Cholera

Health authorities in KwaZulu-Natal have put in place precautionary measures after a suspected cholera outbreak on the south coast.

Harare - A cholera outbreak that has hit several Zimbabwean districts has claimed five more lives in the capital Harare, taking the death toll countrywide to almost 30, the official Herald newspaper said on Monday.

Thirteen people in the Eastern Cape have died from cholera and more than a hundred had to be treated in hospital for the disease after a recent outbreak. The provincial government has promised the affected communities emergency medical resources to stop the spreading of the disease

Mozambique's Deputy Health Minister Aida Libombo admitted on Wednesday that cases of cholera have increased in the country, but the number of deaths and the fatality rate have dropped significantly, when compared with past outbreaks. Addressing questions tabled by the ruling Frelimo party on the cholera situation in the country, she told the Assembly of the Republic, the Mozambican parliament, that since November 2003 up until 26 February, the total number of cases diagnosed throughout the country was 10,977 patients, with 68 deaths. The case fatality rate is thus 0.6 per cent in this outbreak.

Reports that an outbreak of cholera in the Eastern Cape has resulted in 1 000 people being admitted to hospitals and clinics in the province over the past week are not correct, the department of health said on Sunday. Provincial health spokesman Sizwe Kupelo told Sapa that 192 people, mainly from the O R Tambo and Chris Hani districts, had been treated for cholera over the past seven days. Four people had died from the waterborne disease. Since December 23 last year, a total of 13 people in the province have died as a result of cholera, and a total of 812 have been treated for the disease. He said the outbreak appears to be contained. All those treated over the past week had been sent home. The situation is under control. Kupelo said members of a joint health and water departments' task team remained on stand-by in the region to cope with any possible resurgence of the disease. A house-to-house campaign by team members over the past few days was responsible for the rise in the number of people treated. We treated every complaint of diarrhoea as a cholera case, he said. According to news reports on Sunday, a total of 1 000 villagers from the O R Tambo and Chris Hani districts have been admitted to local clinics with cholera in the last week. A local health manager, Nomonde Mbana, said the Tsomo and Cofimvaba clinics had been notified by All Saint's Hospital last Friday that there was a massive cholera outbreak, the reports said. Health Minister Manto Tshabalala-Msimang last week said the outbreak of cholera in the Eastern Cape appeared to be under control, and different government departments were working together to minimise the threat. (Source: SAPA, 23 February 2003 )

Washington - A folded sari, available to every woman in Bangladesh, can filter enough cholera-carrying particles from drinking water to halve the number of cases of the disease, researchers reported on Monday. The study, published in this week's issue of the Proceedings of the National Academy of Sciences, shows that low-tech solutions can save lives, the international team of researchers said. Tests covering 133 000 people in 65 Bangladeshi villages showed that when women were taught to use a folded sari to filter drinking water, incidences of cholera dropped by 48 percent. The researchers now plan a large-scale education campaign. The team has been working on the idea of filtering drinking water for years. In 1996, they carried out a small study that showed a folded sari could filter out much of the cholera-carrying plankton. The most recent report is the result of testing the idea across much of Bangladesh. Once the cloth dries out, the bacteria die. Folding a sari to give eight layers filters out virtually all the cholera, but women - who gather the water in Bangladeshi society - did not tend to do this, Huq said. The flow of water becomes very slow. We could not implement it in the village because women collecting water were not ready to spend five to seven minutes to wait for the water to collect, he said.With four layers it was a zip. Bangladeshi villagers often filter water through a piece of cloth, but they do not usually fold it. Folding the thin sari cloth greatly increased its filtering power, the researchers found. Now the team wants to find out if other items of clothing used in other countries will work as well.(Source: Maggie Fox, IOL, 15 January 2003)

The United Nations Children's Fund (Unicef) says about 935 000 children and 408 000 women in rural Matabeleland provinces were suffering from diarrhoeal diseases, including cholera and dysentery, due to poor access to adequate and safe water and poor hygiene. In its report to James Morris, the UN secretary-general's special envoy for humanitarian needs in southern Africa during his visit last week, Unicef said it had supported the control of cholera outbreaks in seven districts. The districts covered include Kezi, Nkayi, Gwanda and Matopo. Unicef said: This was through provision of water treatment tablets, water tanks, chlorine of lime, plastic sheets and information, education and communication material for cholera prevention. This response has proven to be effective. The UN agency said they conducted an assessment of the consequences of the drought, Cyclone Eline and the agrarian reform in May, as they related to the accessibility to safe water and sanitation facilities. The report said based on the assessment, priority areas for further intervention were identified and the organisation would implement several projects in the areas. Unicef said it would provide technical support in institutional capacity development at local, district, provincial and national levels for effective response to the emergency situation. Other projects to be funded include the development of community skills in latrine construction and repair of water pumps, monitoring of drinking water quality, promotion of sustainable community management of water and sanitation facilities. Unicef said it would help treat water supplies in targeted vulnerable communities and provide water trucking to communities without water. We will support advocacy activities for emergency water and sanitation, the report said. This will include the construction of family, institution and school latrines in the most vulnerable communities. It would also rehabilitate broken-down and dried-up wells and boreholes. (Staff Reporter, The Daily News (Harare)September 10, 2002 )

KwaZulu-Natal health MEC Zweli Mkhize announced Wednesday that in most of the province's districts there had been no new cases of cholera reported since the beginning of the month. Mkhize said the decline could be attributed to the cold weather and lack of heavy rainfall but that surveillance, monitoring and medical intervention would continue unabated till the epidemic was completely eradicated. Only isolated cases have been found in Umkhanyakude, Uthungulu, Amajuba and Llembe districts in KwaZulu-Natal, with an average of three or less cases being reported a day, Mkhize said. Mkhize also said that although the situation was currently under control, communities were advised to continue taking precautionary measures and only use clean, treated water. There have been 120 368 reported cases of cholera and 289 reported cholera deaths in the last three years since the epidemic broke out. (Source: SAPA, 17 July 2002)

The governments policy of cutting off water supplies to poor rural communities that cannot pay for the service may be the target of class action, writes Tony Carnie

A 2000-2002 case study of the source of the outbreak in the Madlebe Tribal Authority areas, uThungulu Region, KwaZulu-Natal. The cholera epidemic that burst on to the national health map in August 2000 in KwaZulu-Natal continues. New cases are reported almost daily in the province and elsewhere in the country without the unease of its recurrence abating. 114,000 cases and over 260 deaths have been reported in the province to date. Recent research conducted by RDSN and ILRIG with SAMWU support reveals stark new evidence of the causes of the outbreak. The ramifications of these findings include the culpability of the water service authority and the Department of Water Affairs and Forestry for the outbreak, and a reappraisal of primary health care systems. After government’s claims of meeting over half the 1994 backlog in water services, political mismanagement of the environment has left poor, rural communities ‘endlessly marking time’. The cholera epidemic is asking how history’s victims can ever escape. The Cholera Outbreak will be launched with a half-day workshop: Date: Monday, 25 March 2002 Venue: Tropicana Hotel 85 Marine Parade South Beach Durban Time: 8h30 registration to 14h00 (includes lunch) Please confirm your attendance with Rosina at (011) 403-7324, rosina@rdsn.org.za or Jurie at (031) 307-2954 , jurie@healthlink.org.za by Monday, 18 March.