Home > Africa, bacteria, Cholera, Epidemiology, sanitation, sub-Saharan Africa, water > Cholera in Africa “A Lion in Our Village”

Cholera in Africa “A Lion in Our Village”

Mon, 07Sep2009

In the march 12 2009 New England Journal of Medicine there was an excellent article on Cholera an easily treatable illness be  ignored

source http://content.nejm.org/cgi/content/full/360/11/1060 New England Journal of Medicine  march 12 2009  Volume 360:1060-1063 number 11

Eric D. Mintz, M.D., and Richard L. Guerrant, M.D. authors

following excerpts from  :

A Lion in Our Village — The Unconscionable Tragedy of Cholera in Africa

“Inexcusably, the completely preventable ancient scourge of cholera rages among poverty-stricken and displaced people today, with as many as one in five persons with severe illness dying for lack of safe drinking water and sanitation and a simple therapy consisting of salt, sugar, and water. Cholera, a dreaded waterborne disease of centuries past, remains a troubling barometer — and often a fatal consequence — of inadequate access to safe drinking water and sanitation. Epidemic cholera is the indicator of widespread contamination of drinking water with human feces. As such, it is the bellwether of many less dramatic but equally fatal or disabling diseases that flourish in filth and a litmus test of our willingness to tolerate flagrant violations of the human right to clean water and sanitation….”

“…Unlike the severe acute respiratory syndrome, avian influenza, and other infectious-disease threats that have emerged recently, cholera is easily avoided and easily treated. The failure of the global community to mobilize the resources needed to prevent and to treat cholera among the less fortunate reflects our lack of commitment to equity and social justice. Improving access to safe drinking water, adequate sanitation, and basic health services are among the core Millennium Development Goals agreed to by all United Nations member states.

Epidemic cholera represents a fundamental failure of governance, and bold and visionary leadership is required if we are to attack its root causes. Such leadership has been demonstrated in other contexts in Africa. For example, President Yoweri Museveni of Uganda began to change public attitudes toward the human immunodeficiency virus and succeeded in reducing the rates of AIDS in his country, in part by recharacterizing the disease as similar to any other threat to the community: “When a lion comes into your village,” he said, “you must raise the alarm loudly.”…”

“…It is time to sound the alarm again. Whereas reported case fatality rates for cholera in the rest of the world are now well below 1%, rates in excess of 5% are still commonly reported in many African countries.1 According to United Nations agencies, the cumulative case fatality rate in the ongoing cholera epidemic in Zimbabwe remained stubbornly above 4.7% through February 12, 2009, by which point 5 months had elapsed since the epidemic began, and more than 73,000 cases and 3500 deaths had been reported…

[Article’s] Source Information

Dr. Mintz is leader of the Diarrheal Diseases Epidemiology Team, Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention, Atlanta. Dr. Guerrant is the director of the Center for Global Health at the University of Virginia School of Medicine, Charlottesville.

Full  article: http://content.nejm.org/cgi/content/full/360/11/1060 New England Journal of Medicine  march 12 2009  Volume 360:1060-1063 number 11

[Article’s] References

  1. Gaffga NH, Tauxe RV, Mintz ED. Cholera: a new homeland in Africa? Am J Trop Med Hyg 2007;77:705-713. [Free Full Text]
  2. Ram PK, Choi M, Blum LS, Wamae AW, Mintz ED, Bartlett AV. Declines in case management of diarrhoea among children less than five years old. Bull World Health Organ 2008;86:E-F. [Medline]
  3. Roy SK, Hossain MJ, Khatun W, et al. Zinc supplementation in children with cholera in Bangladesh: randomised controlled trial. BMJ 2008;336:266-268. [Free Full Text]
  4. Guerrant RL, Oriá RB, Moore SR, Oriá MOB, Lima AAM. Malnutrition as an enteric infectious disease with long-term effects on child development. Nutr Rev 2008;66:487-505. [CrossRef][Web of Science][Medline]
  5. Lucas MES, Deen JL, von Seidlein L, et al. Effectiveness of mass oral cholera vaccination in Beira, Mozambique. N Engl J Med 2005;352:757-767. [Free Full Text]

The New England Journal of Medicine is owned, published, and copyrighted © 2009 Massachusetts Medical Society. All rights reserved.

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