Malawi Declares End to Devastating Cholera Outbreak

Summary

• Malawi declared an end to its worst cholera outbreak, which began in March 2022 and resulted in nearly 2,000 deaths.
• The country registered no new cholera cases or deaths in 26 of its 29 health districts over the past four weeks, thanks to a national campaign and various health interventions.
• Health experts warn that the outbreak could resurface if sanitation issues are not addressed.

Lilongwe, Malawi - Malawi has officially declared the end of the country's worst cholera outbreak, which began in March 2022 and claimed nearly 2,000 lives. The Ministry of Health announced on Monday that no new cases or deaths from cholera had been reported in 26 of Malawi's 29 health districts over the past four weeks.

The cholera outbreak, which prompted a national emergency declaration by President Lazarus Chakwera in February 2023, was addressed through the "Tithetse Kolera" or "Let’s End Cholera" campaign. The campaign aimed to halt cholera transmission across all districts and reduce the fatality rate from 3.2% to below 1%, a threshold considered a controlled outbreak by the World Health Organization (WHO).

Dr. Wilfred Chalamira Nkhoma, co-chairperson for the presidential task force on COVID-19 and cholera, attributed the end of the outbreak to the successful implementation of various interventions. "By WHO definition, a country ends cholera transmission when they have gone at least four weeks without reporting a laboratory-confirmed case of cholera," Nkhoma explained. "That is the case with Malawi right now. We haven’t had a confirmed case since June 6."

Key measures in combating the outbreak included educating the public about cholera transmission, increasing surveillance, and effectively managing cases. The Ministry of Water and Sanitation played a crucial role, supported by non-governmental organizations working in the water and sanitation sector. Additionally, an oral cholera vaccination campaign, which began in December 2022, administered approximately 6 million doses, prioritizing high-risk areas.

Despite these efforts, health experts caution that the outbreak could resurface if sanitation issues are not thoroughly addressed. Maziko Matemba, a national community health ambassador, highlighted ongoing challenges: "At the moment, if you go to villages or public places, people are not maintaining proper sanitation. Even public toilets and food preparation practices remain problematic."

The Ministry of Health reported that Malawi had recorded 56,376 cholera cases and 1,772 deaths since the outbreak began. To prevent future outbreaks, the government plans to continue educating the public on cholera transmission, prevention, and control.

Dr. Nkhoma emphasized the importance of sustained efforts, stating, "The key is to increase access to safe water and improve sanitation. We must continue these efforts to avoid further outbreaks."