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Chad: Cholera Outbreak - Aug 2017

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On 15 August 2017, the Ministry of Health of Chad notified WHO of a suspected cholera outbreak in Koukou District, Sila Region in the south-east of the country (bordering Sudan). The outbreak first emerged on 14-15 August 2017 when the local health facility (Tioro Health Centre) reported a cluster of 50 cases of acute watery diarrhoea including 13 deaths (case fatality rate 26%) from Marena, a remote village in Koukou District. Subsequently, suspected cases have been reported by the Dogdoré Health Centre (receiving cases from Dabanalaye and Hilé Hussein villages) since 19 August 2017, and most recently from the GozAmir and Koukou Urbain (Quartier Habilé) health centres since 4 September 2017. As of 5 September 2017, 206 cholera cases including 25 deaths (case fatality rate 12.1%) have been reported across Koukou district. Marena (133 cases) and Dogdoré (64 cases) are currently the worst affected regions. (WHO, 8 Sep 2017)

MSF’s emergency response team in Chad was quick to arrive in Koukou to investigate the first suspected cases. Cholera treatment units were then established in two of the villages with the most cases...The possible threat of cholera spreading to other villages and to the Goz Amir refugee camp, where 33,000 Sudanese are living, remains a cause for concern....The MSF-supported cholera treatment unit in Marena village was the first to treat patients affected by the disease. Despite the decrease in case numbers, there is still a regular stream of patients. The situation is more precarious in a second treatment centre in Dogdoré. Before MSF arrived, patients in this unit were taken care of by the only nurse in the health centre in Dogdoré. Access to Dogdoré has been slowed down by wadis (rivers and streams), which have overflowed due to torrential rains. The flooding has several times prevented teams from accessing the site of the health centre with their equipment. (MSF, 15 Sep 2017)

As of 7 October, a cholera outbreak that erupted in August in the south-eastern Salamat and Sila regions had infected 519 people and claimed 63 lives. The outbreak appears to be under control in Sila region as no further cases have been reported in the past week. The disease has spread to more villages in Salamat region, infecting 58 people and killing 11. WHO, MSF and UNICEF are providing treatment, water and raising cholera awareness. (OCHA, 9 Oct 2017)

The district of Am Timan, in the Salamat region, has seen an increase in the number of cases of cholera ... According to the Ministry of Public Health, there were a total of 327 cases in the region of Salamat, with 14 deaths most of which are in Am Timan District, since the first case was recorded on 11 September to 16 October. However, to meet this need, MSF opened a cholera treatment center (CTC) in the city of Am Timan. From the date of the opening of the CTC on September 22 to October 18, 2017, the center received a total of 295 cases, with 3 deaths ... As of October 15, the number of CTC patients had doubled comparison to the previous week. Am Timan Nord and Amsinené were the most affected with 64% of cases coming from these areas. (MSF, 19 Oct 2017)

A cholera outbreak that erupted in the eastern Salamat region appears to be getting under control. Thirty-eight cases were reported in the week ending on 6 November, down from 152 the previous week. Outbreak control measures such as public awareness have been well received by communities. The drying up of a local river considered to be one of the sources of contamination has also contributed to the decline of infections. Since the epidemic broke out on 11 September, 717 cases and 24 deaths had been reported as of 1 November. (OCHA, 7 Nov 2017)

The cholera outbreak that erupted in the eastern Sila and Salamat regions in August 2017 has been brought under control, according to the regions’ health authorities. No cases have been reported since 29 November. A total of 1,254 cases and 80 deaths were recorded in the outbreak. (OCHA, 15 Jan 2018)

The case incidence has been decreasing since week 43. In week 49, no new cases were reported. A total of 817 cases and 29 deaths were reported in the Salamat region from 11 September 2017 to 10 December 2017. No new cases have been reported in the Sila Region since 22 October 2017. (WHO, 22 Jan 2018)