At least 1.8 million people vaccinated against cholera in Kenya, Malawi hard hit

A resident of Mathare slums in Nairobi is immunized against cholera on the first week of the drive that is geared towards curbing the spread of the disease. [Denish Ochieng, Standard]

Kenya has vaccinated more than 1.8 million people against cholera, as Malawi continues to grapple with the prolonged outbreak of the disease.

The Head of immunisation, at the Ministry of Health, Dr Lucy Mecca said by Friday last week, at least 1.8 people had been vaccinated.

The Ministry's target was to vaccinate more than 2.2 million people by Monday, February 20 in the ongoing drive. The official was optimistic that the Ministry would meet the target.

"As per the data, we shall surpass the target of vaccinating 2.2 million people. We are still collecting data from respective counties, as we end the exercise," said Mecca.

Daniel Lang'at, the Head of Department of Disease Surveillance in the Ministry of Health, said the targeted vaccination is aimed at preventing more cases and deaths.

The targeted vaccination in the counties of Nairobi, Garissa, Wajir and Tana River was scheduled for 10 days.

"Public health officers deployed to counties hardly hit by the disease are walking to homes, markets, and schools to vaccinate all eligible people to stop the disease," said Dr Lang'at.

The Oral Cholera Vaccine (OCV) is an option for emergency use to prevent cholera outbreaks.

The country has reported more than 4,566 cumulated cases and 83 deaths, from October last year, when an outbreak was reported.

"Though we have not contained the disease, the epidemic curve is on the downward trend in terms of infections and mortality," said Lang'at.

Cholera is an acute bacterial disease which presents with diarrhoea, as a result of consuming food which is contaminated with the bacterium Vibrio Cholerae.

The disease causes severe acute watery diarrhoea, vomiting, and dehydration which leads to death, if not treated on time.

A number of risk factors driving the disease namely outsourcing of food vendors with questionable hygiene standards, congestion in the refugee camps and sourcing of water from contaminated sources due to the prolonged drought.

Other factors contributing to the spread of the disease include poor sanitation in informal urban settlements and the sprouting of unregulated water vendors.

"The spread of the disease cannot be prevented by vaccination alone, we need to heighten sanitation, and ensure we consume safe water and food," added the official.

During the launch of the vaccine, Ms Nakhumicha directed counties to heighten surveillance in all public and private health facilities at the community level.

She also asked counties to provide cholera supplies to assist in management of patients, provision of cholera supplies to assist in the management of patients, and provision of water and sanitation supplies to help in the purification of water sources and household water treatment.

To help trace cases on time, the Ministry issued a cholera emergency alert to all counties to heighten surveillance for all diarrhoea, including cholera.

As Kenya vamps up vaccination, Malawi is experiencing a widespread cholera outbreak, with 40,000 confirmed cases and nearly 1,500 deaths since the outbreak.

The disease was first declared in the country in March last year.

Mohamed Malick Fall, Regional Director for Eastern and Southern Africa, UNICEF said Malawi is among the countries with the worst cholera cases.

Fall said UNICEF in partnership with Gavi, Vaccine Alliance is distributing vaccines, in addition to other commodities, to help fight the disease.

At least 2.9 million doses were dispatched to the country, from the Gavi-supported Global Oral Cholera Vaccine Stockpile, in November.

"Cholera is one of the health crises we are fighting in Malawi by supplying vaccines and revamping up preventive measures to prevent more infections and deaths," said Fall.

Dr Alinafe Kasiya, Malawi Country Director, VillageReach, an organisation that advocates for quality healthcare in Sub-Saharan Africa, told The Standard in an interview that cholera is not a new disease in the country, but the outbreak is atypical.

"While epidemics typically start in the rainy season, last year the epidemic began in the dry season. The arrival of the rains only accelerated the spread of the waterborne contagion," said Kasiya.

Schools have been closed as the disease spreads across Malawi.

Dr Kasiya attributed the outbreak to poor and unreliable water supplies and sanitation, worsening socioeconomic conditions, and conflict.

He said climate change is also contributing to the toll on communities as extreme weather, such as droughts and tropical storms, affects the availability of clean and safe drinking water in some regions of the continent.

"Drought attributed to climate change has highly contributed to a surge in cholera cases and deaths in Malawi. With the drought, we do not have quality water and sanitation is a challenge," he added.

Several countries have embraced the Oral Cholera Vaccine (OCV) in Africa, among them Ethiopia, Kenya, Malawi, Mozambique, Nigeria, South Sudan, Uganda, and Zambia.

However, according to WHO in December 2022, the global vaccine stockpile has been exhausted due to high demand.

Kasiya said the acute shortage of vaccines is one of the many obstacles hindering the proactive use of the cholera vaccine in Africa.

He emphasised the need to have localisation of vaccine manufacture to fight the shortage.

"While we await another supply of the cholera vaccine, we need to invest in the systems and workforces that will ultimately help get people vaccinated at the last mile of health.

Mass vaccination campaigns are only as strong as the people running and supporting them," said Kasiya.

Further, Kasiya said to fight the disease in Malawi, there is need for communities to engage leaders to help foster trust in the process, and enough staff to set up sites, carry out vaccinations, and record data while keeping routine health services running.

VillageReach advocates for quality healthcare that reaches all communities, working with partners in Sub-Saharan Africa to solve healthcare delivery challenges.