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Assessing the preparedness of primary healthcare facilities during a cholera outbreak in Kinshasa, Democratic Republic of the Congo, 2018
P. Ndumbi | F. Mboussou | F. Otiobanda | G. Mbayo | D. Bompangue | V. Mukinda | M. N. Nsambu | J. M. Kanyonga | R. Ngom | E. Hamblion | B. Impouma
Date of Publication:
June 1, 2020
During the 2017–2018 cholera outbreak in Kinshasa, many patients initially reported to primary healthcare centers (HCs) before being transferred to the nearest cholera treatment centers. This study aims to assess the level of preparedness of HCs in responding to cholera outbreaks.
The median number of preparedness criteria met by HCs was 5 [range: 0–11]. Five percent (n = 9) of HCs [95% confidence interval (CI): 2.3%–9.3%] met at least 10 criteria. HCs that previously reported ≥3 cholera cases were less likely to meet the criteria for ‘presence of an isolation unit’ (adjusted odds ratio [aOR]: 0.12; 95% CI [0.03–0.61]) and ‘availability of sufficient quantity of chlorine’ (aOR: 0.13; 95% CI [0.02–0.64]).
Despite past experience of cholera cases, health facilities in Kinshasa exhibit a low level of cholera preparedness. There is a need to prioritize the reinforcement of the preparedness of primary HCs to prevent future cholera outbreaks.
Responding to epidemics in large-scale humanitarian crises: a case study of the cholera response in Yemen, 2016–2018
Paul Spiegel | Ruwan Ratnayake | Nora Hellman | Mija Ververs | Moise Ngwa | Paul H Wise | Daniele Lantagne
Date of Publication:
BMJ Global Health
We examined the cholera response during the humanitarian crisis in Yemen to inform control strategies. We conducted interviews with practitioners and advisors on preparedness; surveillance; laboratory; case management; malnutrition; water, sanitation and hygiene (WASH); vaccination; coordination and insecurity. We undertook a literature review of global and Yemen-specific cholera guidance, examined surveillance data from the first and second waves (28 September 2016–12 March 2018) and reviewed reports on airstrikes on water systems and health facilities (April 2015–December 2017). We used the Global Task Force on Cholera Control’s framework to examine intervention strategies and thematic analysis to understand decision making. Yemen is water scarce, and repeated airstrikes damaged water systems, risking widespread infection. Since a cholera preparedness and response plan was absent, on detection, the humanitarian cluster system rapidly developed response plans. The initial plans did not prioritise key actions including community-directed WASH to reduce transmission, epidemiological analysis and laboratory monitoring. Coordination was not harmonised across the crisis-focused clusters and epidemic-focused incident management system. The health strategy was crisis focused and was centralised on functional health facilities, underemphasising less accessible areas. As vaccination was not incorporated into preparedness, consensus on its use remained slow. At the second wave peak, key actions including data management, community-directed WASH and oral rehydration and vaccination were scaled-up. Despite endemicity and conflict, Yemen was not prepared for the epidemic. To contain outbreaks, conflict-affected states, humanitarian agencies, and donors must emphasise preparedness planning and community-directed responses.
Health facility preparedness for cholera outbreak response in four cholera-prone districts in Cameroon: a cross sectional study
Jerome Ateudjieu | Martin Ndinakie Yakum | Andre Pascal Goura | Sonia Sonkeng Nafack | Anthony Njimbia Chebe | Joliette Nguefack Azakoh | Benjamin Azike Chukuwchindun | Eugene Joel Bayiha | Corine Kangmo | Gnodjom Victorin Boris Tachegno | Anne-Cécile Zoung Kanyi Bissek
Date of Publication:
BMC Health Services Research
The risk of cholera outbreak remains high in Cameroon. This is because of the persistent cholera outbreaks in neighboring countries coupled with the poor hygiene and sanitation conditions in Cameroon. The objective of this study was to assess the readiness of health facilities to respond to cholera outbreak in four cholera-prone districts in Cameroon. A cross-sectional study was conducted targeting all health facilities in four health districts, labeled as cholera hotspots in Cameroon in August 2016. A total of 134 health facilities were evaluated, most of which (108/134[81%]) were urban facilities. The preparedness regarding surveillance was limited with 13 (50%) health facilities in the Far North and 22(20%) in the Littoral having cholera case definition guide. ORS for Case management was present in 8(31%) health facilities in the Far North and in 94(87%) facilities in the littoral. Less than half of the health facilities had a hand washing protocol and 7(5.1%) did not have any source of drinking water or relied on unimproved sources like lake. A total of 4(3.0%) health facilities, all in the Far North region, did not have a toilet.
A MOOC as an immediate strategy to train health personnel in the cholera outbreak in Mexico
Laura Magaña-Valladares | Cynthia Rosas-Magallanes | Alejandra Montoya-Rodríguez | Guillermo Calvillo-Jacobo | Celia Mercedes Alpuche-Arande | Sebastían García-Saisó
Date of Publication:
May 16, 2018
BMC medical education
In September 2013, two cases of cholera were reported in Mexico; 1 week later, a new outbreak was reported in the Huasteca region of Hidalgo. Upon the determination that the diagnostic and therapeutic interventions implemented by health personnel overlooked predefined procedures, the National Institute of Public Health, in coordination with the Ministry of Health, immediately designed the massive open online course “Proper cholera containment and management measures” to strengthen and standardize basic prevention and control practices. During the first 5 months, 35,968 participants from across the country finished the course: medical and nursing personnel, health promoters, and hospital staff. To understand the magnitude of the data, an analysis was performed to calculate the MOOC coverage, and multiple linear regression models were generated to relate the score earned in the course to the characteristics of the participants. In addition, a qualitative analysis was performed to identify the dissemination of information, technological barriers, and feedback on course design. A total of 17% of participants were from the state where the outbreak originated, and 33.5% were from its neighboring states. This study shows that the need for information is greater when an emergency occurs, and the involvement of the authorities increased the extent of the training response. In conclusion, a MOOC can be a useful training strategy to prepare personnel for emergency situations.