Situation at a glance
Cholera is endemic in Malawi with seasonal outbreaks reported during the wet season. Since 1998, cholera cases have been reported in the country with significant morbidity and mortality in affected populations, especially in the southern region, which is low-lying, flat, and prone to flooding during the rainy season.
The current outbreak, which started in March 2022 has affected 27 of 29 districts of Malawi and represents the largest outbreak reported in the country in the past ten years. The outbreak is taking place in the context of tropical storm Ana (January 2022) and Cyclone Gombe (March 2022) which caused floods leading to the displacement of a population with low pre-existing immunity that now lacks access to safe water, sanitation, and hygiene.
Description of the cases
On 3 March 2022, the Ministry of Public Health of Malawi notified WHO of a cholera outbreak after laboratory confirmation of a cholera case in Machinga district hospital on 2 March 2022.
Between 3 March through 31 October 2022, a cumulative total of 6056 cases including 183 deaths have been reported from 27 of 29 districts in Malawi (overall case fatality rate (CFR) 3.0%) with active transmission ongoing in 23 districts as of 31 October. Five districts account for 79% of the reported cases and 68% of the deaths: Nkhata Bay (1128 cases and 31 deaths), Nkhotakota (811 cases and 40 deaths), Rumphi (783 cases and 13 deaths), Karonga (683 cases and 14 deaths), and Blantyre (650 with 26 deaths).
The outbreak originated in the Southern region of Malawi with cases reported in Nsanje and Machinga districts. Currently, the most affected districts in Malawi are in the Northern part of the country. The most affected age groups are 21-30 years, and males are disproportionately affected.
Source: World Health Organization