PDF(Pubmed)
Abstract：
Cholera remains a significant public health concern in Ethiopia. More than 15.9 million Ethiopians, constituting 15% of the total population, live in areas with a history of recurrent cholera outbreaks. The last 9 years of national cholera surveillance data show the country has been experiencing cholera outbreaks every year. The current cholera outbreak, starting in August 2022, has affected the entire country, with 841 reported cases and a 3.13% case fatality rate (CFR) in 2022, and >30 000 cases with nearly a 1.4% CFR in 2023. In line with \"Ending Cholera-A Global Roadmap to 2030,\" the government of Ethiopia is committed to eliminate cholera in the country and has prepared its \"National Cholera Elimination Plan (NCP): 2022-2028\" with aims to achieve zero local transmission in cholera hotspot areas by 2028 and 90% fatality reduction from the recent (2020-2022) average of 1.8% CFR. The plan is multisectoral, has a clear coordination platform, contains all interventions with in-depth situational analysis, is concordant with existing plans and strategies, and is cascaded at the regional level and implemented with existing government and public structures. Nationwide, total 118 cholera hotspot woredas (districts) were identified, and a comprehensive situation analysis of the existing cholera outbreak response capacity was assessed. This multisectoral and multiyear NCP has forecasted around US$404 million budget estimates with >90% allocated to improving the country\'s water, sanitation, and hygiene (US$222 million; 55% of total NCP budget) and case management (US$149 million; 37%). The cholera vaccination strategy included in the NCP exhibited a 5-year oral cholera vaccine (OCV) introduction plan with 2 doses (30 604 889 doses) and single dose (3 031 266 doses) in selected cholera hotspot areas. However, its implementation is challenged due to a lack of financial support, inability to get the requested vaccine for targeted hotspot woredas (due to the current shortage of doses in the OCV global stockpile), recurrent cholera outbreaks, and high humanitarian needs in the country. It is recommended to have a sustainable financial mechanism to support implementation, follow the requested vaccine doses, and reorganize the planned coordination platform to foster the implementation.
摘要：
霍乱仍然是埃塞俄比亚的一个重大公共卫生问题。超过1590万埃塞俄比亚人，占总人口的15%，生活在有霍乱反复爆发史的地区。过去9年的国家霍乱监测数据显示，该国每年都会爆发霍乱。目前的霍乱爆发,从2022年8月开始，影响了整个国家，2022年报告病例841例，病死率（CFR）为3.13%，2023年报告病例>3万例，CFR接近1.4%。根据“结束霍乱-到2030年的全球路线图”，埃塞俄比亚政府致力于消除该国的霍乱，并制定了“国家霍乱消除计划（NCP）：2022-2028”，目标是到2028年实现霍乱热点地区的零本地传播，并比最近（2020-2022年）平均1.8％的CFR减少90％的死亡人数。该计划是多部门的，有明确的协调平台,包含所有干预措施，并进行深入的情境分析，符合现有的计划和战略，并在区域一级进行级联，并与现有的政府和公共结构一起实施。全国范围内,共确定了118个霍乱热点地区(区)，并评估了现有霍乱疫情应对能力的全面情况分析。这个多部门和多年的NCP已经预测了约4.04亿美元的预算估计，其中>90％用于改善该国的水，卫生，卫生（2.22亿美元；占NCP总预算的55%）和病例管理（1.49亿美元；37%）。NCP中包含的霍乱疫苗接种策略在选定的霍乱热点地区展示了5年口服霍乱疫苗（OCV）引入计划，包括2剂（30604889剂）和单剂量（3031266剂）。然而,由于缺乏财政支持，其实施受到挑战，无法获得针对目标热点的疫苗（由于OCV全球库存中当前剂量不足），反复爆发霍乱,以及该国高度的人道主义需求。建议建立一个可持续的财务机制来支持实施，按照要求的疫苗剂量，重组计划协调平台，促进实施。
