Clinical Characteristics of 6578 Adult Patients With Cholera Admitted to Community and Referral Cholera Treatment Centers in Lusaka, Zambia, October 2023 to April 2024
By
Nyuma Mbewe
Tadatsugu Imamura
Suilanji Sivile
Annel Sinkala
Paul Zulu
Chitalu Chanda
Neil Naik
Nawa Kalima
Roy Tepa
Kabaso Mwewa
Kenneth Kapololwe
Anchindika Mugala
Aggrey Mweemba
Davie Simwaba
Muzala Kapina
Kelvin Mwangilwa
Lalisa Nambeya
Sophia Msiska
Aspha Choonga
Bob Chirwa
Shingo Mitsushima
Yuuki Tsuchihashi
Nathan Kapata
Taro Kamigaki
Lloyd Mulenga
Roma Chilengi
May 8, 2025
Clinical Scorecard: Clinical Features of 6,578 Adult Cholera Patients Hospitalized in Lusaka, Zambia, from October 2023 to April 2024
At a Glance
Category Detail
Condition Cholera caused by Vibrio cholerae infection Key Mechanisms Acute diarrheal disease leading to hypovolemic shock and electrolyte loss in severe cases Target Population Adult patients hospitalized with cholera in Lusaka, Zambia Care Setting Community and referral cholera treatment centers (CTCs) in Lusaka
Key Highlights
Largest cholera outbreak in Zambia's history with 6,578 adult cases identified between October 2023 and April 2024 Overall case fatality rate (CFR) was 1.0%, highest (4.1%) in referral CTC specializing in patients with underlying conditions Age, HIV infection, diabetes mellitus, and severe dehydration at admission independently correlated with fatal outcomes Guideline-Based Recommendations
Diagnosis
Suspected cholera defined as ≥3 bouts of watery stools within 24 hours Management
Initial clinical assessment at community CTCs for disease severity and risk factors Referral of patients with underlying conditions or severe symptoms to specialized referral CTCs Strategic centralization of severe cases to prevent overwhelming healthcare resources Monitoring & Follow-up
Monitor patients for severity of dehydration and presence of comorbidities such as HIV and diabetes mellitus Risks
Increased risk of fatal outcomes associated with older age, HIV infection, diabetes mellitus, and severe dehydration at admission Patient & Prescribing Data
Adult cholera patients hospitalized in Lusaka during the 2023–2024 outbreak
Enhanced case management targeting high-risk groups (older age, HIV, diabetes, severe dehydration) may reduce case fatality rates
Clinical Best Practices
Early identification and assessment of disease severity and underlying conditions at first point of care Use of a referral system to manage severe cases and those with comorbidities in specialized CTCs Implementation of outbreak management strategies to prevent healthcare system overload Focus on hydration status and management of electrolyte loss to prevent fatal outcomes References
