Epidemiological characteristics and outcomes of the 2023–2024 cholera outbreak in South Yemen: A retrospective descriptive study from MSF-supported centres

BACKGROUND

The cholera burden in Yemen is the highest in the world, with the country facing recurrent outbreaks. It is worsened by the ongoing conflict, limited access to clean water, and the deteriorated sanitation and health systems. In November 2023, a cholera outbreak started in Shabwah governorate and seemed to be controlled in January 2024. However, in March 2024, cholera spread westward, causing 40,000 suspected cases in South Yemen.

METHODS

Routinely collected data were used to provide descriptive statistics of the 2023–2024 cholera outbreak of patients managed in the Médecins Sans Frontières (MSF)–supported cholera treatment centers (CTCs) and units (CTUs) of Aden, Ataq, Mafraq and Mocha.

RESULTS

There were 10,252 suspected cholera cases admitted to MSF-supported facilities. Of these, 52.5% were male, and 41.4% were aged 15–44 years and 24.1% 0 to 4 years. Most cases were managed in Aden (56.2%) and Mocha (24.8%). Of these, 43.1% were classified as non-dehydrated (plan A), 41.9% had moderate dehydration (plan B), and 15.0% had severe dehydration (plan C). The overall case fatality rate in MSF-supported facilities was 0.2% compared to 0.52% across South Yemen. Aden’s Sadaqa CTC treated 80.3% of all Plan C cases, reflecting its role as a referral hub.

CONCLUSION

The 2023–2024 cholera outbreak highlighted persistent challenges in South Yemen, such as conflict, inconsistent laboratory testing and surveillance, and limited access to healthcare, despite a low case fatality rate. Outbreak preparedness must shift from reactive to anticipatory, including strategic storage of medicines, vaccines and diagnostics and clear guidelines on how to use them.