One of the neighborhoods I visited on a recent trip to Côte d’Ivoire and Guinea was the slum area of Port Bouet, a fisherman’s colony with boats flying colorful flags representing many West African countries. Mid-day was intensely bright, hot and humid, with the strong smell of smoking fish at every turn in the road. As we approached the lagoon, large fish smokers were spewing out smoke and the sound of voices bargaining in the crowded fish market was loud and raucous.
Initial data suggests that fishermen may be affected by cholera earlier and in larger numbers than other groups.
As fishermen travel frequently, they also provide opportunities to spread cholera, just like passengers on airplanes with the flu. Coastal areas where fishermen live are often in low lying areas where conditions are difficult to build toilets (too sandy) and where the availability of clean water is a challenge due to changes in the water table. This lack of water and sanitation provide ideal conditions for cholera and other diarrheal diseases.
Surveillance is only useful if it leads to action.
When cholera breaks out in a country it can sometimes take weeks for a case to be confirmed if there are no trained lab technicians or adequate supplies. When cases aren’t confirmed it can mean a slower response time to treating patients.
The Bill & Melinda Gates Foundation supports the Africhol project of Agence de Médecine Préventive that works with Ministries of Health in nine African countries to conduct cholera surveillance. The project includes training to lab technicians and lab supplies to improve cholera surveillance in high-risk areas.
Good surveillance not only helps countries understand the burden of disease but also helps plan interventions to combat disease. Africhol surveillance data is helping countries target their treatment and prevention efforts.
In Guinea, which saw over 7,000 cholera cases this last summer, the Ministry of Health was able to confirm their first case within a week, giving authorities and NGO’s time to prepare treatment centers in high risk areas and prepare for the onslaught of cases. Guinea was the first country last summer to use a new cholera vaccine in low-lying areas along the coast, including many fisherman communities.
Surveillance is only useful if it leads to action. Africhol data is helping countries better understand where cholera occurs, how it spreads and actions they can take to combat the disease.