Typhoid spreads

Some 203 new cases of typhoid were this week recorded as the disease spread to other parts of the country amid fears the contagion could explode to the 2008 cholera outbreak levels.

The fresh cases were recorded in Kuwadzana (93), Mufakose (31), Crowborough (22), Parirenyatwa Hospital (1), Bindura (23) and other areas across the country (33).

Since the first outbreak in October, the epidemic has claimed one life and recorded 3 074 suspected cases.

Health ministry director of epidemiology and disease control unit Portia Manangazira yesterday told the Parliamentary Portfolio Committee on Health and Child Welfare efforts to contain the outbreak were being hampered by poor water and sanitation facilities around the country.

We have recorded 203 new typhoid cases this week only, said Manangazira. At the beginning we had 20, then 30 and 100. Now its over 200, so we actually have an outbreak and it is raging. We have already had reports of cases out of Harare, especially in Bindura.

The conditions in Bindura, she said, were similar to those that sparked the cholera outbreak in Harare.
What especially worried me was the water and sanitation situation at Bindura Provincial Hospital where there are only two taps.

The hospital staff was using the bucket system and there was sewage flowing (on the premises), yet this is a provincial hospital, Manangazira said.

She said under normal circumstances, an individual required at least 20 litres of water for use on a daily basis and in the case of a diarrhoeal outbreak, at least 50 litres sufficed.

There has been very poor management of sewage as most cities in the country are throwing sewage into rivers which are the sources of drinking water, she said.

I regret to say we are not quite on top of the situation. At the moment we need a budget to assist us in training personnel, development of community awareness materials, coordination of meetings and running a command centre. She said the ministry did not have adequate supply of drugs for patients, especially Rocephin, which was the drug of choice in treating typhoid.

The ministry, Manangazira said, had established a list of 30 high risk districts including Chitungwiza (Unit G, N and O), Harare, Tafara/Mabvuku, Kadoma and Makonde.

Meanwhile, acting Secretary for Health and Child Welfare Davies Dhlakama has attributed the high mortality rates at the countrys hospitals to the prohibitive cost of blood required during delivery.

Giving oral evidence before the Parliamentary Thematic Committee on Millennium Development Goals (MDGs), Dhlakama said 40% of maternal deaths recorded countrywide were caused by post-natal bleeding and failure by expecting mothers to raise the $100 needed for each pint of blood.

Blood costs plus or minus $100 per pint and normally one needs two to three pints, he said.

There are those expecting mothers who are unable to pay for blood and 40% of maternal deaths are caused by post-natal bleeding and so we give coupons to mothers to access blood, resulting in 422 facilities having benefited since 2010.

That blood must be tested so that it is HIV and hepatitis virus-free and those tests are very expensive.

He told the committee government had injected $10 million towards scrapping off user fees.
Development partners like the Department of International Development of the United Kingdom put in $120 million last year and the European Commission will tomorrow sign for $4 million to go towards helping remove maternal fees, he added.

Apart from prohibitive maternity and blood fees, Dhlakama also cited shortages of midwives and medicines as some of the drawbacks in the countrys quest to achieve its MDG targets.

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