Numbers vary, but cholera remains high in Zimbabwe

As there are now many more actors on the ground than at the beginning of the outbreak, it is very possible for countrywide numbers to increase while the number of cases MSF is seeing is decreasing.

The UN reported that a large spike in cholera cases occurred on January 6: 1,080 new cases with 19 deaths; the day before 675 new cases were reported with 59 deaths. However, MSF staff are reporting an overall decrease in the number of cases being seen by MSF.

The approximate number of suspected cholera cases MSF has seen to date is more than 16,000.

A likely explanation for the difference between the UN figures and what MSF is seeing is the spread of cholera outbreak across entire country – all ten provinces have reported cases. As there are now many more actors on the ground than at the beginning of the outbreak, it is very possible for countrywide numbers to increase while the number of cases MSF is seeing is decreasing.

It is important to note that MSF continues to see new cases and areas of concern remain.

There is a clear shift from the bigger cities to district towns and smaller towns with many new areas affected, many in rural areas. This makes the management of cases more challenging as resources need to be dispersed and logistics are more difficult.

The rainy season is in full swing in most areas.

MSF mobile teams will continue to provide rapid assistance to Ministry of Health (MoH) facilities and will focus on sites with more than 10 cases per day. A focus will also continue on case management and better surveillance.

Regions

The number of patients in the Harare cholera treatment centers (CTCs) remains high, but the number of cases MSF is seeing is decreasing and the overall situation is stabilising. Fewer than 50 new cases are being seen by MSF per day.

However some prisons in Harare are experiencing a significant number of cases. MSF and ICRC are in contact with prison authorities. The vast majority of cases in Harare still come from the same four high density suburbs of Budiriro, Glen View, Mbare and Glen Norah. The number of cases from other suburbs is increasing, including Mabvuku and Tafara, Rugare, Waterfalls and Hopely Farm. A CTC will soon open at Hopely Farm.

The situation in Masvingo and Manicaland is calm and the number of cases is still decreasing but there are still some areas with new cases. Mutare and Masvingo cities remain areas of concern.

In Glendale, Mashonland Central, the water situation is precarious and there is concern that if nothing is done, another large scale outbreak, such as the one that hit Chegutu in mid-December, could occur. MSF will carry out an assessment in Mashonland Central this week.

The overall number of cases in Chegutu is going down quickly, but a recent increase in the last few days can be explained by; increased movement during the Christmas and New Year's holidays; ongoing rains; continued poor sanitation; and by the reopening of some water pipes where people are starting to collect water, which is not necessarily potable.

There was a slight increase in the number of cases in Beitbridge due to movements and gatherings during the holidays, but the overall number of cases in Beitbridge remains low. Water tanks provided by the South African government is supplying water to high density areas.

The number of cases in Bulawayo continues to decrease, but the sewage system remains blocked.

Sixteen cases were reported by WHO in Matabeleland North. Cases have also been reported near Victoria Falls, Zambia. An outreach team will assess these areas.