ABSTRACT
Since the seventh pandemic caused by Vibrio cholerae biotype El Tor began in Indonesia in 1961, most regions of the world continue to report cholera outbreaks.1 Cholera is most common in rural areas or communities where sanitation conditions and water supply are problematic.2 In 1997, a cholera epidemic affected most countries of eastern, central and southern parts of Africa, including Mozambique. Nearly 80% of cases reported worldwide to WHO were from Africa ( 118 000 cases), and Africa had the highest case fatality rate, 4.9%, compared with 1.3% in the Americas and 1.7% in Asia.1 In Mozambique the epidemic started in August 1997, reaching an estimated 9000 cases and 259 deaths.1 Cholera continues to be endemic in Mozambique, concentrated mainly in Beira and Maputo cities, with many cases occurring during the rainy season.3 In many African countries, V. cholerae O1 serotype Ogawa has been the strain most frequently isolated and associated with cholera outbreaks.46 As with many other diarrhoeal diseases, cholera can be managed by re-hydration alone, but antimicrobial therapy can help to shorten the course of disease and to break the transmissibility cycle during epidemics. Antimicrobial therapy is also recommended for severe or chronic cases of diar rhoea. However, the increase in antimicrobial-resistant strains of bacteria causing diarrhoeal disease is concerning, especially in developing countries.7,8 Tetracycline derivatives are the first-line drug for cholera treatment in many of these countries, however, V. cholerae strains resistant to this antimicrobial and others, including ciprofloxacin, have been reported.8 In rural areas of Mozambique, data on antimicrobial resistance are scarce, par ticularly for V. cholerae strains
