Epidemiology of the 2016 Cholera Outbreak of Chibombo District, Central Zambia

Abstract

Background: The first outbreak of cholera in Zambia was reported in 1977/1978, and then cases appeared again in 1982/1983. The first major outbreak occurred in 1990 and lasted until 1993. Since then, cholera cases have been registered every year except in 1994 and 1995. Generally most cases were recorded in the fishing camps of the rural areas and in the peri-urban areas of Lusaka and Copperbelt provinces. There is no documented evidence of previous cholera outbreaks in Chibombo district. An outbreak of cholera occurred in this area in 2016. The aim of the study was to document the epidemiological features of this outbreak
Methods: We used routine data of suspected and confirmed cholera cases in this area which covered the period from 09th February to 20th March 2016. Available information on the patients included stool culture results, household, sex, and age. Descriptive analysis involved the frequency of the various variables as percentages.
Results: A total of 23 suspected and confirmed cases were seen at the district health facility. Thirteen of the cases (57%) were from the same catchment area of which 4 (31%) were from the same household. Of these 10 were female. Of these 20 (87%) were adults and 3(13%) were children. Stool culture results were available for 18 (78%) of which 8 (45%) were positive for vibrio cholera. Of the cases that tested positive the index case was identified as a 62 year old woman who had travelled from an area experiencing an outbreak in Lusaka. On the other hand, of the 11 water samples available 2 (18%) were found to have faeces coliforms contamination. All patients were treated with ciprofloxacin and intravenous fluids. There was no related mortality.
Discussion: This was an imported outbreak with the index coming from an area experiencing an epidemic in Lusaka. Possible sources could have included water contaminated with faeces matter. There is need to raise awareness of cholera transmission whenever the country is experiencing outbreaks of cholera.
Conclusion: Even areas that have never experienced cholera outbreaks are at risk and there is need to raise awareness.