Journal of Infectious Diseases
Volume 208 suppl 1 November 1, 2013
http://jid.oxfordjournals.org/content/208/suppl_1.toc

Supplement: Cholera in Africa: Microbiology, Epidemiology, Prevention and Control
Editorial Committee Introduction
Martin Mengel1, Eric Mintz2, Gopinath Balakrish Nair3 and Bradford D. Gessner1
1 Agence de Medecine Preventive, Paris, France
2 US Centers for Disease Control and Prevention, Atlanta, Georgia
3 National Institute of Cholera and Enteric Diseases, Kolkata, India

The current supplement presents an overview of cholera disease burden and critical issues for the diagnosis, detection, prevention, and control of cholera in Africa. In 2013, the seventh cholera pandemic reached its 43rd year in Africa, with no evidence that it will end soon. More than 20 African countries have reported cholera to the World Health Organization (WHO) every year between 2007 and 2012, including large recent epidemics in the Democratic Republic of Congo (DRC), Sierra Leone, Uganda, Ghana, Niger, and Guinea [1].

In the current supplement, articles from individual countries highlight the human toll of cholera, including more than 200 000 cases and 7000 deaths in DRC from 2000 through 2008 [2]; 68 000 cases and 2600 deaths in Kenya from 1998 through 2010 [3]; 28 000 cases and 1300 deaths in Cameroon from 2010 through 2011 [4]; 25 000 cases and 220 deaths in Mozambique from 2009 through 2011 [5]; and more than 12 000 cases and 500 deaths in Togo from 1996 through 2010 [6]. Two patterns emerge from these reports. The first is endemic, as in DRC, where cholera has occurred continuously in specific regions with an increase in the number of outbreaks during the rainy season. The second pattern is epidemic or outbreak driven, as in Mozambique, where many districts have been affected over relatively short periods, separated by prolonged quiescent periods. Although factors such as climate might increase outbreak risk, in these settings it remains difficult to predict the specific districts or communities that will be affected during any given year.

Difficulties in interpreting country-level data exist. Most African countries currently rely on reporting of aggregate data from the district level, whose completeness remains unknown. This could lead to serious underestimation of …