Efficient surveillance is key for detecting cholera outbreaks, controlling cholera in endemic areas, and reducing deaths. 

Challenges to Effective Surveillance

However, in many sub-Saharan African countries, surveillance capacity is limited. This results in the underestimation of true disease burden.

Affected countries have attempted to cope by using syndromic case definitions, as proposed by WHO, and declaring all acute cases of diarrhea in children > 5 years as cholera once a single case is confirmed in an endemic area (e.g., village, town, district).

But this practice is not ideal as it may lead to the overestimation or underestimation of cholera burden. In general, underestimation is the result of two main issues:

  • Poor access to health care facilities (which may prevent case detection)
  • Lack of diagnostic facilities and trained personnel (which may prevent etiologic determination)

Africhol Helps to Strengthen Cholera Response

Africhol assists participating countries by expanding their laboratory capacities for routine confirmation of suspected cholera cases.

Additional activities will include:

  • Investigation of affected households and nearby vicinity (to identify additional cases)
  • Assessment of clinical cases within specified surveillance zones to provide incidence data
  • Outbreak investigations to expand knowledge of the different epidemiological contexts in which cholera occurs
  • Environmental investigations to learn more about the relationship between endemic and epidemic cholera and environmental triggers