Africhol in Guinea
According to data from the Ministry of Health of Guinea, about 60 000 cases and 2,276 deaths from cholera have been reported since 1970. The frequency of cholera outbreaks has increased in Guinea-Conakry over the last two decades. These epidemics spread from coastal zones which serve as reservoirs.
In collaboration with the Department for Disease Control and the National Public Health Institute, Africhol supported cholera surveillance activities within the country and established in 2011 an enhanced surveillance zone in the health district of Ratoma in the city of Conakry. Since 2015, the enhanced surveillance zone has been extended to the following 5 coastal prefectures: Boke, Boffa, Coyah, Dubreka and Forecariah.
Cholera epidemiology in Guinea
According to the World Health Organization (WHO), Guinea reported 19,257 cases and 880 deaths between 1999 and 2009.
Guinea has experienced cholera epidemics since 1970, with outbreaksoccurringmore and more frequently, until reaching a yearly occurrence between 2003 and 2007. The major 1994 cholera outbreak accounted for 31,415 cases and 671 deaths, within the city Conakry alone. From 1998 to 2009, the annual number of cholera cases in Guinea varied from 6 cases (2003) to 8,500 cases (2007). Vibrio cholerae serogroup O1 biotype El Tor was the causative agent of all these outbreaks.
Before 1994, outbreaks in the country remained limited to the coastal strip and the capital. The first cases appeared in people living in the coastal lagoon near the border with Sierra Leone. Starting with the Conakry 1994 epidemic, cholera spread to even the most remote prefectures in the country.
Cholera lethality ranged from 3.6% in 2007 to 8.6% in 2006. In 2008, Guinea reported 32 deaths over the 513 cholera cases, leading to a CFR of 6.24% which was the fourth highest CFR reported by countries worldwide that year.
A study on data from 2003-2007 (UNICEF, 2009) described a link between the rainy season and the resurgence of cholera outbreaks, with a seasonal increased risk from April to June.
Routine national cholera surveillance
In Guinea, cholera surveillanceis part of the “Surveillance Intégrée de la Maladies et la Riposte” (SIMR), and is an ongoing and systematic collection, analysis and data interpretation of morbidity and mortality of disease. Data are collected in health facilities and sent weekly to cholera surveillance focal points in eight administrative regions comprising 38 health districts. The Prefectural Health Directorate (DPS) compiles the data and then forwards it to the Regional Health Directorate (DRS) which summarizes and transmits it to the “Direction de la Lutte contre la Maladie” (DLM) at the Ministry of Health (MoH). In case of an outbreak, anational crisis committee, chaired by the Minister of Health, meets once a week for an update on the epidemiological situation.
Within the guidelines of the SIMR, the following case definitions for cholera are applied:
- Suspected case of cholera:
During an epidemic:a patient over one year of age suffering from watery diarrhea with or without vomiting.
Outside of an epidemic: a patient over one year of age suffering from severe watery diarrhea with severe dehydration or resulting in death.
- Confirmed case of cholera: a suspected case with laboratory confirmation of of Vibrio cholerae O1/O139 in the stool.
- Clustered cholera cases:
In an area with no known cases of cholera, or with only sporadic suspected cases:
- At least one confirmed case of cholera
- At least two suspected cases of cholera and severe diarrhea over a period of one week, or reported by more than one health facility within the same sector or same DPS.
Enhanced surveillance zones in Guinea
Since 2011, in collaboration with the Ministry of Health, Africhol has established its enhanced surveillance zone in the sanitary district of Ratoma in Conakry city, with the Cholera Treatment Centre (CTC) at Donka National Hospital as a base for cholera surveillance activities. In 2015, the enhanced surveillance zone were extended to the following 5 coastal prefectures: Boke, Boffa, Coyah, Dubreka and Forecariah.
November 30, 2015
The Africhol project coordination team composed of Dr Aline Munier and Dr Berthe Njanpop Lafourcade conducted a field monitoring visit in Conakry (Guinea) between 16 and 21 November 2015. This visit follows on the reinitialization in May 2015 of the Africhol cholera surveillance in Guinea, which...
October 18, 2012
The cholera outbreak in Guinea is further on the decline. Fewer new cholera cases were notified during week 41 in the 11 districts which have been affected since the beginning of the outbreak on 2 February 2012. However, 13 cholera cases with 2 deaths have been recorded in a new location:...
October 10, 2012
The number of cholera cases has continuously receded in all 10 affected Guinean districts after peaking in week 34, in which alone 1,152 cases were reported. The weekly notifications from last week, week 40, were 121 new cases. Read more
September 20, 2012
As of 16 September 2012, the Guinean Africhol coordination team at the department for disease control has reported a total of 6,599 cases including 121 deaths (case fatality ratio of 1.8%) in the cholera outbreak in Guinea ongoing since February 2, 2012. Read more
July 19, 2012
In the last two weeks, 79 cases and one death were reported, bringing the total to 717 cases and 42 deaths since the first reported case on February 7, 2012. Case fatality ratios remain high at 5.8%. The most affected districts include the city of Conakry, with 52 cases in week 28 and 27 cases...
July 10, 2012
In total, from February 2 to July 9, 2012, five districts of Guinea recorded 638 cholera cases and 41 deaths with a fatality ratio of 6.4%.
June 02, 2012
Since the beginning of February, an outbreak of cholera has hit five coastal districts of Guinea: Forecariah, Boffa, Conakry, Boke, and Mamou. As of May 31, 2012, a total of 510 cases, including 38 deaths, had been reported, with an overall case fatality ratio of 7.4%.
April 25, 2012
Africhol is participating in a mass anti-cholera vaccination campaign launched for the first time in Africa by Doctors Without Borders / Médecins Sans Frontières (MSF). The first two phases of this campaign, which is a response to cholera outbreak in Guinea, began in the...
February 29, 2012
On February 2, 2012, the first cases of cholera since 2008 were reported in Guinea. An outbreak investigation team, led by the Ministry of Health and supported by Africhol, was deployed to affected districts in Lower Guinea.
July 19, 2011
Africhol made a first visit to Guinea from June 27 to July 8, 2011.
Publications & Data
Authors: Stanislas Rebaudet, Martin A. Mengel, Lamine Koivogui, Sandra Moore, Ankur Mutreja, Yacouba Kande, Ousmane Yattara, Véronique Sarr Keita, Berthe-Marie Njanpop-Lafourcade, Pierre-Edouard Fournier, Eric Garnotel, Sakoba Keita, Renaud Piarroux
PLOS Neglected Tropical Diseases, 8(6): e2898, 5 June 2014, doi:10.1371/journal.pntd.0002898
Authors: Francisco J. Luquero, Lise Grout, Iza Ciglenecki, Keita Sakoba, Bala Traore, Melat Heile, Alpha Amadou Diallo, Christian Itama, Anne-Laure Page, Marie-Laure Quilici, Martin A. Mengel, Jose Maria Eiros, Micaela Serafini, Dominique Legros, Rebecca F. Grais
Authors: Francisco J. Luquero, Lise Grout, Iza Ciglenecki, Keita Sakoba, Bala Traore, Melat Heile, Alpha Amadou Dialo, Christian Itama, Micaela Serafini, Dominique Legros, Rebecca F. Grais
PLOS Neglected Tropical Diseases, Volume 7, Issue 10, e2465, 17 October 2013
Authors: Iza Ciglenecki, Keita Sakoba, Francisco J. Luquero, Melat Heile, Christian Itama, Martin Mengel, Rebecca F. Grais, Francois Verhoustraeten, Dominique Legros
PLOS Medicine, Volume 10, Issue 9, 10 September 2013
Authors: Isabel Martinez-Pino, Francisco J. Luquero, Kéïta Sakoba, Souleymane Sylla, Melatwork Haile, Rebecca F. Grais, Iza Ciglenecki, Marie-Laure Quilici, Anne-Laure Page
PLOS Neglected Tropical Diseases, Volume 7, Issue 8, e2366, 15 August 2013
The cholera outbreak in Guinea is further on the decline. Fewer new cholera cases were notified during week 41 in the 11 districts which have been affected since the beginning of the outbreak on 2 February 2012 (see table below). However, 13 cholera cases with 2 deaths have been recorded in a new location: Kaala, a subdistrict of the Dalaba district.
The number of cholera cases has continuously receded in all 10 affected Guinean districts after peaking in week 34, in which alone 1,152 cases were reported. The weekly notifications from last week, week 40, were 121 new cases. Between the beginning of the outbreak on 2 February 2012 and 9 October 2012, a total of 7,076 cases including 125 deaths (case fatality ratio [CFR] of 1.7%) have been reported. From the capital Conakry alone, 4,548 cases and 24 deaths (CFR=0.5%) were notified.
As of 16 September 2012, the Guinean Africhol coordination team at the department for disease control has reported a total of 6,599 cases including 121 deaths (case fatality ratio of 1.8%) in the cholera outbreak in Guinea ongoing since February 2, 2012. These cases and deaths have been recorded in 10 districts throughout the country and in the capital Conakry.
From February 2 to August 7, 2012, Guinea has recorded 2,054 cholera cases with a fatality rate of 2.9%. The most affected prefectures are: Conakry, Forecariah, Boffa, Mamou, Boké, Fria, Dubréka and Coyah. So far, the capital Conakry has registered 1,387 cases including 13 deaths.