Malawi strengthens cholera surveillance despite decline in cases

MALAWI— Malawi’s Ministry of Health, in conjunction with the World Health Organization (WHO), has strengthened early detection systems by improving community-based surveillance and reinforcing laboratory surveillance.

Cholera rapid diagnostic kits have been distributed to health facilities in 29 districts, and laboratory workers have received training to speed up the identification of probable cases.

Despite a significant decrease in cholera cases, with only an average of 10 cases per week as of January 2024, compared to nearly 700 cases per week during the peak of the outbreak in January 2023, Malawi has remained committed to combating the disease through stringent infection control measures.

The Ministry is presently concentrating on the implementation of the 7-1-7 method, which emphasizes timely case identification (within seven days of emergence), swift communication (within one day of detection), and completion of seven early response actions (within seven days of notification).

Community health volunteers play an important role in active case discovery, allowing health practitioners to quickly adopt targeted interventions to reduce infection spread.

These volunteers also work with environmental health professionals to promote water chlorination and advocate for good sanitation and hygiene practices in communities.

In a recent example from Mzimba District, WHO worked with local health officials to quickly manage 14 discovered cases while undertaking intensive disease surveillance on over 3000 community members. Within a fortnight, these efforts had successfully contained the spread of illness.

Malawi is implementing the third version of the Integrated Disease Surveillance and Response (IDSR) guidelines, which will improve the usefulness of surveillance and laboratory data for outbreak identification and response.

Chifundo Kamkhwali, Lilongwe District’s IDSR focal person, emphasized on the importance of monitoring and detection in containing cholera outbreaks, especially in major towns like Lilongwe and Blantyre, which had the highest number of cases last year.

In her speech, Hon Khumbize Kandodo Chiponda, Minister of Health, recognized the government’s increased cholera preventive efforts, citing lessons learnt from the 2023 outbreak.

She credited the Tipewe Cholera campaign, as well as collaboration with the Presidential Taskforce, WHO, and other partners, with successfully controlling the outbreak.

Despite the Ministry of Health’s declaration in August 2023 that cholera was no longer a national public health emergency, with no cases reported in 26 of the country’s 29 districts, Hon Chiponda emphasizes the importance of continuing vigilance at the individual, family, and community levels in maintaining water treatment and practicing good hygiene and sanitation.

WHO’s intervention includes donations of water testing machines, tent units, oral rehydration point kits, intravenous therapy for severe cases, and various medical supplies and equipment to the Lilongwe and Mzimba areas.

Dr. Neema Rusibamayila Kimambo, WHO Representative in Malawi, for her part, reaffirmed WHO’s commitment to assisting Malawi in implementing a comprehensive, multisectoral cholera control strategy that is consistent with the Global Task Force on Cholera roadmap to eliminate cholera by 2030.

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