Foreword
This bulletin provides a weekly overview of the outbreaks occurring in Zimbabwe. It includes disaggregated data to inform and improve the continuing public health response by the various partners. It also provides guidance to agencies on issues relating to data collection, analysis and interpretation, and suggests operational strategies on the basis of epidemiological patterns so far. The bulletin is published weekly. Note that the epidemiological week runs from Monday to Sunday. This edition covers week 46 (week ending 15 November 2009).
The C4 team welcomes feedback. Data provided by individual agencies is welcome but will be verified with MOHCW structures before publication.
Acknowledgements
We are very grateful to MoHCW District Medical Officers, District and Provincial Surveillance Officers, Provincial Medical Directors, Environmental Heath Officers, and MoHCW's National Health Information Unit, who have helped to gather and share the bulk of the information presented here.
Likewise, we acknowledge agencies, including members of the Health and WASH clusters, who have kindly shared their data with our team. MoHCW recognizes and thanks the efforts made by NGOs and other partners assisting in the response and providing support to MoHCW.
Figures
See also summary tables (annex 1), maps (annex 2) and graphs (annex 3). The case definitions can be found in appendix 1 and detailed data by district are shown in appendix 2
Since September 2009
9 out of the 62 districts in the country have been affected by the ongoing cholera outbreak. 117 cumulative cholera cases and 5 deaths were reported by 15th November 2009 to the World Health Organization (WHO) through the Ministry of Health and Child Welfare's (MoHCW) National Health Information Unit. The crude case fatality rate since the outbreak started stands at 4.3%. By week 46 last year, 2505 cumulative cases and 97 deaths had been reported, with a crude case fatality rate of 3.9%.
The cases reported this year are 4.7% of last year's cases , whilst the deaths are 5.2% of last year's deaths. This year's case fatality rate is higher than last year's by 0.4% .
Week 46 (9th November - 15th November 2009)
1 case was reported this week,compared to 14 in the previous week. The case is a resident of Waverly Township, Kadoma and was seen at Kadoma General Hospital on the 15th of November.
Geographical distribution of cases
The cases reported came from the following districts: Bindura, Chegutu, Chipinge, Gokwe North, Gokwe South, Harare, Kadoma, Makonde and Rushinga. The affected districts are in the following five provinces namely: Harare, Manicaland, Midlands, Mashonaland Central and Mashonaland West. 56 (47.8%) of the cumulative cases were reported by Midlands, followed by Manicaland Province with 32 cases (27.4%) and Mashonaland West which had 21 cases (17.9%). Mashonaland West province has the highest number of districts affected by cholera namely 3.
Urban/Rural distribution of cases
81.2 % of the cumulative cases were from rural areas and the remainder 18.8% from urban areas compared to last year's scenario of 79% cases from urban areas and 21% from rural areas in the corresponding week.
