Editor's Comment

Let’s take measures to prevent cholera

CHOLERA MANAGEMENT.

IN RECENT years, Zambia has continuously suffered from outbreaks of cholera.

This year will not be an exception. Already, nine cases have been reported in Chipata, Mazyopa, and Kabanana townships as well as SOS Children’s village in Lusaka.
This is indeed a public health concern.
According to a World Health Organization (WHO) Global Task Force on Cholera Control country profile for Zambia published in February 2011, an analysis of available rainfall and epidemic data in Lusaka shows a very strong association between rainfall and epidemic outbreaks in the city.
Outbreaks usually start during the month of October and end between mid-May/beginning of June of the following year corresponding to the rainy season.
As we have reported in our story, the first outbreak of cholera was reported in Zambia in 1977/1978, then cases appeared again in 1982/1983. This was obviously at the time the economy was not doing well.
But the first major outbreak occurred in 1990 and lasted until 1993. Since then, cholera cases were registered every year except in 1994 and 1995.
Generally, most cases are recorded in the fishing camps of the rural areas and in the peri-urban areas of Lusaka and Copperbelt provinces. In Lusaka, cases and deaths are said to mostly appear in the western suburbs of the city where access to safe water and good sanitation is poor.
The UNICEF Situation report published in May last year on the outbreak of cholera in Zambia showed that cases were reported in Lusaka, Rufunsa, Chibombo, Kabwe, Nsama in Northern Province, Ndola, Mazabuka and Monze.
The index case was in Kanyama township in Lusaka district, which later spread to nearby Chibombo, and then to the other districts. All of the reported cases seemed to be have been linked to the Lusaka outbreak, with the exception of the cases in Nsama district, which seem to be imported from DR Congo.
The UNICEF report noted that sources of new infections were linked to contaminated water, contaminated food sold in the street and inadequate sanitation, which is exacerbated by low levels of hygiene practices.
The recent outbreak though comes at a time when the capital city is implementing the Lusaka Water Supply, Sanitation and Drainage (LWSSD), which is aimed at expanding access and improving the reliability of water supply and sanitation. The project also aims at improving drainage services in select urban and peri-urban areas of the city. It is expected that 1.2 million people in Lusaka will benefit from the project to be implemented over a period of five years ending next year.
The implementation of the project has led to rationing of water in certain parts of Lusaka, which obviously poses its own health challenges. The rationing is obviously an unavoidable scenario if the ultimate goal is to be achieved, that of improving water supply and sanitation.
But the danger of a cholera outbreak is always lurking in Lusaka.
Certain areas in Lusaka lack sewers with residents using pit latrines and septic tanks. And in the event that these pits are not emptied of the faecal sludge, then there is the risk of the waste going into groundwater and contaminating nearby water supplies.
Further, majority of the residents in these informal settlements depend on boreholes to access water, and because these boreholes are often contaminated by raw sewerage, disease is easy to break out in these communities.
Cholera, a waterborne disease, spreads easily in such conditions. But it is also associated with food, particularly raw or undercooked food.
In fact, an infected person who does not practise proper hand or body hygiene passes the infection to another person when handling food and water.
Some people do not exhibit symptoms of cholera. But others, and these include severe symptoms such as vomiting, nausea, dehydration, dry skin, mucous membranes, watery diarrhoea and stomach pain.
If not treated, the consequences can be dire including severe dehydration and even death.
So, while we wait for the overall water supply and sanitation situation to improve in the capital city, there are certain things that we can do to prevent cholera.
These should include drinking treated water as well as properly cooked food. Several studies have for instance shown that outbreaks of cholera in Lusaka are strongly related to foodborne exposures. Last time out, there was a mantra: “Boil it, Cook it, Peel it, or Forget it!”
But also, we should remember always to wash our hands frequently and thoroughly with soap and water.
In other words, we should practise good hygiene at all times.
Cholera is preventable.




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