The southern part of Chad has been the scene of a meningococcal meningitis outbreak since 18 March 2011, affecting half the districts in Chad at an alarming rate. This epidemic is accompanied by cases of measles which have appeared in almost the same region. To date, approximately 2,337 cases have been detected and 109 deaths recorded.
The situation has been further exacerbated in the impoverished and neglected Bongor region where a serious cholera epidemic left 1,500 people ill and 30 confirmed dead.
Faced with these epidemics, local emergency services are overstretched and the Chadian health ministry is calling for the urgent support of all its humanitarian partners.
According to Dr Zeneba Mourba, of the Chadian Red Cross, “We must act quickly to fight cholera and meningitis, especially since we are in a season when temperatures can reach 50 degrees Celsius, combined with the abundance of mangoes that children pick up and eat without washing with no attention to hygiene, as well as the rainy season in May, all aggravating the situation. It is therefore urgent to act now to save the lives of these children who have no alternatives and are not able to protect themselves from these epidemics.”
WHO, UNICEF, Médecins Sans Frontières and the International Federation of Red Cross and Red Crescent Societies (IFRC), in coordination with the Chadian ministry of health, will conduct vaccination campaigns, and take effective measures focusing on prevention, preparedness and emergency response to the outbreaks.
Local Red Cross branches will mobilize communities and raise awareness about the danger of epidemics and the importance of preventive measures such as hygiene, whilst referring each suspected case to the nearest health centre and continuing to monitor closely developments in surrounding areas not yet affected.
“The only problem we see is that the not all the Red Cross volunteers may have received the health training modules to be applied in such emergencies,” added Panu Saaristo, coordinator of the IFRC in matters of health emergencies. “We will have to train them more quickly in order to create an effective mechanism for mobilization, prevention and response.”
A joint report published by the IFRC and GAVI, Immunization: unfinished business, shows that too many children still die from vaccine-preventable diseases, as is the case here in Chad. However, vaccination is a key and inexpensive solution that improves the general health of children in the poorest countries in the world. Nevertheless, to achieve continued success, we need long-lasting political and financial commitment.
Meningococcal meningitis is a bacterial form of meningitis that infects the brain and spinal cord. The meningitis belt of sub-Saharan Africa – stretching from Senegal in the west to Ethiopia in the east – has the highest rates of the disease. Group A meningococcus accounts for an estimated 80–85 per cent of all cases in the meningitis belt, with epidemics occurring at intervals of 7 to 14 years. In the 2009 epidemic season, 14 African countries implementing enhanced surveillance reported 88,199 suspected cases, including 5,352 deaths – the largest number since the 1996 epidemic. Several vaccines are available to control the disease.
Measles is one of the leading causes of death among young children even though a safe and cost-effective vaccine is available. In 2008, there were 164,000 measles deaths globally – nearly 450 deaths every day or 18 deaths every hour. More than 95 per cent of measles deaths occur in low-income countries with weak health infrastructures. Measles vaccinations resulted in a 78 per cent drop in measles deaths between 2000 and 2008 worldwide. In 2008, about 83 per cent of the world's children received one dose of measles vaccine by their first birthday through routine health services – up from 72 per cent in 2000.
Cholera is an acute diarrhoeal disease that can kill within hours if left untreated. There are an estimated 3–5 million cholera cases and 100,000–120,000 deaths due to cholera every year. Up to 80 per cent of cases can be successfully treated with oral rehydration salts. Effective control measures rely on prevention, preparedness and response. Provision of safe water and sanitation is critical in reducing the impact of cholera and other waterborne diseases. Oral cholera vaccines are considered an additional means of control cholera, but should not replace conventional control measures.
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