Jacqueline Deen (International Vaccine Institute, Seoul, Korea) and colleagues in Indonesia, India, and Mozambique established cholera surveillance based at treatment facilities at these three sites.
The lowest overall cholera rate was in Jakarta with 0.5 cases per 1000 population per year. The incidence was three times higher in Kolkata (1.6/1000/year) and eight times higher in Beira (4.0/1000/year), adding to the growing impression of a large cholera problem in Africa. In all sites, children were the most affected.
“Cholera is an often forgotten disease affecting the world’s forgotten people,” say Deen and colleagues. “When a large cholera outbreak occurs, the disease appears briefly on the radar of public attention. Some unfortunate populations around the world suffer recurrent episodes of cholera but their plight goes unnoticed.”
The authors argue that the new estimates from their study are valuable when considering where and among whom interventions against cholera are most needed. “Improvement of water supply and sanitation is the best strategy against cholera and other diarrheal diseases,” say the authors, “but may not be achievable in these impoverished areas in the near future. Other immediate, short- to medium-term strategies such as vaccination against cholera may be useful.”
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