Disease Surveillance Officer, Ministry of Health – Epidemiology Unit
Republic of Malawi
Malawi is prone to regular cholera outbreaks, particularly in the southernmost districts of Machinga, Zomba and Phalombe which share the Lake Chilwa (population: 742,083 people). Outbreaks usually occur in the period of May to November every year, during the time the lake is open for fishing. This year the Ministry of Health collaborated with the Agence de Medicine Preventive (AMP) to conduct a preventive mass-vaccination campaign targeting 80,000 people with a two-dose OCV regimen of Shancol®. Funding for the vaccines and the campaign was to be provided by AMP.
While preparations for the vaccination campaigns were underway, Malawi started registering cholera cases in the islands of Lake Chilwa and areas surrounding the lake. A total of 670 cases were reported in this region, and over 730 total cases reported in Malawi. In response to the outbreak the Ministry of Health Malawi requested 160,000 OCV doses from the WHO emergency global stockpile to vaccinate a target population of 80,000 people around the lake.
The planned preemptive vaccine campaign was turned into re-active campaign, aimed at providing two doses per person in the shore and floating homes (in the lake) and islands.
The first round of vaccination was done from February 16th-20th and was based on direct observed therapy (DOT) for all the three areas. The second round of vaccination was conducted March 8th -10th. DOT was used for the second dose in the shore. People in the floating homes were given the second dose when they received the dose and instructed to take it after 14 days.
Results: Overall 80,000 (100% of the a
signed vaccine for first dose were all used) and 60,240 (75.3.%) completed the required two doses.
Conclusion:This report has highlighted the first large-scale OCV mass campaign conducted in the mobile population of fishermen in Malawi. It has been demonstrated that it is feasible and acceptable by mobile fishermen community to conduct OCV campaign with high coverage. The process and results of the campaign will set a basis for further campaigns of similar nature in Malawi and other sub-Saharan Africa countries.