摘要：The Democratic Republic of Congo (DRC) is the country in the world which
reported the highest number of cholera cases to WHO from 2002 to 2007
(128 936 cases out of a worldwide 902 071 cases). We, therefore, implemented
research work which intends to understand the epidemiology of cholera in the DRC and
to ensure improvements in the strategy to fight against cholera. This
broad study enabled us to accurately determine the cholera epidemic's mechanisms
on different scales; to identify the source zones of the disease, and the
groups of populations acting as vectors of the spread. It was then possible
to demonstrate the role of "sanctuary'', played by some suburbs of lakeside
cities. A collaborative network, including several scientific institutions in
Europe and in the DRC, local and national government administrations in the
field of public health and sanitation, international agencies, NGOs and
private foundations, was progressively set up. Following the conclusions of
our epidemiological studies, a drastic change of strategy was proposed: the
limited curative approach on the one hand, the few existing water/sanitation programs on the other hand, have been merged in a global
approach involving a larger scale water and sanitation infrastructure
improvement, environmental protection, hygiene awareness and medical surveys
targeting a few focus areas playing a central role in the epidemics. In
conclusion, by better targeting intervention zones, one can gather human and
technical resources previously scattered on the vast territory of the DRC. The
strategy presented here revives the hope to eliminate cholera in the DRC.
