The Democratic Republic of Congo is facing a cholera epidemic in the eastern part of the country, with cases reported throughout the year. The provinces of Ituri, North Kivu, South Kivu, and Tanganyika are affected by cholera, which is endemic in these areas. On 14th December 2022, a cholera epidemic was declared by the Governor of the province of North Kivu following the isolation of Vibrio cholerae among 140 of the 247 samples collected from suspected cases in Nyiragongo HZ.

As of 4th February 2023, 4386 cholera cases (of which 1009 are laboratory-confirmed) with 16 deaths (CFR 0.4%) have been reported. The World Health Organization (WHO) assesses the risk posed by this outbreak as high at the national and regional level, and low at the global level, given the concurrent epidemics, inadequate levels of access to healthcare, and poor hygienic and sanitary conditions.

Description of the Situation

In the province of North Kivu, there was an upsurge in the number of reported cholera cases in the health zones of Nyiragongo and Karisimbi. The number of new cases (suspected and confirmed) increased from 51 in week 47 to 556 cases in week 50 of 2022 and to 683 cases in week 52 of 2022-2023. In Nyiragongo, the most affected age group is 5-14 years, followed by 1-4 years and 15-29 years. Children under the age of one represent 8% of the cases.

In total, 15 health areas including seven in the Nyiragongo HZ and eight in Karisimbi HZ are affected by the cholera epidemic. The health area of Kanyaruchinya in Nyiragongo is the most affected, contributing to 73.3% of all suspected cases, while the Methodist health area in Karisimbi is the most affected with 59.4% of all cases.

The cholera outbreak is primarily affecting internally displaced populations (IDPs), with 97% of the cases reported among IDPs in the HZ of Nyiragongo and 59% of cases among IDPs in the Methodist health area of Karisimbi HZ. However, the outbreak is also spreading across the surrounding communities with nearly 3% of the cases in Nyiragongo and 41% of the cases in Karisimbi belonging to the host community.

Epidemiology of Cholera

Cholera is an acute enteric infection caused by the ingestion of the bacterium Vibrio cholerae present in contaminated water or food. The disease is primarily linked to insufficient access to safe drinking water and inadequate sanitation. It is an extremely virulent disease that can cause severe diarrhoea and spread rapidly. Most people infected with V. cholerae do not develop any symptoms, although the bacteria are present in their stool. The incubation period is between 12 hours and five days.

Conclusion

The cholera epidemic in the Democratic Republic of Congo is affecting the eastern part of the country and is primarily affecting internally displaced populations. The risk posed by the outbreak is high at the national and regional level, and low at the global level. A multisectoral community-based response, including a cholera vaccination campaign, has been implemented. The most affected areas are in the province of North Kivu and the health areas of Kanyaruchinya in Nyiragongo and Methodist in Karisimbi.