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Ghana - Cholera factsheet

Cholera overview
Cholera was first reported in Ghana in 1970. Since 1990 and up to 2010, the overall yearly trend showed a decrease over time in size. However, there have been large outbreaks in 2011 and 2012 and cases have been reported each year (Fig. 1). Between 1998 and 2013, epidemiological surveillance reported 55,784 cases with 1,095 fatalities (case fatality rate ≈ 2%)1. Main outbreaks were reported in the densely populated regions of Greater Accra and Ashanti, and in bordering coastal regions. Ghana is affected by cross-border outbreaks mainly from Nigeria and Togo, especially along the Guinea coast.


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Strategic recommendations
High-risk cholera areas along the coastline are located on a corridor where outbreaks spread from and to neighboring countries, Benin, Togo, Nigeria and IvoryCoast (Tab. II). It should be noted that the Central and the Northern regions bordering Burkina Faso can also be affected by cholera outbreaks. This highlights the importance of cross-border activities for coastal regions and to a less extend for districts bordering Burkina Faso. In Greater Accra region and bordering regions, preparedness and response plans should be developed and implemented including:

  1. (1) strengthening early detection and rapid response systems of which community based surveillance and cross-border alert;
  2. (2) setting up coordination mechanisms across the sectors and borders;
  3. (3) building capacity on outbreak management;
  4. (4) targeted pre-positioning of supplies and
  5. (5) preparing communications messages and plans (Tab. II).

Sustainable Water, Sanitation and Hygiene activities should be a priority in districts regularly affected with long outbreaks (Tab. II,Type 1). An 2014 integrated
WASH-epidemiological study6 has been conducted by UNICEF in Great Accra Region and proposes to

  1. 1) initiate advocacy with Ghana Water Company Limited to improve the water quantity and quality provided to the poorest,
  2. 2) strengthen post-chlorination of the network by installing dosing chlorine pumps at strategic points along the network conduct,
  3. 3) promote the use of GIS technology during an outbreak to identify any strategic hotspots in Accra, and
  4. 4) when hotspots are identified, implement WASH and Health development programs targeting identified communities and consider the use of Oral Cholera Vaccine.


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