The 2008 Cholera Epidemic in Zimbabwe: Experience of the icddr,b Team in the Field

Abstract

During August 2008–June 2009, an estimated 95,531 suspected cases of cholera and 4,282 deaths due to cholera were reported during the 2008 cholera outbreak in Zimbabwe. Despite the efforts by local and international organizations supported by the Zimbabwean Ministry of Health and Child Welfare in the establishment of cholera treatment centres throughout the country, the case-fatality rate (CFR) was much higher than expected. Over two-thirds of the deaths occurred in areas without access to treatment facilities, with the highest CFRs (>5%) reported from Masvingo, Manicaland, Mashonaland West, Mashonaland East, Midland, and Matabeleland North provinces. Some factors attributing to this high CFR included inappropriate cholera case management with inadequate use of oral rehydration therapy, inappropriate use of antibiotics, and a shortage of experienced healthcare professionals. The breakdown of both potable water and sanitation systems and the widespread contamination of available drinking-water sources were also considered responsible for the rapid and widespread distribution of the epidemic throughout the country. Training of healthcare professionals on appropriate cholera case management and implementation of recommended strategies to reduce the environmental contamination of drinking-water sources could have contributed to the progressive reduction in number of cases and deaths as observed at the end of February 2009.

Retrospective Analysis of Serotype Switching of Vibrio cholerae O1 in a Cholera Endemic Region Shows It Is a Non-random Process

“…It is caused by Vibrio cholerae bacteria of serogroup O1, whose propensity for epidemic and even pandemic spread can have devastating effects in terms of morbidity and mortality. Recent examples of severe epidemics leading to many thousands of deaths are those that occurred in Zimbabwe and Haiti [ 1 , 2 ]. Over the past nearly two centuries seven pandemics have been documented [ 3 ].…”

Responding to Cholera Outbreaks in Zimbabwe: Building Resilience over Time

“…The health system was dysfunctional as far as promoting provision of core health services because of the nationwide economic decline and staff attrition. For instance, most health workers including nurses, doctors, EHTs and laboratory scientist left for greener pastures either within or outside the country leaving RHCs without nurses and many district hospitals without doctors [21]. This left the health system poorly serviced by human resources [22].…”

“…The 2008/2009 cholera outbreak in the country drew a lot of interest from the local and international scenes including journalists, scientists and human rights activists [17][18][19][20][21][22]. From the documentation on the various themes pertaining to this outbreak the country remains with a wealth of information to learn from and avoid similar situations from happening in the future.…”

The Multi-Country Study on the Drivers of Violence Affecting Children in Zimbabwe: Using a mixed methods, multi-stakeholder approach to discover what drives violence

“…Health, education, and water and sanitation services were unfunded, while nearly half of the population required food assistance. Interruptions in water supply, failing sanitation systems and contaminated drinking water sources caused a deadly cholera outbreak in 2008-2009 (UNICEF, & Government of Zimbabwe, 2011), followed closely by a widespread measles outbreak in 2009 (Mowjee, 2011), symbolizing the breakdown in social service delivery (Ahmed et al, 2011).…”