malawian youth
Lilongwe/Geneva: Malawi is experiencing the deadliest outbreak of cholera in the country’s history. The widespread cholera outbreak, with 36 943 cases and 1210 associated deaths, has been reported from all 29 districts of the country since March 3, 2022.
Since the beginning of the outbreak, and as of February 3, 2023, the age group 21 to 30 years is the most affected (27.7% of cases) followed by the 11 to 20 age group (22.8%). Of all the cases,17 943 are males representing 57% of the caseload. Most deaths have been reported among those aged 60 years and above as of 29 January 2023. Most deaths have occurred among males (66%).
With a sharp increase in cases seen over the last month, fears are that the outbreak will continue to worsen without strong interventions, the World Health Organization warned in Geneva today.
In light of the ongoing rainy season, wide geographical spread, and a consistently high case fatality rate (CFR) of above 3%, the ongoing cholera outbreak was declared a public health emergency by the Malawi government on December 5, 2022.
Currently, the large geographic spread and the high number of reported cases in the country are stretching all capacity to respond to the outbreak, increasing the risk of serious public health impact.
The outbreak in Malawi is occurring against a backdrop of a surge in cholera outbreaks globally, which has constrained the availability of vaccines, tests, and treatments. Currently, 23 countries are experiencing cholera outbreaks, and a further 20 countries that share land borders with affected countries are at risk.
In total, more than 1 billion people around the world are directly at risk of cholera. “Around the world, we estimate that more people died from cholera last year than in the previous five years put together,” WHO Director-General Dr Tedros Adhanom Ghebreyesus said.
Cholera has been endemic in Malawi since 1998 with seasonal outbreaks reported during the rainy season (November through May). However, the current outbreak has extended through the dry season, with cases being reported since March 2022.
The current outbreak started in March 2022 in Machinga district following tropical storm ‘Ana’ (January 2022) and Cyclone ‘Gombe‘ (March 2022) which caused floods leading to the displacement of a population with low pre-existing immunity and had lack of access to safe water, sanitation, and hygiene. The outbreak was mainly limited to the flood-affected areas in the southern region until August 2022 when it spread to the northern and central parts of the country. Since December 2022 cases have spread back towards the south of the country with all regions affected including Blantyre and Lilongwe, the two main cities of the country.
From 1998 to date, cholera cases have been reported in the country, especially in the southern region, which is low-lying, flat, and prone to flooding during the rainy season. The highest numbers of cases and deaths were reported in 1998/99 (25 000 cases, 860 deaths, CFR 3.4%), 2001/02 (33 546 cases, 968 deaths, case fatality rate 2.3%), and 2008/09 (5751 cases, 125 deaths, CFR 2.2%).
– global bihari bureau
