• Cholera Epidemic in Guinea-Bissau (2008): The Importance of "Place"

      Luquero, Francisco J; Banga, Cunhate Na; Remartínez, Daniel; Palma, Pedro Pablo; Baron, Emanuel; Grais, RFebeca F; Epicentre, Paris, France; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden; Department of Epidemiology, Ministry of Health, Bissau, Guinea-Bissau; Medicos Sin Fronteras, Barcelona, Spain (2011-05-04)
      As resources are limited when responding to cholera outbreaks, knowledge about where to orient interventions is crucial. We describe the cholera epidemic affecting Guinea-Bissau in 2008 focusing on the geographical spread in order to guide prevention and control activities.
    • Distribution of hygiene kits during a cholera outbreak in Kasaï-Oriental, Democratic Republic of Congo: a process evaluation.

      D'Mello-Guyett, L; Greenland, K; Bonneville, S; D'hondt, R; Mashako, M; Gorski, A; Verheyen, D; Van den Bergh, R; Maes, P; Checchi, F; et al. (BioMed Central, 2020-07-24)
      Background: Cholera remains a leading cause of infectious disease outbreaks globally, and a major public health threat in complex emergencies. Hygiene kits distributed to cholera case-households have previously shown an effect in reducing cholera incidence and are recommended by Médecins Sans Frontières (MSF) for distribution to admitted patients and accompanying household members upon admission to health care facilities (HCFs). Methods: This process evaluation documented the implementation, participant response and context of hygiene kit distribution by MSF during a 2018 cholera outbreak in Kasaï-Oriental, Democratic Republic of Congo (DRC). The study population comprised key informant interviews with seven MSF staff, 17 staff from other organisations and a random sample of 27 hygiene kit recipients. Structured observations were conducted of hygiene kit demonstrations and health promotion, and programme reports were analysed to triangulate data. Results and conclusions: Between Week (W) 28-48 of the 2018 cholera outbreak in Kasaï-Oriental, there were 667 suspected cholera cases with a 5% case fatality rate (CFR). Across seven HCFs supported by MSF, 196 patients were admitted with suspected cholera between W43-W47 and hygiene kit were provided to patients upon admission and health promotion at the HCF was conducted to accompanying household contacts 5-6 times per day. Distribution of hygiene kits was limited and only 52% of admitted suspected cholera cases received a hygiene kit. The delay of the overall response, delayed supply and insufficient quantities of hygiene kits available limited the coverage and utility of the hygiene kits, and may have diminished the effectiveness of the intervention. The integration of a WASH intervention for cholera control at the point of patient admission is a growing trend and promising intervention for case-targeted cholera responses. However, the barriers identified in this study warrant consideration in subsequent cholera responses and further research is required to identify ways to improve implementation and delivery of this intervention.
    • Localised transmission hotspots of a typhoid fever outbreak in the Democratic Republic of Congo

      Ali, E; Bergh, RVD; D'hondt, R; Kuma-Kuma, D; Weggheleire, AD; Baudot, Y; Lambert, V; Hunter, P; Zachariah, R; Maes, P (PAMJ-Center for Public Health Research and Information, 2017)
      In a semi-urban setting in the Democratic Republic of Congo, this study aims to understand the dynamic of a typhoid fever (TF) outbreak and to assess: a) the existence of hot spots for TF transmission and b) the difference between typhoid cases identified within those hot spots and the general population in relation to socio-demographic characteristics, sanitation practice, and sources of drinking water.
    • Management of Cholera Epidemics in a Refugee Camp

      Brown, V; Jacquier, G; Bachy, C; Bitar, D; Legros, D; Epicentre, 8 rue Saint Sabin, 75011 Paris, France. (2002-12)
      Cholera epidemics in refugee camps represent a major public health emergency. In camps, precarious living conditions contribute to the transmission of the vibrio. Among the major epidemics reported in camps, we note as well those which have affected Africa in the last two decades. These epidemics are characterized by high attack rates and high case fatality ratios. Attack rates in refugee camps can exceed 5%. Appropriate control measures are adopted at international level. Actions carried out urgently must allow the proper supply of water, the control of excreta, and the improvement of general sanitary conditions and individual hygiene. Efficient management of cases in specialized cholera treatment centres (CTC) should decrease the case fatality ratio to less than 1%. Treatment is mainly based on the prompt rehydration of patients. For wide camps, rapid access to oral rehydration units is essential. Availability of all necessary equipment in kit form is required.
    • South-Asian tsunami.

      Guthmann, J P; Sauvageot, D; De Filippi, L; Burny, M E; Brown, V (2005)