17décembre2017

Cholera Platform

Against cholera

UNICEF Cholera factsheet

Togo Cholera Factsheet

CHOLERA OVERVIEW

Cholera was first reported in Togo in 1970. Since 1990, there have been notable outbreaks in 1991, 1998, 2001 and between 2004–2006 with cases reported every year. The overall yearly trend shows a decrease over time in size (Fig 1). Between 2006 and 2013, epidemiological surveillance reported 2,142 cases with 38 fatalities (case fatality rate ≈ 1.8%)1. The main outbreaks were reported in the capital Lomé (65%), with the remaining outbreaks predominantly reported in the regions of Maritime (19.5%) and Plateaux (13.3%) (Tab. I). Lomé and border districts are affected by outbreaks from Ghana, Benin and Nigeria.

 

APERÇU DU CHOLÉRA
Le choléra est apparu pour la première fois au Togo en 1970. Depuis1990, des épidémies importantes ont été enregistrées notamment en 1991, 1998, 2001, 2004 – 2006. La tendance générale montre une diminution annuelle du nombre de cas (Fig. 1). Entre 2006 et 2013, la surveillance épidémiologique a notifié 2 142 cas et 38 décès, soit un taux de létalité de 1.8 %1.Les principales épidémies ont été enregistrées dans la capitale Lomé (65 %) et dans les régions de Maritime (19,5 %) et des Plateaux (13,3 %) (Tab. I).La ville de Lomé et les districts frontaliers sont touchés par des épidémies en provenance du Ghana, du Bénin et du Nigeria.

 

 

STRATEGIC RECOMMENDATIONS

High-risk cholera areas along the coastline are located on a corridor where outbreaks spread from and to neighbouring countries — Ghana, Benin and Nigeria — highlighting the importance of cross-border collaboration (Fig. 2). It should be noted that central regions (Plateau and Central) can be affected by cholera outbreaks with a high incidence showing the need of preparedness and early detection5,6.

In coastal regions, preparedness and response plans should be deve­loped and implemented including:

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

Sustainable Water, Sanitation and Hygiene activities should be a priority in districts regularly affected and with a long duration (Tab. II, Type 1). An 2014 integrated WASH-epidemiological study has been conducted by UNICEF and proposes long-term programmatic responses in type I cholera hot spots7. Concrete actions should be undertaken in Katanga fishermen informal settlements (Lomé D3) and Adakpamé (Lomé D2), 1) to improve access to water (construction/rehabilitation of water points), public latrines, and treatment of drinking water (social marketing approach) and 2) to strengthen prevention against cholera and change at risky hygiene practices (proximity and media awareness campaigns).