Preparedness key to limiting AWD/cholera risk
A total of 6,709 cases of Acute Watery Diarrhea (AWD/cholera) were reported across Somalia in 2019, according the Early Warning, Alert and Response Network (eWARN) system of WHO. Most of the cases (86 per cent) were reported in the regions of Banadir (3,931), Gedo (1,012), Bay (453) and Karkar (400). The peak periods in 2019 were during February and March, and again in April to July 2019. At least 31 per cent of cases were reported in children under 5 years of age, and 69 per cent in people above the age of 5.
Since January 2020, at least 1,505 AWD/cholera cases have been reported across Somalia. This is similar to the situation at the same time in 2019. The most affected regions currently are Hiran, Banadir, Bay and Lower Shabelle. Belet Weyne district of Hiran region has recorded most cases- 247 cases and four deaths, accounting for a case fatality rate (CFR) of 1.6 per cent which exceeds the emergency threshold of >1 per cent. Since the second week of February, ta downward trend is reported with no additional cases.
Belet Weyne was inundated by floods during the Deyr rains in November 2019, displacing most of the town residents. According to the WASH Cluster, 80 per cent of latrines in the town and surrounding villages either collapsed or were damaged. The floods also contaminated water sources. Partners believe advance preparedness is necessary because there could be another AWD/cholera outbreak during the upcoming Gu’ rains.
Response activities scaled up in Belet Weyne
Activities to control the further spread of AWD/cholera have been scaled up. The state Ministry of Health has established a new Cholera Treatment Center (CTC) in the Ceel Jaale neighborhood of Belet Weyne to provide case management. Active surveillance measures are in-place along with the collection and transportation of stool samples to the Federal Reference Laboratory in Mogadishu for testing and case confirmation.
In addition, rapid response teams from the federal health ministry, local health authorities, WHO and partners remain vigilant; closely monitoring the situation, strengthening surveillance, verification and providing decentralized treatment. Health and WASH Cluster partners are working in close coordination on contact tracing, scale-up of community awareness on hygiene and sanitation in affected areas. Health workers have been updated on detection and reporting standards, case management protocols including early-treatment and use of oral rehydration salts for home and clinic-based care, infection prevention control in health care facilities. Actions to increase community and clinical care are being backed-up by the provision of medical supplies.