[Endemic cholera in Chad: a real public health problem]

At the present time, cholera epidemics have become annual, even seasonal, events in Chad. This review of data obtained from a Division of the Sanitation Information System in Chad was carried out to determine the epidemiological profile and natural course of cholera in Chad and to propose preventive measures within the country's means. The main findings were that cholera epidemics start at the junction between the dry and rainy season (March to June), that they last for six months, and that peak incidence occurs 4 to 6 weeks after the first reported cases. The mortality rate is approximately 5 p. 100 depending on time and place. Two foci were located: one at Logone-Gana (Chari-Baguiri) and the other at Fianga (Mayo-Kebbi). These findings show that cholera is now endemic in Chad. A major implication of this study is that decentralized epidemiological surveillance should be set up with monitoring units located around endemic sites. Mortality could probably be lowered by better patient care at the beginning of the epidemic. Improvements in public hygiene, waste disposal, and water purification are needed.