A disease that advances hidden
Cholera in Togo is a disease that often spreads silently. “There are many healthy carriers. Out of 100 cases of cholera, barely 10 people develop the disease,” explains Dr Tante Ouyi, head of non-communicable disease surveillance at the Ministry of Health. “Some people suffer from severe diarrhea without samples being taken, giving the impression that they do not have cholera. This is the problem in Lomé. The reported cases are those for which the samples turned out to be positive, but there are certainly undetected cases,” he emphasizes.
This phenomenon complicates the fight against the disease in areas already weakened by precarious health infrastructures. In Adakpamé, a district of the Golfe 1 commune, cholera has taken root, and the detection of new cases is a real challenge. This reality alarms health authorities, who are stepping up efforts to stem the epidemic.
“Some people suffer from severe diarrhea without samples being taken, giving the impression that they do not have cholera. This is the problem in Lomé. The reported cases are those for which the samples were positive, but there are certainly undetected cases. »
– Dr Tante Ouyi, head of non-communicable disease surveillance at the Ministry of Health
Since the beginning of October, the Gulf health district, which includes the capital Lomé, has experienced an increase in cases. Four deaths have been confirmed. In Adakpamé, a district in the west of the capital, authorities and community stakeholders are working to intensify prevention and awareness. The crisis committee, set up by the Ministry of Health, is actively mobilized to stop the spread of the disease.
Dr Tante Ouyi, head of non-communicable disease surveillance at the Ministry of Health.
Credit: Naphtali Ledy
However, the true extent of the situation remains difficult to determine. “A single case in a community like ours cannot live in isolation,” warns Dr Ouyi, suggesting that the number of unreported cases could be much higher than official figures indicate.
Faced with this emergency, the crisis committee’s mission is to raise awareness and distribute pharmaceutical products such as chlorine. The National Agency for Sanitation and Public Health (ANASAP) was also mobilized to collect garbage and disinfect the affected areas, the minister said.
A key community lever in the fight against cholera
Community involvement is essential to avoid large-scale spread. “They play a crucial role in the prevention of cholera. It is essential that they actively participate in improving hygiene practices, sanitation management and local monitoring of health risks,” underlines Dr Koffi Atassé Serge, public health doctor specializing in epidemiology and community health. It also emphasizes the need for communities to promptly report suspected cases of acute diarrhea.
Already, several neighborhoods are on alert. In endemic areas, where sanitation is often insufficient and the use of public toilets is widespread, the consumption of street food remains a common habit, often without respect for hygiene rules. Mobilization is therefore urgent.
In the Bè Wété district, for example, neighboring the affected area, the Neighborhood Development Committee (CDQ) took immediate measures. “We contacted private health centers, community leaders and NGOs to eradicate this disease,” says Napoléon Akpaloo, chairman of the committee. Women play a key role here, relying on their weekly meetings to organize awareness-raising actions.
In Akodésséwa, another neighborhood under surveillance, information campaigns were launched in public places. “As soon as we heard about the disease, we intensified efforts at the bus station, at the market and in front of public toilets to remind everyone of the rules of hygiene,” explains Kougnima Max, president of the CDQ.
The support of volunteers from the Togolese Red Cross (CRT) is also decisive in prevention. “Our volunteers are mobilized for hygiene activities, disinfection of public places and distribution of chlorine tablets. They also raise awareness among communities about the precautions to take regarding water, food and hand washing,” explains Dr Koffi Nsoukpoe, head of the CRT Health department.
Persistent challenges
Despite Togo’s experience in managing cholera, obstacles remain, particularly in terms of rapid detection of cases. The lack of rapid diagnostic tests (RDTs) complicates the authorities’ ability to respond proactively. “Until we have a TDR, it is difficult to say that the situation is under control. These tests are essential to break the chain of contamination,” recognizes Dr. Tante Ouyi.
To sustainably overcome this epidemic, an integrated approach is necessary, combining prevention, access to drinking water and adequate sanitation facilities, as well as reinforced surveillance. The mobilization of communities, on the front lines facing this threat, remains a key asset in this fight against a disease that continues to ravage in silence.
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