Cholera epidemic in Burundi over its peak

MSF intervention keeps mortality low in spite of war-like circumstances.

"The mortality rate is very low, given the war-like circumstances in which our teams had to work to deal with the situation," said Luc Nicolas, operational coordinator for MSF.

The cholera epidemic that hit Bujumbura, capital of Burundi, over the past months seems to be over its peak. At the beginning of the epidemic three to four cases per day were counted. At the peak of the epidemic the number went up to as high as 32 cases in one day. MSF first reported on the outbreak on this site with a July 24 article: Cholera epidemic within displaced near Bujumbura, Burundi

As of August 23, the number has decreased steadily. During the epidemic MSF increased the CTC (cholera treatment centre) in Kamenge district to a capacity of 100 patients. Initially this CTC was only a small isolation room within the TFC (therapeutic feeding centre). MSF also opened a new CTC in Rubiza district. In total more than 600 cases were counted, but only eight deaths (five in the CTC and three reported by the community at home).

"The mortality rate is very low, given the war-like circumstances in which our teams had to work to deal with the situation," said Luc Nicolas, operational coordinator for MSF. "The epidemic hit when fighting increased between rebel and army troops. During the day our people were treating cholera patients while at night they could hear shooting and fighting very close by. It is not obvious to obtain such good results and control an epidemic this fast in these conditions."

Most patients were coming from Gihosha district. This region has to cope with a chronic lack of water and an influx of displaced people coming from Bujumbura Rural province, due to the fighting. MSF installed two water bladders of 15,000 litres each. Also other preventive measures - such as water trucking, spraying in suspected cases houses, active research of cases and distribution of sanitation items to the most affected areas - were taken in collaboration with local health authorities, GVC (an Italian NGO) and ICRC (International Committee of the Red Cross.

"The reasons behind the good results achieved are multiple," explained country coordinator Stephan Goetghebuer. "Such as good coordination between us, the Ministry of Health and ICRC; early prevention measures; good emergency preparedness stock; an enthusiastic staff; and the relatively quiet area given the war circumstances."

The cholera epidemic seems under control now. The CTC in Rubiza is closed and the number of patients in the CTC of Kamenge is decreasing. Over the past weeks there also were alarming reports of a suspected meningitis epidemic, especially in the northern provinces of Karuzi and Ngozi where there were several meningitis cases.

Six teams - MSF and the staff from the Ministry of Health - did in depth research to look for infected people, assess the scale of the problem and, where necessary, provide curative treatment. The results of the exploratory missions showed no general epidemic rate. The Ministry of Health will vaccinate the population of four communities in Myinga Province and MSF is continuing its support with two teams for data collection, epidemiological surveillance, training and sample analyses.