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Cholera Epidemiology and Response Factsheet - Cameroon

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Cholera Overview

Cholera in Cameroon was first reported in 1971. Since 1990, there have been large outbreaks in 1991, 1996, 1998, 2004, 2010 and 2011. The overall yearly trend shows an increase over time in size (Fig. 1).
Between 2004 and 2013, epidemiological surveillance reported 46,172 cases with 1,817 fatalities, a high CFR ≈ 3.9%.
Main outbreaks were reported in the north in Far North and North regions and in the south of the country in the littoral region which hosts the economic capital Douala.
The country is affected by cross-border outbreaks, especially along its borders with Chad and Nigeria.

Cholera Distribution
In the north of Cameroon, the regions of North and Far North reported 47.3% of cholera cases between 2004 and 2013. The average CFR is high ≈ 8% explained in part by a weak access to health facilities and a high number of community deaths.

In the south of Cameroon, the region of Littoral reported almost one third (29.6%) of cases mainly in the city of Douala. In addition, the nearby region of South west at the border with Nigeria notified approximately 8% of cases.

The region of Centre hosting Yaoundé reported less cases than Douala but more frequently with 6 years out of 10.

There are two seasonal patterns of outbreaks in Cameroun. In the north, outbreaks are occurring in May/June (week 23 – 26). There is an increase of the number of cases reported during the rainy season between June and November and a sharp decrease from mid-November (Fig. 3). While, cholera has been endemic in the south part of the country, especially in Douala. Outbreaks are occurring at the end of the dry season around January/February. The number of cases is usually increasing from February/March5,6 .

The Cameroun is affected by cross-border outbreaks mainly from Nigeria and Chad.
The recent increase of the size of outbreaks can be explained in part by a reduced sensitivity to ciprofloxacin in Vibrio cholerae O1 strains and the atypical cholera toxin B (ctxB) genotype7 .