Guinea-Bissau Cholera Factsheet
OVERVIEW OF CHOLERA
Cholera was first reported in Guinea-Bissau in 1986. Since 1990, large-scale epidemics occurred in 1994, 1996, 1997, 2005 and 20081. The general trend shows an annual decrease in the number of cases (Fig. 1). Between 1996 and 2017, epidemiological surveillance reported 71,307 cases with 1,638 deaths (case fatality rate ≈ 2.3%)2. The majority of cases (83.7%) were reported in the capital Bissau and the regions of Biombo and Bolama, known as the Bijagos Islands2 (Table 1). Cross-border cholera outbreaks have occurred between Guinea-Bissau and Guinea, likely favored by fishing and trade activities.
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STRATEGIC RECOMMENDATIONS
Cross-border outbreaks frequently occurred, between Guinea and Guinea-Bissau, in the regions of Bissau, Biombo, and Tombali and the Bijagos Islands, often involving fishing and trade activity (Table II). Overall these observations highlight the importance of establishing a cross-border early warning system in coastal sectors by monitoring the movement of fishermen.
In regularly affected sectors, preparedness and response plans should include (1) strengthened early warning and rapid response systems including community-based surveillance and cross-border alerts; (2) the establishment of cross-sectoral and cross-border coordination mechanisms; (3) epidemic management capacity building; (4) targeted supply prepositioning; and (5) communication plans and messages.
Sustainable access to water, sanitation and hygiene programs should be prioritized in Type 1 hotspots (Fig. 5, Table II).
A cross-sectional study was conducted to identify case clusters in 2008 in the most affected neighborhood of the capital (Bairro Bandim) to rationalize means and resources during response and to target interventions4. Geo-referencing patients’ homes can provide real time outbreak data at the city level for response teams. A 2012 study suggested that timely and targeted reactive oral cholera vaccination, in particular neighborhoods of Bissau City that are responsible for driving cholera outbreaks in the city, can be a useful tool to control cholera outbreaks throughout the capital5.
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