Africhol in the Democratic Republic of Congo (DRC)

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Since the first cases in the country from the seventh cholera pandemic wave, the DRC has been among the five countries in the world the hardest hit by cholera. Nowadays, eastern provinces are more affected by the disease than the western ones. In 2011, four provinces are epidemic: Orientale since February, Equateur since May, and Bandundu and the city of Kinshasa during June 2011.

The Africhol site in the DRC is the city of Goma, in the North Kivu province bordering Lake Kivu, with the Cholera Treatment Centre (CTC) at the General Hospital Reference in Goma, and the UTC in the Karisimbi health area as reference health structures.


Cholera Epidemiology in the DRC

The first cases of cholera were reported in the DRC in 1974, and since the late 1990s, the DRC has been among the five countries in the world the most affected by cholera. From 2001 to 2009, 213,377 cases and 6,319 related deaths were reported in the country, with an attack rate of 36 cases per 100,000 and a lethality rate of 2.85%.

The provinces most affected by cholera are the eastern ones: South Kivu, North Kivu, Katanga, and Orientale, with 47.3 cases per 100,000 inhabitants, and a maximum of 93.1 cases per 100,000 people in South Kivu. To the west of the DRC, the incidence varies between 0.5 and 1.4 cases per 100,000 inhabitants. In the lake areas, cholera has a seasonal pattern, with the incidence peaking during the rainy season.

In 2011, when considering the number of cholera cases reported to Ministry of Health since the beginning of the year (from week 1 to week 26), seven provinces have reported 9,065 cases and 210 deaths (CFR of 2%). The epidemic began in the Province Orientale (northeast) and then spread west to the province of Bandundu, before reaching, in June, those of the Equateur and Kinshasa, bordering the Congo River. The city of Kinshasa has a case fatality rate of 15% followed by the province Equateur (8%), Bandundu and Orientale (5%).

Routine National Cholera Surveillance

In the DRC, the Ministry of Public Health is the main actor in the fight against cholera. The surveillance of cholera is conducted by the Direction de la Lutte contre la Maladie (DLM), the Institut de Recherche Biomédicale, and the provincial health inspections, health areas and their treatment centres. The coordinating structure is the Comité Intersectoriel de Lutte contre le Choléra (CILC), that brings together national and international partners involved in the fight against cholera.

According to the definitions currently used by the Ministry of Health, the cholera case definitions are the following:

  • Suspected caseof cholera: a patient with severe diarrhea with dehydration or death from acute watery diarrhea
  • Confirmed case of cholera: a patient for whom Vibrio cholerae serogroup O1 or O139 is isolated from a stool sample or rectal swab
  • Acute diarrhea: a patient with more than six loose or watery stools within 24 hours, with a sudden onset and duration not exceeding 72 hours before the consultation in a health facility.
  • Cluster cases of cholera:

In an areawith no known cases of cholera, or with only sporadic suspected cases:

- At least one confirmed case of cholera

- At leasttwo suspected cases of cholera or acute diarrhea over a period of one week, or reported by more than one health facility within the same sector or health district.

In a cholera endemic area:

- A two to three fold increase of reported suspected cholera cases compared to the number of cases reported in previous weeks.

Enhanced Surveillance Zones in the DRC

In collaboration with the MoH, the Africhol enhanced cholera surveillance zone chosen was the city of Goma, in the North Kivu province bordering Lake Kivu. The estimated total population is 554 413 inh. over an area of​​ 491.5km2.

In this area, the main hospitals serving as reference health structures are the Cholera Treatment Centre (CTC) at the General Hospital Reference in Goma, and the UTC in the Karisimbi health area.

Latest News

December 17, 2014

The Africhol team took part in the roundtable organised by the Ministry of Health of the Democratic Republic of Congo (DRC) at the congress to mark 30 years of the National Institute of Biomedical Research (INRB), which was held in Kinshasa from December 5 to 7.

November 08, 2013

From October 27th to 31st 2013, an Africhol project coordination team composed of Mme Delphine Sauvageot (Project Coordinator for West Africa) and Dr. Berthe Njanpop Lafourcade (Laboratory Expert), performed a monitoring visit in Democratic Republic of Congo (DRC).

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July 31, 2013

Between April and June 2013, 295 cases were notified from the Africhol enhanced surveillance zone (Goma, UTC Buhimba, Kiziba) among which 71 cases have been tested positive for cholera, with 2 deaths (CFR = 0.67%).

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April 16, 2013

The National Plan of Elimination of Cholera 2013-2017 of the Democratic Republic of Congo is now available. This plan describes detailed steps by which the government aims to lower the national incidence of confirmed cholera cases to below one per 100,000...

September 11, 2012

The Report on Cholera Epidemiology in the Democratic Republic of Congo, 2011 by the national cholera division is now available here.

Situation épidémiologique du choléra en République D...

March 08, 2012

Africhol in the Democratic Republic of Congo (DRC) has specially dedicated funds to increase the number of visits investigators make to residences and local areas where cholera cases have been confirmed.

This project intends to bolster the organization of residential and environmental...

March 08, 2012

The Democratic Republic of Congo (DRC) recorded 131 cholera cases (two of which were fatal) in the Africhol surveillance zone in January: 116 cases in Goma (northeast) and 15 in Karisimbi (southeast).
Since 2011, the DRC has reported a total of 22,263 cholera cases nationwide, of which...

January 16, 2012

From July to December 2011, the DRC’s National Institute for Biomedical Research (Institut National de Recherche Biomédicale, INRB) analyzed 813 samples, of which 562 (69.1%) were collected as part of Africhol supported activities. Among the 813 samples, 187 yielded cholera.

July 19, 2011

A surge of cholera cases has been reported since week 22 in five districts in the DRC. The first cases were reported from Kinshasa during week 24.

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Publications & Data

DRC

Authors: Jean Jacques Muyembe, Didier Bompangue, Guy Mutombo, Laurent Akilimali, Annie Mutombo, Berthe Miwanda, Jean de Dieu Mpuruta, Kabunga Kambale Deka, Fataki Bitakyerwa, Jaime Mufitini Saidi, Armand Luhembwe Mutadi, Raphael Senga Kakongo, Freddy Birembano, Martin Mengel, Bradford D. Gessner, and Benoît Kebela Ilunga
Cholera in Africa: Microbiology, Epidemiology, Prevention and Control
Africhol - The Cholera Surveillance Network in Nine Sub-Saharan African Countries

The Ministry of Health of the Democratic Republic of Congo presented the “The National Plan for the Elimination of Cholera 2013-2017” at a international conference last month. Since 2007, the Democratic Republic of Congo has initiated a comprehensive program to fight against cholera, with the aim to lower the national incidence of confirmed cases below one per 100,000 people. First addressed exclusively as a health issue, the strategy now considered is multisectoral combining "Health, Water, Sanitation and Hygiene."

Situation épidémiologique du choléra en République Démocratique du Congo en 2011
Author: Cellule de suivi du choléra en RDC - Juin 2012
Read the report (in French)