Malawi’s cholera cases still on the rise amid vaccine drive

MALAWI —Despite a nationwide vaccination campaign that started in May, Malawi is struggling to contain a cholera outbreak.

The number of cholera cases in Malawi increased dramatically during October, from 110 at the start of the month to 183 at the start of November.

The number of cholera infections has been rapidly increasing, with the total number of infections since the outbreak began in March at around 6,056, according to the health ministry earlier this week.

The current upsurge in cases is reported in the dry season which is traditionally a low transmission period for Malawi. 

The rainy period occurs from November through March which could increase cholera transmission across the region.

The outbreak is the most severe in Malawi in the past decade.

“It is one of the worst cholera outbreaks to hit Malawi in over ten years and this calls for all stakeholders within and beyond the health, water, and sanitation sectors to contribute to the cholera response,” said Health Minister Khumbize Chiponda.

The fight to contain cholera spread in Malawi still faces the challenge of inadequate financing. The funding GAP for the Cholera response plan stands at US$14 million, according Mr. Chiponda.

According to Crisis24, the Nkhata Bay District has been hit the hardest, with 1,128 cases and 31 deaths, followed by Nkhotakota (811 cases and 40 deaths), Rumphi (783 cases and 13 deaths), and Blantyre (650 cases and 26 deaths).

Most of the deaths occurred while in the communities or at health facilities after presenting at the facilities late for treatment.

The major factors associated with the cholera outbreak in the communities are poor food hygiene, lack of safe water, and low latrine coverage and usage (open defecation).

The government reported in August 2022 that the outbreak had spread from eight districts in May 2022 to ten districts.

At the time, George Mbotwa, a spokesperson for a health office in Nsanje district, which borders Mozambique, said the district’s continued cholera incidents were largely due to people moving between the two countries.

Malawi and Mozambique collaborated to set up vaccination sites on both sides of the border.

Cholera is an acute diarrheal infection caused by consuming contaminated food or water, and it is linked to poor sanitation.

Health Minister Khumbize Chiponda said several people infected with cholera were refusing to receive treatment for religious reasons while others were seeking medical attention only when it was already too late.

Chiponda urged all religious establishments to encourage their congregations to seek medical attention to avoid the unnecessary loss of life.

The Ministry of Health is using vaccination campaigns and contact tracing to slow the spread of the disease.

Malawi is facing multiple public health emergencies namely, COVID-19, polio, and cholera outbreaks, and the government is overwhelmed hence the need for more coordinated response strategy.

Kenya became the latest African country to report a new surge in cholera. The country’s health ministry has warned of dozens of confirmed cases across six counties.

The situation is even worse on the other side of the continent where Nigeria is experiencing a spike in cholera infections following extensive flooding.

Elsewhere, The Haitian Ministry of Health has reported a total of 3,429 suspected cases in 6 departments of the country from the notification of the first two confirmed cases of Vibrio cholerae in the greater Port-au-Prince area on 2 October 2022 to 30 October 2022.

The complex humanitarian and security crisis in Port-au-Prince and neighboring cities continue hampering access to health services and laboratories, therefore, epidemiological surveillance could be affected.

The unprecedented rise in cholera outbreaks worldwide has strained global supply of cholera vaccines causing the standard two-dose vaccination regimen in cholera outbreak response campaigns to be cut down to just a single dose.

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