Highlights
• As of 31 January 2024, a total of 21,835 cholera cases, 71 confirmed deaths and 416 suspected deaths have been reported from 61 districts across all 10 provinces.
• Of the cumulative cholera cases, approximately 31 per cent are children aged below 15 years, and 14 per cent are children aged below 5 years of age.
• The country received ICG approval for 2.3 million OCV doses targeting eligible population aged one year and above in 160 wards within 24 high risk districts in 7 provinces.
• A total of 465,401 people including 246,058 children aged below fifteen years have received the OCV single dose reactive vaccine since the campaign was launched on 29 January 2024.
• UNICEF and partners have reached 260,437 people with critical hygiene supplies including 101,405 children.
• An estimated 2,960,361 people have been reached with risk communication and community engagement activities.
Situation Overview & Humanitarian Needs
By 31 January 2024, a total of 21,835 cholera cases, and 487 deaths with a case fatality rate (CFR) of 2.2 per cent have been reported from 60 districts.
An upward trend in week-by-week cholera cases continues being seen from epi-week 50, 2023 to epi-week 3, 2024. Most cholera cases continue being reported from Harare, Masvingo, Manicaland and Chitungwiza Provinces contributing 84 per cent of the national case load.
There was continued increase in cases in Mashonaland Central, Mashonaland West and Mashonaland East Provinces from the beginning of 2024 related to the increased mobility of the population during the festive season as well as the rainy season. Week by week cholera case fatality has been gradually declining from September 2023 to week 3, 2024.
Children, women of childbearing age, religious decliners, illegal miners, and famers in rural settings continue being high-risk groups with fifty two percent (52 per cent) of the cumulative cholera cases being women while 14 per cent are children under 5 years of age.
Key factors driving cholera transmission include the continued low access to safe water, inappropriate sanitation and infection, prevention, and control (IPC), health system challenges (staff attrition, capacity, access, and quality issues), unsafe burial practices, wanning immunity from last oral cholera vaccine (OCV) campaign in 2019, multiple disease outbreaks (polio, measles), and limited funding among UN agencies and partners to scale up response.
The country entered its rainy season late in December 2023 contributing to an increased number of cases. In addition, subregional population movements and large gatherings for economic, cultural, and religious reasons amidst ongoing cholera outbreaks across neighbouring countries (Zambia, Malawi, Mozambique) present continued risks for cross-border transmission.
While the rains have increased the risk of flood and water contamination due to sewer runoff and seepage, the forecasted El Nino-induced drought will cause further water scarcity with household resulting to unsafe water sources and water rationing for sanitation, complicating the situation.
Cholera caseloads reported have exceeded the 10,730 cases reported in the 2018/19 cholera outbreak, with fears of a similar situation as the major outbreak of 2008/9. In the most likely scenario, WHO/UNICEF estimate an attack rate of 0.3 resulting in 38,763 cases by February 2024, if current interventions do not halt transmission, noting that cholera attack rates are typically higher in urban and peri-urban areas than in rural settings.
