Cholera vaccination necessary
Uganda has been intermittently hit by cholera outbreaks. This year alone, more than 30 deaths and 2,000 cholera cases have been reported in Hoima and Kyegegwa districts. Moreover, it is particular geographical areas or spots (cholera hotspots) that are always severely affected before the disease spreads to other areas.
Cholera is an acute illness caused by bacteria called Vibrio cholera, characterised by acute watery diarrhoea. Within a very short time, cholera patients can die if their cases are not quickly managed by a health worker.
The disease is transmitted through drinking water or eating food contaminated with faeces harbouring the bacteria. It is largely defined as a disease of inequity. According to the Global Task Force to End Cholera, the disease and poverty go hand-in-hand. In the affected countries, the poorest of the poor, are the most affected.
In Uganda, cholera outbreaks have been reported in areas near rivers or lakes in the Western Rift Valley, especially near lakes Albert, Edward, Katwe and George. Similarly, communities living along borders, especially DR Congo and South Sudan, have in the past been greatly affected. This makes fishing communities and refugee settlements in the areas very vulnerable. Unfavourable conditions like overcrowding, poor sanitation, and inadequate water supply can lead to cholera outbreaks.
While the long-term solution for the prevention of cholera remains access to safe water, hygiene promotion, etc, Oral Cholera Vaccines (OCV) can play a vital role in prevention and control of an outbreak. The cholera vaccine is not different from other vaccines that are administered on a routine basis in Uganda. The vaccine contains either weakened or killed bacteria or its components that when introduced into the human body, will stimulate it to provide immunity against cholera. The vaccine is administered through the mouth.
OCVs have been reported to provide protection in about 52 per cent of cases in the first year after vaccination. Protection increases to about 62 per cent of cases during second year after vaccination. This protective value of OCVs should be a basis for considering their use in cholera-prone areas.
According to the WHO, two OCVs types are recommended and are readily available. These can be procured by the governments or development partners for mass vaccination campaigns. Uganda is currently one of the 47 countries that are eligible for financial support for vaccines and vaccine delivery provided by GAVI and may readily access the OCV under this arrangement.
The safety profile for the OCVs has been studied extensively before and after putting the vaccines on the market. The OCVs has been shown to have a good safety profile, including when used in pregnancy and in HIV-infected or other immune-compromised individuals. The commonly reported adverse effects with OCV use are abdominal discomfort, pain or diarrhoea.
Uganda’s most vulnerable communities should be prime targets for cholera vaccination to prevent outbreaks.
Godfrey Nsereko,
Kampala
