Extended cholera epidemic in Ethiopia

The current cholera epidemic in Ethiopia is among the longest ever recorded in the country. The index case was reported on August 27, 2022 from Harana Buluk District (Bale Zone, Oromia Region), and the first outbreak was confirmed on September 9, 2022. The outbreaks then further spread to Somali Region, followed by SNNP and Sidama Regions (1).

The epidemic has continued into 2023, with a total of 1,068 suspected cases reported as of February 2nd (2). The number of weekly cases then further increased between March and June. As of July 4, a total of 12,613 suspected cholera cases and 169 deaths have been reported. Out of the four affected regions, Oromia and SNNP have reported the highest case numbers, with 6,817 and 3,978 cumulative cases, respectively. Weekly cholera case numbers have only recently started to subside in late-June (3).

Outbreaks in districts in southern Ethiopia were possibly associated with cross-border transmission. The outbreak in Dollo Ado likely involved cross-border transmission with Somalia, as 139 suspected cholera cases were reported in neighboring Belet Hawa during week 11 (4). Cholera cases were also reported in counties in northern Kenya that border the Ethiopian frontier, including Mandera and Marsabit (5).

Water supply coverage is low in the cholera-affected areas (1). Indeed, limited access to water and sanitation services, poor hygiene practices (including open defecation), and population movement due to severe weather events and insecurity are major factors that have contributed to the rapid spread of the disease. Since the onset of the epidemic, outbreak control has been challenging due to inadequate response capacities, contamination of water sources, and limited access due to insecurity and floods. There is a critical need to strengthen the outbreak response and bolster cross-border collaboration with Kenya, Somalia and South Sudan (3).