These outbreaks were generally contained by case management, but the strategy began to fail with increasing chloroquine resistance. As a result, the outbreak was kept in check during the early stages, but as the intensity of transmission increased at the beginning of May, the number of patients outstripped the capacity of the health facilities, leading to a severe management crisis at all levels including in drug procurement systems. Stocks of antimalarial drugs have now been exhausted in most districts owing to the unusually severe outbreak this year. An integrated approach to malaria control is needed. Mortality rates are still at emergency level, and they are not expected to decrease, as the number of new cases continues to rise.
Environmental conditions are still suitable for mosquito breeding.
Shigella in Guinea Following reports of an outbreak of diarrhoeal disease, a rapid-response team has visited the district of Dabola located 450km from Conakry. All 7 patients have been treated with norfloxacin and have recovered. No new case has been reported. A total of 14,402 cases of severe diarrhoea, including cholera cases, has been reported between 29 May and 12 July. The most affected area is Kabul province, Central region where nearly 7,000 cases have occurred.