Zambia - High priority areas / Hotspots


Cholera burden and dynamics

Cholera hotspots

–the periphery of urban areas (Lusaka, Ndola and Kitwe)

–Along the border with the DRC and Tanzania around the Mweru and Tanganyika Lakes

–In the center of the country, around the Lukanga swamp area

–Along the border with Zimbabwe around the Kafue Flat swamp area and Kariba Lake

Risk factors

–70% of fishermen are seasonal immigrants, a highly mobile population throughout the country originally from the northern provinces (Bemba ethnic group). Accelerated migration of fishermen and fish tradesmen within the country and across borders during the fishing season.

–Congolese refugee influx in Chienge and Nchelenge border districts (Luapula province).

–Seasonal labor, trade and frequent migration with neighboring countries such as DRC, Zimbabwe, and to a less extend Tanzania, Malawi and Angola, increased the risk of cholera upsurge in border districts.

–Outbreaks of cholera concentrated in the fishing camps and villages around waterbodies in northern, central and southern provinces (Lake Mweru, Lake Tanganyika, Lake Kariba, Lukanga and the Kafue Flat swamps).

–Fishermen and their families spend several weeks every year in fishing camps and use surface waters for all domestic needs including drinking and sanitation.

–In 2016, water was found to be contaminated with Vibrio cholerae in the Lukanga fishing camp of Kapiri Moshi District (Central Province).

–The population mostly uses ordinary pit latrines and relies on shallow wells and boreholes.

–Lusaka is partially built on karstic landscape combined with a shallow water table.

–The environmental conditions combined with pit latrines and poor storm water drainage increased the risk of flooding, resulting in large-scale contamination of water points.

–One quarter of the rural population resorts to open defecation, and sharing a latrine was considered as a high-risk behavior in Lusaka.

–Two thirds of households in Zambia do not treat water prior to drinking.

–Less than 10% of the caregivers were able to identify all critical times for handwashing, while in Lusaka, handwashing with soap or the presence of soap was a protective factor.

–Contact with a cholera patient, low cholera immunity and weakened immune system due to HIV or AIDS.


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