Timely Response and Containment of 2016 Cholera Outbreak in Northern Zambia

Abstract

Background:  The Northern Province of Zambia has recorded outbreaks of Cholera in Nsumbu area over the years including the year 2008 and 2012. Recently, an outbreak of cholera was reported in Northern Province between March and April 2016. This study aims to document the appropriateness of the response to the cholera outbreak to guide outbreak preparedness and timely response in the future.

Method: A prospective study where a team was put in place to investigate an outbreak of diarrhoeal disease of undetermined cause. The team comprising of surveillance, medical, environmental and laboratory staff was formed to investigate this outbreak within the context of cholera an on-going cholera epidemic Lusaka and other parts of Zambia.

Stool samples and water samples were taken for laboratory investigations. Various interventions including contact tracing and community sensitisation were employed to contain the outbreak. A descriptive analysis of the data and review of literature was used to determine the quality of detection, investigation and response to this cholera outbreak.

Results: Sixty six people were clinically affected 8 of who were laboratory confirmed for strain 01 Ogawa. The case fatality rate (CFR) was 4.5%(3/66). The outbreak was detected and contained within 24 days.

Discussion: The CFR was high compared to the WHO standards of a similar scenario in the 2012 outbreak in the same area. Of the 3 deaths, one was brought in dead and a week into the outbreak while the other two died at the health facility.   The two fell sick in Congo DR and brought to Kapisha health post for treatment. Although the high CFR indicates inadequate response or poor case management the general response and management of the cases seemed adequate with detection and response within 48 hours of the notification. The interventions employed played a pivotal role in containing the outbreak.

Conclusion: Based on the CFR, the response to the outbreak was inadequate. However, the outbreak was generally well managed. The interventions implored as a response to the outbreak and active and rapid response contributed to the containment of the cholera in Nsama district within a short period.