United Nations officials are warning that an estimated 80,000 children in West and Central Africa could be at high risk of cholera as the rainy season begins.
In a news release yesterday, UNICEF said the increased risk of cholera is being driven by active outbreaks in the Democratic Republic of the Congo (DRC) and Nigeria, which is raising the threat of cross-border outbreaks in neighboring countries. The hardest-hit country, DRC, has reported 38,000 cases and 951 deaths through July, with children under 5 accounting for 25% of cases. Nigeria has reported 3,109 suspected cases and 86 deaths.
Cholera spreads through water and food contaminated by the Vibrio cholerae bacterium, causing severe diarrhea and dehydration. Though easily treatable with antibiotics, oral rehydration solution, and intravenous fluids, it can quickly become life-threatening if it goes untreated.
Other countries experiencing ongoing outbreaks of the highly infectious bacterial disease include Chad, the Republic of Congo, Ghana, Ivory Coast, and Togo. In addition, Benin, Cameroon, the Central Africa Republic, Liberia, and Niger are considered vulnerable to outbreaks. On top of known risk factors such as poor hygiene and lack of sanitation, UNICEF officials say heavy rains, widespread flooding, and high levels of displacement in the region are fueling the increased risk of cholera transmission.
“With access to safe water and hygiene conditions already dire, urgent action is needed,” said Gilles Fagninou, UNICEF’s regional director for West and Central Africa. “This is a matter of survival.”
Conflict, displacement fueling DRC outbreak
DRC has one of the highest cholera incidence rates on the continent. UNICEF said the situation in Kinshasa, DRC’s capital city, has become critical, with cases surging over the past 4 weeks following weeks of intense rainfall and widespread flooding. The case-fatality rate is 8%.
The situation in DRC has been exacerbated by armed conflict between the government and a rebel group that has resulted in mass displacement, destroyed water and sanitation infrastructure, and an incapacitated healthcare system. Deep cuts to US humanitarian assistance have also hampered the response to the cholera outbreak.
“This is a full-blown public health emergency,” Manenji Mangundu, PhD, MPH, Oxfam’s country director for DRC, said in a news release. “Families are returning to ruins—no shelters, no toilets, no clean water. In many areas, latrines have been flooded or stripped for firewood, forcing people to defecate in the open and contaminate the only water available.”
UNICEF said children account for most of the displaced population and are living in extremely precarious conditions, adding that children in the country could face the worst cholera crisis since 2017 unless measures to contain the epidemic are intensified.
With access to safe water and hygiene conditions already dire, urgent action is needed…This is a matter of survival.
The increase in cholera cases in West and Central Africa comes amid a continent-wide rise in illness. As of early June, African countries had reported more than 130,000 cases, with 2,700 deaths, and are on pace to pass 2023 and 2024 case numbers. In a June meeting, leaders from 20 African countries endorsed a plan to adopt a continental approach to managing cholera outbreaks. The approach is similar to the strategy African health officials have used to combat mpox.
UNICEF has been delivering water, hygiene, and sanitation (WASH) supplies for treatment facilities and communities and supporting cholera vaccination efforts in the affected areas. But agency officials said West and Central Africa will need $20 million over the next 3 months to support health, WASH, and risk communication efforts in the region.
“We are in a race against time, working hand in hand with the authorities to deliver essential healthcare, safe water, and proper nutrition to children already at risk of deadly diseases and severe acute malnutrition,” Fagninou said.