Cholera outbreaks in Malawi in 1998-2012: social and cultural challenges in prevention and control

Authors

  • Kelias Phiri Msyamboza World Health Organization, Malawi Country Office, Lilongwe, Malawi
  • Mathew Kagoli Ministry of Health, Lilongwe, Malawi
  • Maurice M'bang'ombe Ministry of Health, Lilongwe, Malawi
  • Sikhona Chipeta Ministry of Health, Lilongwe, Malawi
  • Humphrey Dzanjo Masuku Ministry of Health, Lilongwe, Malawi

DOI:

https://doi.org/10.3855/jidc.3506

Keywords:

cholera, sub-Saharan Africa, Malawi

Abstract

Introduction: Cholera still remains a significant cause of morbidity and mortality in developing countries, although comprehensive surveillance data to inform policy and strategies are scarce.

Methodology: A desk review of the national cholera database and zonal and districts reports was conducted. Interviews were conducted with district health management teams, health workers, and participants in communities in six districts affected by cholera in 2011/2012 to obtain data on water, sanitation, and sociocultural issues.

Results: From 1998 to 2012, cholera outbreaks occurred every year in Malawi, with the highest number of cases and deaths reported in 2001/2002 (33,546 cases, 968 deaths; case fatality rate [CFR] 2.3%). In 2011/2012, cholera outbreak was widespread in the southern region, affecting 10 out of 13 districts, where 1,806 cases and 38 deaths (CFR 2.1%) were reported. Unsafe water sources, lack of maintenance of broken boreholes, frequent breakdown of piped water supply, low coverage of pit latrines (range 40%-60%), lack of hand washing facilities (< 5%), salty borehole water, fishermen staying on Lake Chilwa, cross-border Malawi-Mozambique disease spread, and sociocultural issues were some of the causes of the persistent cholera outbreaks in Malawi.

Conclusions: Despite improvements in safe drinking water and sanitation, cholera is still a major public health problem. Introduction of a community-led total sanitation approach, use of social and cultural information in community mobilization strategies, and introduction of an oral cholera vaccine could help to eliminate cholera in Malawi.

Author Biographies

Kelias Phiri Msyamboza, World Health Organization, Malawi Country Office, Lilongwe, Malawi

Department of Disease Control and Prevention, World Health Organisation, Malawi Country Office.

Mathew Kagoli, Ministry of Health, Lilongwe, Malawi

Epidemiology Unit, Ministry of Health Headquarters, Lilongwe, Malawi.

Maurice M'bang'ombe, Ministry of Health, Lilongwe, Malawi

Epidemiology Unit, Ministry of Health Headquarters, Lilongwe, Malawi.

Sikhona Chipeta, Ministry of Health, Lilongwe, Malawi

Epidemiology Unit, Ministry of Health Headquarters, Lilongwe, Malawi.

Humphrey Dzanjo Masuku, Ministry of Health, Lilongwe, Malawi

Environmental Health Section, Ministry of Health Headquarters, Lilongwe, Malawi.

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Published

2014-06-11

How to Cite

1.
Msyamboza KP, Kagoli M, M’bang’ombe M, Chipeta S, Masuku HD (2014) Cholera outbreaks in Malawi in 1998-2012: social and cultural challenges in prevention and control. J Infect Dev Ctries 8:720–726. doi: 10.3855/jidc.3506

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Section

Original Articles