Disease Burden Worldwide and in Africa
According to 2005 United Nations population data and the Millennium Development Goal Indicators database, cholera is endemic in 51 countries. To be considered endemic, cholera must have been reported for at least three out of the last five years.
The number of suspected cholera cases reported to the World Health Organization (WHO) every year is nearly 200,000, with around 5,000 deaths. However, these numbers are thought to be misleading due, in part, to underreporting and limitations in surveillance systems. The true global cholera burden is estimated to be 3 to 5 million cases and 100,000 to 120,000 deaths annually.
According to the WHO Global Health Observatory, the 30 affected African countries reported 98% of all cholera cases and 99% of all deaths in 2009 with an average case fatality rate of 2.25% (range 1–10%).
Prevention and Control
Measures for the prevention and control of cholera depend on the local context. In general, interventions include improvements in infrastructure, such as water and sanitation, and community education. Recently, a new generation of effective and affordable vaccines has opened new possibilities for short- to mid-term cholera control. To determine which interventions are the most efficient within a given context, accurate epidemiological data are needed.
While in other parts of the world the international community is making a concerted effort to improve water and sanitation infrastructure no such initiatives are in sight for Africa.