HIGHLIGHTS

Sudan declared a cholera outbreak in Gedaref State on 26 September, and on 7 October, cholera was declared in Khartoum and South Kordofan states. Suspected cases have also been reported from Aj Jazirah state; since then, 1,457 suspected cases (including 30 lab-confirmed cases) and 64 associated deaths have been reported.

A visit by partners to a Cholera Isolation Centre in Gedaref Teaching Hospital found that the delayed arrival of patients at hospitals may have contributed to the high number of deaths.

Humanitarian agencies have scaled up response to the outbreak. Surveillance is ongoing in affected and high-risk areas to identify and address risk factors.

With support from partners, the Ministry of Health is coordinating efforts to scale up access to clean water and sanitation facilities, and awareness of transmission risks and proper hygiene practices.

In Blue Nile State, cholera kits have been delivered to Ed Damazine and supplies from last year are still available.

SITUATION OVERVIEW

Sudan declared a cholera outbreak in Gedaref State on 26 September after four cases were confirmed. Subsequently, the outbreak was also reported in Khartoum and South Kordofan. According to the World Health Organization (WHO), 1,457 suspected cholera cases and 64 associated deaths have been reported from four states as of 17 October 2023. The outbreak comes at a time that Sudan’s health care system is stretched to the limit: about 70 per cent of hospitals in conflict-affected states are non-functional and facilities in non-conflict-affected states are overwhelmed by the influx of displaced people.

OCHA, UNICEF, and WHO visited the Cholera Isolation Centre in Gedaref Teaching Hospital and found that while agencies have provided sufficient medication for cholera treatment and conducted WASH and health activities to mitigate the outbreak, the delayed arrival of patients (many with co-morbidities) at hospitals may have contributed to the high number of deaths. Before the outbreak, WHO had provided cholera supplies, including antibiotics, oral rehydration solution and intravenous fluids, to six states, including Gedaref, Khartoum and South Kordofan, and rapid diagnostic test kits to all 18 states. Currently, surveillance is ongoing in affected and high-risk areas to identify and address risk factors.

RESPONSE

A multi-sectoral response has been launched to contain the outbreak and prevent its spread to high-risk areas. According to WHO, the scaled-up response involves enhanced surveillance, laboratory confirmation, capacity building, treatment of patients, provision of supplies including water and sanitation support, and risk communication as well as community engagement. Apart from resources, partners will require unhindered access to affected localities to respond effectively to the outbreak.

Gedaref State:

• Médecins Sans Frontières (MSF) has established two Cholera Treatment Units (CTU) in the affected localities in addition to two mobile teams. WHO and UNICEF have provided cholera kits.

• WHO is supporting one Cholera Treatment Centre (CTC) and four Cholera Treatment Units (CTU) – four CTUs with medicines and health supplies, and one CTC fully supported with staffing, equipment and medical supplies. Medicines are available for 300 severe cases. WHO is providing incentives to doctors, nurses and support staff from 1 October to 31 December.

• WHO is supporting 2 mobile clinics from staffing to equipment.

• WHO is supporting 160 Risk Communication and Community Engagement volunteers.

• WHO conducted physical training in Gedaref State hospitals targeting over 200 medical doctors and four online trainings on cholera case management protocols targeting over 3,000 Sudanese health workers.

• WHO is supporting communication cost of over 250 surveillance focal points in addition to training over 100 doctors on cholera case definition and printing and distribution of over 2,000 cholera case reporting and investigation forms.

• WHO is supporting the operations of 14 rapid response teams in the affected localities and the transfer of samples to the Public Health Laboratory in Port Sudan.

• WHO is supporting water quality monitoring in 6 localities by supporting 60 water quality monitors.

• A request to the International Coordinating Group on Vaccine Provision for oral cholera vaccines was made with technical support of WHO Health Emergencies Program on 16 Oct 2023 to protect 2,756,010 above 1 year population and contain the outbreak.

• With support from partners, the Ministry of Health is coordinating efforts to scale up access to clean water and sanitation facilities, and awareness of transmission risks and proper hygiene practices to reduce contamination risks.

Blue Nile State

• Doctors in Damazine attended an online refresher training conducted by WHO on new guidelines for cholera response.

• Rapid response teams deployed and health facilities report daily.

• Cholera kits were delivered to Damazine and supplies from last year are still available. However, the lack of salary payments to health Ministry staff could affect the response.

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OCHA coordinates the global emergency response to save lives and protect people in humanitarian crises. We advocate for effective and principled humanitarian action by all, for all.

https://www.unocha.org/sudan

https://reliefweb.int/country/sdn

https://www.humanitarianresponse.info/en/operations/sudan