29 September 2023, Cairo, Egypt – Sudan has declared a cholera outbreak in Gedaref State, where 264 suspected cholera cases, 4 confirmed cases and 16 associated deaths had been reported by 25 September 2023. Investigations are ongoing to determine whether cholera has also spread to Khartoum and South Kordofan states, where increased cases of acute watery diarrhoea have been reported.
Dr Nima Abid, WHO Representative in Sudan, visited Gedaref State on 17 September 2023 and met with health authorities and partners to coordinate the response. “Unhindered access to affected and neighbouring localities is essential to respond effectively to the ongoing outbreak,” said Dr Abid. “A cholera outbreak can have a devastating effect in the context of a health system already overstretched because of war, shortages of medical supplies and health workers, malnutrition and access challenges.”
Even before the outbreak was declared, WHO had already provided cholera supplies, including antibiotics, oral rehydration solution and intravenous fluids, to 6 states, including Gedaref, Khartoum and South Kordofan, as well as rapid diagnostic test kits to all 18 states of Sudan. WHO was also supporting 3 cholera isolation centres in Gedaref State – 2 of them with medicines and health supplies, and fully supporting the final centre with the provision of equipment and medical supplies.
Earlier this year, more than 2800 Sudanese health workers took part in an online capacity-building programme conducted by WHO on the management of acute watery diarrhoea in times of crisis. Another online training course, on cholera, dengue and malaria management protocols, took place this week, for more than 8000 Sudanese health workers. On-the-job training on surveillance and standard case management for cholera and other infectious diseases was also conducted in Gedaref for 185 health workers.
Currently, WHO is deploying rapid response teams to the affected localities and is actively supporting the Ministry of Health to transfer samples of suspected cholera cases to the Public Health Laboratory in Port Sudan, a facility capacitated by WHO to provide a national reference service. Surveillance is ongoing in affected and high-risk areas to identify and address risk factors. Plans have been initiated to facilitate a request to the International Coordinating Group on Oral Cholera Vaccine Provision for Cholera Control for oral cholera vaccines to protect the population and contain the outbreak.
With support from WHO and health partners, the Ministry of Health is also coordinating efforts to scale up access to clean water and sanitation facilities, as well as ensuring affected and at-risk communities are aware of transmission risks and proper hygiene practices to reduce contamination risks and prevent further spread of the outbreak.
As a result of the war that erupted in April 2023, Sudan is grappling with unprecedented mass displacement, disease outbreaks and malnutrition, which have been compounded by heavy rains and flooding. The health system is overwhelmed by attacks on health facilities and the scarcity of medical supplies and equipment, health workers and operational funds. About 70% of hospitals in conflict-affected states are non-functional, while the active hospitals and clinics in non-conflict-affected states are overwhelmed by the influx of internally displaced people.
