1921
Volume 100, Issue 5
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract.

A comprehensive targeted intervention (CTI) was designed and deployed in the neighborhoods of cholera cases in the Kathmandu Valley with the intent of reducing rates among the neighbors of the case. This was a feasibility study to determine whether clinical centers, laboratories, and field teams were able to mount a rapid, community-based response to a case within 2 days of hospital admission. Daily line listings were requested from 15 participating hospitals during the monsoon season, and a single case initiated the CTI. A standard case definition was used: acute watery diarrhea, with or without vomiting, in a patient aged 1 year or older. Rapid diagnostic tests and bacterial culture were used for confirmation. The strategy included household investigation of cases; water testing; water, sanitation, and hygiene (WASH) intervention; and health education. A CTI coverage survey was conducted 8 months postintervention. From June to December of 2016, 169 cases of O1 were confirmed by bacterial culture. Average time to culture result was 3 days. On average, the CTI Rapid Response Team (RRT) was able to visit households 1.7 days after the culture result was received from the hospital (3.9 days from hospital admission). Coverage of WASH and health behavior messaging campaigns were 30.2% in the target areas. Recipients of the intervention were more likely to have knowledge of cholera symptoms, treatment, and prevention than non-recipients. Although the RRT were able to investigate cases at the household within 2 days of a positive culture result, the study identified several constraints that limited a truly rapid response.

[open-access] This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.18-0863
2019-05-01
2019-07-21
Loading full text...

Full text loading...

/deliver/fulltext/14761645/100/5/tpmd180863.html?itemId=/content/journals/10.4269/ajtmh.18-0863&mimeType=html&fmt=ahah

References

  1. Hasan NA, 2012. Genomic diversity of 2010 Haitian cholera outbreak strains. Proc Natl Acad Sci USA 109: E2010E2017. [Google Scholar]
  2. Luquero FJ, Banga CN, Remartinez D, Palma PP, Baron E, Grais RF, , 2011. Cholera epidemic in Guinea-Bissau (2008): the importance of “place”. PLoS One 6: e19005. [Google Scholar]
  3. Debes AK, Ali M, Azman AS, Yunus M, Sack DA, , 2016. Cholera cases cluster in time and space in Matlab, Bangladesh: implications for targeted preventive interventions. Int J Epidemiol 45: 21342139. [Google Scholar]
  4. Ali M, 2016. Potential for controlling cholera using a ring vaccination strategy: re-analysis of data from a cluster-randomized clinical trial. PLoS Med 13: e1002120. [Google Scholar]
  5. Azman AS, 2018. Micro-hotspots of risk in urban cholera epidemics. J Infect Dis 218: 11641168. [Google Scholar]
  6. Finger F, Bertuzzo E, Luquero FJ, Naibei N, Toure B, Allan M, Porten K, Lessler J, Rinaldo A, Azman AS, , 2018. The potential impact of case-area targeted interventions in response to cholera outbreaks: a modeling study. PLoS Med 15: e1002509. [Google Scholar]
  7. Ali M, Nelson AR, Lopez AL, Sack DA, , 2015. Updated global burden of cholera in endemic countries. PLoS Negl Trop Dis 9: e0003832. [Google Scholar]
  8. Desai SN, Pezzoli L, Martin S, Costa A, Rodriguez C, Legros D, Perea W, , 2016. A second affordable oral cholera vaccine: implications for the global vaccine stockpile. Lancet Glob Health 4: e223e224. [Google Scholar]
  9. Azman AS, 2016. Effectiveness of one dose of oral cholera vaccine in response to an outbreak: a case-cohort study. Lancet Glob Health 4: e856e863. [Google Scholar]
  10. Parker LA, 2017. Neighborhood-targeted and case-triggered use of a single dose of oral cholera vaccine in an urban setting: feasibility and vaccine coverage. PLoS Negl Trop Dis 11: e0005652. [Google Scholar]
  11. Nelson EJ, Andrews JR, Maples S, Barry M, Clemens JD, , 2015. Is a cholera outbreak preventable in post-earthquake Nepal? PLoS Negl Trop Dis 9: e0003961. [Google Scholar]
  12. Debes AK, Ateudjieu J, Guenou E, Ebile W, Sonkoua IT, Njimbia AC, Steinwald P, Ram M, Sack DA, , 2016. Clinical and environmental surveillance for Vibrio cholerae in resource constrained areas: application during a 1-year surveillance in the far north region of Cameroon. Am J Trop Med Hyg 94: 537543. [Google Scholar]
  13. Sobsey MD, Pfaender FK, , 2002. Evaluation of the H2S Method for Detection of Fecal Contamination of Drinking Water. Geneva, Switzerland: World Health Organization. [Google Scholar]
  14. Dichter G, , 2011. IDEXX Colilert*-18 and Quanti-Tray* Test Method for the Detection of Fecal Coliforms in Wastewater. IDEXX Laboratories I, ed. [Google Scholar]
  15. CDC. Chlorine Residual Testing Fact Sheet, CDC SWS Project. Atlanta, GA: Centers For Disease Control and Prevention. Available at: https://www.cdc.gov/safewater/publications_pages/chlorineresidual.pdf.
  16. WHO, 2015. Vaccination Coverage Cluster Survey Reference Manual. Geneva, Switzerland: World Health Organization. [Google Scholar]
  17. Taylor DL, Kahawita TM, Cairncross S, Ensink JH, , 2015. The impact of water, sanitation and hygiene interventions to control cholera: a systematic review. PLoS One 10: e0135676. [Google Scholar]
  18. Curtis V, Schmidt W, Luby S, Florez R, Toure O, Biran A, , 2011. Hygiene: new hopes, new horizons. Lancet Infect Dis 11: 312321. [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.18-0863
Loading
/content/journals/10.4269/ajtmh.18-0863
Loading

Data & Media loading...

  • Received : 26 Oct 2018
  • Accepted : 27 Jan 2019
  • Published online : 01 May 2019

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error