| 01 Mars 2012
About 1.4 billion people live in places where they are at risk of cholera infection, according to a study published this month in the Bulletin of the World Health Organization.
The study estimates that around 3 million people are infected with cholera every year and around 100 000 people die from the disease. These figures are more than ten times higher than the official number reported to the World Health Organization (WHO).
Cholera infection, which causes acute watery diarrhoea and severe dehydration, occurs mainly where people live in crowded housing with poor sanitation. Half the cases and deaths are in children aged less than 5 years.
Countries are required to notify WHO of cholera outbreaks under the International Health Regulations but WHO estimates that it only receives reports of less than 10% of cases. “Many countries do not have adequate laboratory and surveillance systems to detect cholera,” says Dr Claire Lise Chaignat, from the Department of Pandemic and Epidemic Diseases at WHO. “Countries are also reluctant to report outbreaks due to fear of a negative effect on tourism and trade.”
“Many deaths in developing countries probably occur before patients reach the hospital so statistics are likely to be underestimated,” says study author, Dr Mohammad Ali, from the International Vaccine Institute, Seoul, Republic of Korea.
“If cases are not reported then resources cannot be allocated to deal adequately with the disease. Policymakers need to know the burden of disease and the population at risk.”
The study used a combination of sources, including an online forum for infectious disease specialists, media reports and sanitation data, to supplement WHO cholera reports. It found that the burden of cholera is highest in Africa and southern Asia. The three largest countries where cholera is endemic are China, India and Indonesia, although the study only considered the percentage of their populations living with poor sanitation. However, the researchers considered the entire population of Bangladesh to be at risk of cholera infection due to frequent, widespread flooding.
Epidemic cholera, such as the recent large outbreaks in Haiti and Zimbabwe, can have a serious impact on local populations. However, the disease is often overlooked in countries where it is endemic, even though it affects significantly more people. Data from this study may help policy-makers and WHO’s Global Task Force on Cholera Control to determine requirements for future cholera control.
Read the paper here: http://www.who.int/bulletin/volumes/90/3/11-093427/en/index.html
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The Bulletin of the World Health Organization is one of the world’s leading public health journals. It is the flagship periodical of WHO, with a special focus on developing countries. Articles are peer-reviewed and are independent of WHO guidelines. Abstracts are now available in the six official languages of the United Nations.
Also in this month's issue:
• Awareness the first step in breast cancer battle
• Don’t let torture victims fall through the cracks, says human rights expert Erik Holst
• More child-friendly medicines needed
• Shortage of medicines ‘a global challenge’
• Healthy ageing innovations
• Fewer people with access to safe drinking water
The March issue table of contents can be found at: http://www.who.int/bulletin/volumes/90/3/en/index.html
The complete contents of the Bulletin, since 1948, is available free to all readers worldwide through PubMed Central, available at: http://www.pubmedcentral.nih.gov/tocrender.fcgi?journal=522&action=archive
