First cholera outbreak in Zambia since 2019

On April 11, 2022, a cholera outbreak was declared in Lusaka Province, Zambia. The index cases were reported in the townships of Mtendere and Matero. By April 18, 2022, cholera cases were reported in other areas of Lusaka Province (Lusaka District and Chilanga District) and Northern Province (Nsama District), with a cumulative total of 16 suspected cases, including 8 confirmed cases. The areas affected are densely populated and lack adequate sanitation and access to safe drinking water, thus posing a risk of further disease transmission and outbreak spread (1).

A 2018 study has identified and classified cholera hotspots in Zambia. Cholera hotspots were identified based on three epidemiological parameters: outbreak frequency, outbreak duration and standardized attack rate. Indeed, two of the three districts already affected were identified as cholera hotspots: Lusaka District and Nsama District. Overall, the study found that cholera hotspots were located in the following areas: (1) at the periphery of urban areas – Lusaka, Ndola and Kitwe; (2) along the border with the Democratic Republic of the Congo and Tanzania around the lakes Mweru and Tanganyika – Mpulungu, Chienge, Nchelenge, Mwense, Kaputa and Nsama; (3) around the Lukanga Swamp area – Kapiri Moshi, Kabwe and Chibombo; and (4) along the border with Zimbabwe around the Kafue Flat Swamp area and Kariba Lake – Kafue, Sinazongwe, Mazabuka and Luangwa (2).

The country has not had an outbreak since 2019, owing in part to cholera preventive interventions implemented within the context of the national Multi-sectoral Cholera Elimination Plan (3,4). Nevertheless, the country remains vulnerable to imported cases and cholera outbreaks.