An assessment of the response to Cholera outbreak in Lusaka district, Zambia – October 2023 – February 2024
Introduction: On 18 October 2023, the Zambia's Ministry of Health declared an outbreak of cholera in the capital city of Lusaka. Cholera outbreaks pose a significant threat due to their potential to spread rapidly. Examining the effectiveness of the response measures, can identify areas for...
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| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
African Field Epidemiology Network
2024-11-01
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| Series: | Journal of Interventional Epidemiology and Public Health |
| Subjects: | |
| Online Access: | https://www.afenet-journal.net/content/article/7/53/full/ |
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| Summary: | Introduction: On 18 October 2023, the Zambia's Ministry of Health declared an
outbreak of cholera in the capital city of Lusaka. Cholera outbreaks pose a significant
threat due to their potential to spread rapidly. Examining the effectiveness of the
response measures, can identify areas for improvement and enhance preparedness for
future outbreaks. We assessed the response activities implemented during the 2023-
2024 cholera outbreak in Lusaka district. Methods: We retrospectively reviewed case
report, cluster reports and epidemiological data from cholera treatment centres (CTCs)
and electronic integrated disease surveillance and response (eIDSR) platform. We
extracted data on age, sex, area of residence and date of onset of illness and
characterised the outbreak by person, time and place. To assess the gaps in detection
and response timelines, we deployed the 7-1-7 framework; a tool adopted to evaluate
the effectiveness of public health emergence response. We administered the WHO's
cholera response assessment tool to identify major strengths and weaknesses focusing
on five thematic areas: response coordination, surveillance and laboratory
confirmation, case management, control of the environment, and control of the spread
in the community. Results: Of 13,830 cases reported, majority were males (57.0%) and
those aged ≥ 15 years (66.4%) were the most affected. More community deaths (62.6%)
were reported than facility deaths. Majority of cases (64.6%) were clustered around
two constituencies; overall case fatality rate of 3.7%. The index case was detected on
14 October 2023 at local health facility. The specific time from epidemic alert to
confirmation was undefined. The epidemic was notified within 24 hours while the
duration between detection and initial response exceeded 13 days. During the early
stages of response, there were deficiencies in coordination and capacity to investigate
and identify the source of infection at local level. Multisectoral response activities
implemented included: water, sanitation and hygiene interventions, and communitybased case management. Conclusion: Our study identified essential strengths during
cholera outbreak response in Lusaka district. Timely notification and activation of
multisectoral emergence preparedness and response committee, necessitated prompt
implemented response activities. Strengthening local-level epidemiological capacity to
respond and coordinate epidemics is crucial for ensuring effective initial responses to
outbreaks in Lusaka district.
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| ISSN: | 2664-2824 |