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The vaccine shortage comes as southern Africa battles a protracted cholera outbreak which has killed 700 people in Zambia alone.

Medical charity Doctors Without Borders said that the shortage has affected its teams trying to respond to outbreaks in more than 16 countries.

Public health experts have urged manufacturers to speed up the production of the oral vaccine. All drugs currently in production have already been booked.

In January, Zambia rolled out a UNICEF-backed campaign to vaccinate 1.5 million people against cholera. The outbreak which started in 2023 has now spread to all regions of the country, forcing authorities to convert a stadium into a treatment centre and to delay the reopening of schools.

According to Save the Children, cholera cases increased fourfold in Malawi, Zimbabwe, and Mozambique from 2022 to 2023.

The number of infections rose from 26 250 to over 95 300, with more than 1 600 deaths in the three nations, making it one of the worst cholera epidemics in decades.

At least 15 Catholic worshippers were killed in a Burkina Faso village on Sunday when gunmen attacked a community as they gathered for prayers in the country’s conflict-hit northern region, church officials said.

The violence in the village of Essakane was a “terrorist attack” that left 12 of the Catholic faithful dead at the scene, while three others died later as they were being treated for their wounds, according to a statement issued by Abbot Jean-Pierre Sawadogo, vicar-general of the Catholic Diocese of Dori, where the attack happened.

No further details were provided about the attack, which no group claimed responsibility for. But suspicion fell on jihadis who have frequently attacked remote communities and security forces, especially in the northern region.

“In this painful circumstance, we invite you to pray for the rest in God for those who have died in faith, for the healing of the wounded and … for the conversion of those who continue to sow death and desolation in our country,” Sawadogo said in a statement.

About half of Burkina Faso is outside government control as jihadi groups have ravaged the country for years. Fighters have killed thousands and displaced more than 2 million people, further threatening the stability of the country that had two coups in 2022.

The country’s junta has struggled to restore peace in violent hot spots since the first coup in January 2022, the number of people killed by jihadis has nearly tripled compared with the 18 previous months, according to a report by the Africa Center for Strategic Studies in August.

In addition to the junta’s limited capacity, the security situation also has been worsened by the country’s porous borders with Mali and Niger, both of which are also run by juntas and which also struggle with security crises.

An attack on a mosque in eastern Burkina Faso has claimed the lives of dozens of Muslims on the same day as another deadly attack on Catholics attending mass, local and security sources told our source on Monday.

“Armed individuals attacked a mosque in Natiaboani on Sunday around 5:00 am, resulting in several dozen being killed,” a security source said.

“The victims were all Muslims, most of them men” who had come for morning prayers, a resident said by telephone.

Another local source said “the terrorists entered the town early morning. They surrounded the mosque and shot at the faithful, who were gathered there for the first prayer of the day.”

‘Came in large numbers’

“Several of them were shot, including a religious leader,” the source added.

Soldiers and members of the Volunteers for the Defence of the Fatherland (VDP), a civilian force that supports the military, were also targeted “by these hordes who came in large numbers”, the same source said.

The source described it as a “large-scale attack” in terms of the number of assailants, who also wreaked substantial damage.

Natiaboani is a rural community about 60 kilometres (37 miles) south of Fada N’Gour ma, the main town in Burkina’s eastern region, which has seen regular attacks by armed groups since 2018.

On the same day as the attack on the mosque, at least 15 civilians were killed and two others injured during an attack on a Catholic church during Sunday mass in northern Burkina Faso, a senior church official said.

Jean-Pierre Sawadogo, vicar of the Dori diocese, said in a statement that the “terrorist attack” occurred in the village of Essakane while people were gathered for Sunday prayer.

Essakane village is in what is known as the “three borders” zone in the northeast of the country, near the common borders of Burkina Faso, Mali and Niger.

A ferry carrying day labourers sank in the Nile just outside the Egyptian capital, killing at least 10 of the 15 people on board, authorities said Monday.

The five who survived were transported to a hospital and later discharged, the Ministry of Manpower said in a statement. The cause of the sinking was not made immediately clear.

The ministry allocated compensation of 200,000 Egyptian pounds (around $6,466) to each family of the deceased and 20,000 ($646) to each of the five injured.

The labourers were on their way to work at a local construction firm. It took rescue teams hours to recover the bodies, according to local media which aired live-stream videos on social media platforms showing divers searching for the dead as villagers waited on the Nile banks.

The incident took place in the town of Monshat el-Kanater in Giza, which is one of three provinces forming Greater Cairo.

Many Egyptians make their way using boats daily, especially in Upper Egypt and the Nile Delta. Sailing along the Nile is also a favourite pastime during holidays in the Arab world’s most populous country.

Ferry, railway and road accidents are common in Egypt mainly because of poor maintenance and the lack of regulations.

In 2022, two people died and eight went missing after a small truck they were riding in slid off a ferry and plunged into the Nile. And in 2015, 35 people died in a collision between a passenger boat and a scow on the Nile

At the Kenya Medical Research Institute research is underway to create a mobile phone application which uses AI to diagnose tuberculosis and other respiratory diseases.

In a specially contained quiet room Dr Videlis Nduba and his team record coughs from people with respiratory diseases like tuberculosis as well as people without disease.

The aim is create software which can differentiate between the two and make a mobile phone application which can accurately recognise a cough connected to TB and other serious diseases.

Natural or forced coughs are collected using three microphones, including a cheap version, a high definition one and a microphone on a smartphone.

The results are sent to the University of Washington which puts them through an existing computer software system called ResNet 18.

Nduba the principal researcher explains: “This software kind of uses artificial intelligence and what it does is, it tries to analyse the coughs, we call them the cough spectral grams and then it regresses them. So it is a mathematical way of modelling the cough image to determine whether there is a difference between someone with TB when they cough and someone without TB when they cough.”

Nduba believes that if the software can be proven in trials to perform accurately, it can shorten the time before a patient can get a diagnosis and treatment and that will help curb the spread of TB.

“The biggest achievement is reduced time to diagnosis. So, from when someone develops TB symptoms, to when a doctor determines they have TB and they need treatment sometimes the average can run from 3 to 2 months to one year. And when they are in the community they are infectious and they are transmitting TB. The moment they get a cough, if you can just expose them to this software and determine this is TB would reduce TB transmission in the community and a lot of TB is due to transmission,” he says.

But the software is not yet accurate enough to meet the standard required by the World Health Organisation.

The WHO says the application must be at least 90% accurate in recognising a TB infection and it must be at least 80% accurate at detecting if no infection exists.

Nduba’s trials so far have shown 80% accuracy at detecting TB and 70% accuracy for detecting there is no TB.

“The WHO would like a test that may have the 90% capacity to detect a disease like tuberculosis and have more than an 80% chance saying this is not TB when it is not TB. So, our software so far has demonstrated over 80% test compared to 90%, we are not far we just need to fine tune it. And it has shown 70% prediction that there is not TB when there is no TB again very close to the 80% WHO target product profile,” he says.

Former TB patient Johnson Munori is taking part in the research.

He has been treated and is no longer infectious, but he returns to the clinic for check ups.

Munori didn’t realise he had TB until he was diagnosed by a doctor who asked him to take part in the research programme.

He believes the app would be helpful.

“Before I did not know that I had TB until when I came for the screening, that is when I was diagnosed that I have TB and then I came and was told that there is a new technology which we could use to diagnose TB through cough recording. I did that and they confirmed my status and I started on medication. I have taken the medication and I have finished. It is a very convenient technology; new technology which I think will help a lot of people.”

Jarim Omogi is a specialist in public health at Amref International University.

He says the use of AI in medicine is growing.

“As much as we will use AI in diagnosis of this, yes it is very possible. It’s not only possible it is being used currently as we speak by healthcare professionals where they are, the chat GPTs they are being used currently for diagnosis. Therefore what will happen with such technology is that they are going to help because remember in the medical field there are what we call what people need to follow in terms of treatment and therefore the AI and all these applications is basically to activate and help more so in confirmation and two in real time data. So that the patient on the other side can be helped fast and possible. Let’s not look at it as diagnosis. Let’s look at how much time does it take for the patient on the other side to be assisted. How cost effective is it? How fast is it? How cheap is it? That is the benefit of such and therefore yes it can be used.”

The trial has been funded by the National Institutes of Health, but it has not yet received any regulatory approval.