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The mass vaccination against cholera in Mozambique's
second largest city, Beira, ended with 81.7% of those
who took the first dose of the oral vaccine in December
2003 returning in January 2004 for the second dose. In
absolute figures, 53 980 people took the first dose, and
44 111 came back for the second. According to the deputy
national health director, speaking at a
press conference on 15 January,
this can be regarded as
a success because in general, when vaccines involve two
doses, only 70-72% of those who took the first dose
return for the second dose. The vaccine was administered
in the Beira neighbourhood of Esturro, and Barreto hoped
that at least 60% of this neighbourhood's population
would now be protected against cholera for the next two
or three years. "If the vaccine proves effective, the
possibility will be open for expanding its use to other
areas at risk of cholera outbreaks", he said.
He pointed out that vaccination is much cheaper
than treatment. Keeping cholera victims alive in special
cholera wards costs $30 to $35 per patient, and this
figure does not include staff costs. The oral vaccine
has given good results on a limited scale in India and
Afghanistan, but the Beira experiment was the first time
that it has been administered to an entire population.
The results will thus be important, not only for
Mozambique, but for many other developing countries
where cholera is a serious threat. The challenge facing
the health authorities now, he noted, is to follow
up those who took the vaccine and check that they really
are immune to cholera.
Meanwhile the number of diagnosed cholera cases is
continuing to rise in Maputo, Beira, the district of
Massingir and the southern province of Gaza, while
reports in the Maputo daily Noticias indicates the
outbreak has now reached the northern province of
Nampula and the central province of Zambezia. In Nampula
two people have died of the disease in Mucoroge, in the
coastal district of Moma,
and a further eight people are
being treated for cholera in the local health centre. In Zambezia, one person has died.
According to health officials the current death toll
stands at 17. Maputo City has been worst hit with ten
deaths. There have been two deaths in Beira, two in the
southern province of Gaza and two in the northern
province of Nampula. In Maputo there are currently 307
people hospitalised with cholera. There has also been a
sharp increase in the number of cases diagnosed there.
Health authorities are expanding the capacity of the
Cholera Treatment Centre at Mavalane General Hospital by
erecting four more tents that can hold 80 beds on the
hospital grounds. The 250-bed centre had to deal with
307 patients after heavy rains caused a sharp increase
in the number of cases diagnosed in Maputo over the
weekend. Like any water borne disease, cholera thrives
when rain swamps poor areas of major cities that lack
adequate sanitation. However, authorities in Beira have
reported that the situation is under control, with only
19 people hospitalised in the city. A further 13 people
are being treated for cholera in the rural district of
Maringue.
The basic precautions to take against cholera seem quite
easy – notably ensuring that drinking water is clean,
which can be achieved by boiling the water to kill the
micro-organisms that cause the disease. But this is far
from simple in poor urban neighbourhoods. Some cholera
victims interviewed by the Mozambican news agency AIM in
the Mavalane treatment centre said that they did not
boil their water because of the cost of firewood or
charcoal.
Mozambican health authorities are stepping up their
prevention campaign against cholera, urging citizens to
boil water before they drink it, to avoid drinking water
from sources anywhere near sewers or drainage channels,
and to wash raw foods such as salad vegetables properly.
The authorities are also using chlorine to treat water
sources in Nicoadala district, and are ensuring that
health centres throughout Zambezia have sufficient
medicines to deal with any further spread of cholera. |
