One Health Office, Ministry of Health and Child Care, Harare, Zimbabwe
Health System Strengthening Unit, World Health Organization, Harare, Zimbabwe.
BMJ Open. 2023 Jan 30;13(1):e059134. doi: 10.1136/bmjopen-2021-059134.
This study was conducted to explore the epidemiology and microbiological pattern of the cholera outbreaks that occurred in Zimbabwe from 2018 to 2019.
This descriptive study used secondary data of 9971 out of 10 730 suspected cases from the Zimbabwean National Diseases Surveillance system and microbiology data of 241 out of 371 patients from the National Microbiology Reference Laboratory in Harare, for the period 5 September 2018 and 3 January 2019. Descriptive analysis was performed to describe the characteristics of the outbreak in terms of person, place and time.
A cumulative total of 10 730 suspected, 371 laboratory-confirmed cholera cases and 68 deaths were reported in Zimbabwe through the situation analysis report (sitrep). The attack rate during the outbreak was 174.6 per 100 000 with a case fatality rate of 0.63%. Most cases seen were among adults from Harare province. Antimicrobial sensitivity testing results showed that a multidrug resistant strain of O1, Ogawa serotype was responsible for the outbreak. The treatment of cases was changed from the standard recommended medicine ciprofloxacin to azithromycin as confirmed by the antimicrobial sensitivity test results. Strategies employed to contain the outbreak included mass oral cholera vaccination in the hotspot areas of Harare, provision of improved and appropriate sanitation measures, provision of safe and adequate water, chlorination of water and improved waste management practice.
The recurrence of a cholera outbreak is a global concern, especially with the emergence of multi-drug resistant strains of the causal organism. Improving water, sanitation, hygiene infrastructure, health system strengthening measures and inter-sectoral collaboration in responding to the cholera outbreak was key to controlling the outbreak.
本研究旨在探讨 2018 年至 2019 年津巴布韦霍乱疫情的流行病学和微生物学模式。
本描述性研究使用了津巴布韦国家疾病监测系统的 9971 例疑似病例中的 9171 例和哈拉雷国家微生物学参考实验室的 371 例患者中的 241 例微生物学数据，时间为 2018 年 9 月 5 日至 2019 年 1 月 3 日。采用描述性分析方法，从人间、地点和时间三个方面描述疫情特征。
通过情况分析报告（sitreps）报告，津巴布韦共报告了 10730 例疑似病例、371 例实验室确诊霍乱病例和 68 例死亡病例。疫情期间的发病率为 174.6/10 万，病死率为 0.63%。发病者多为哈拉雷省的成年人。药敏试验结果显示，一种 O1、Ogawa 血清型的多药耐药菌株是疫情的罪魁祸首。药敏试验结果证实，治疗方案已从推荐的标准药物环丙沙星改为阿奇霉素。为控制疫情，采取了在哈拉雷热点地区大规模口服霍乱疫苗接种、提供改善和适当的卫生措施、提供安全和充足的水、水氯化和改善废物管理措施等策略。
霍乱疫情的再次发生是一个全球性问题，特别是由于引起疾病的病原体出现了多药耐药菌株。改善水、环境卫生、卫生基础设施、加强卫生系统措施以及在应对霍乱疫情方面开展部门间合作是控制疫情的关键。
