A. Situation analysis
Description of the disaster
On 11 April 2022, a cholera outbreak was declared in Zambia with its index case reported in Mtendere compound which has a population of 106,128 within Chelstone Subdistrict and Matero with a population of 356,462, within Lusaka. The index case involved 3-year-old girl who presented with signs and symptoms suggestive of cholera; results later confirmed the presence of vibrio Cholerae in stool. The patient was admitted at Kalingalinga Clinic, a local health facility where she was treated and discharged.
By 18 April 2022, the outbreak had spread to other areas within Lusaka with a cumulative total of 16 suspected cases of which 8 were confirmed, distributed as follows: Lusaka Province – 7 (Lusaka District 12; - Mtendere 4, Kabangwe 1, Kamwala 1 and Matero 1), Chilanga District (Midles-west 2, Apolo1, and ZESCO Kalundu 2) Northern Province 5 (Nsama District – Nsumbu 5). These are densely populated areas which lack adequate sanitation and access to clean and safe water, posing a danger for further spread of the epidemic. No fatalities have been reported to date. See summary of cases distribution per Cholera Treatment Centre (CTC) in figure 1 below:
Although this cholera outbreak has occurred outside the rainy season, it has the potential to mimic the 2017-2018 outbreak, which started in one area and spread to other hotspots within Lusaka, and eventually to other parts of the country. Already, there are reports of suspected cases in Nsumbu area in Nsama District in Northern Province, and the Ministry of Health is yet to rule out epidemiological link between the two events through a risk assessment and patients record tracking. Once the risk assessment report is shared with partners, it will become clearer regarding the situation and gaps in the response strategy. However, MoH has put in place systems for the response and a Lusaka Provincial multisectoral response plan is being finalised and will be shared with relevant stakeholders.
Zambia faces challenges to attain universal access to safe and clean drinking water, as well as inadequate sanitation, especially in densely populated and unplanned settlements in urban settings. These conditions, coupled with the poor hygiene practices among citizens, has caused recurrent outbreaks of WASH related diseases. To note, although Cholera is endemic in Zambia, the country has not had an outbreak since 2019 owing to various cholera preventive interventions being implemented within the context of the country’s Multisectoral Cholera Elimination Plan.