ABSTRACT
Kasese district in Western Uganda was hit by cholera outbreak from October 1991 to December 1992. The cumulative total of admitted cases was 1685. Deaths were 105. This excludes cases in OPD and temporary treatment centres. At the moment a neighboring district of Bundibugyo has a cholera outbreak. Thirty one (31) countries in Africa are reporting cases of Cholera to WHO. This was a multilateral mode of transmission implicating contaminated river water supplies; travel to endemic areas and food borne transmission. The risk factors were unsafe river water (RR 2.55); travel to a naighboring country with endemic cholera within 2 weeks before onset of signs symptoms (RR2) compared to controls. A steady diet of fish and Bundu (local staple of cassava bread) had a higher risk than controls (RR 1.8). Drinking boiled water protected against Cholera infection (RR 0.4). Laboratory studies demonstrated that V. cholera 01 EL TOR biotype Ogawa serotype was the responsible organism. The response and management of the epidemic centred around appropriate organisation at National; District; Subcounty (S/C); communities and health units. The organisation included proper case management; health education; personal and domestic hygiene; surveillance and notification. National and district task forces with clear terms of reference were formed. A task force was also put in place at sub-county and community (RC1) level. There was collaboration with multilateral agencies namely UNICEF et WHO Training of Health Workers in Cholera Case management was organised. Support supervisors at district level was emphasised. health messages on Cholera were formulated into local languages. Communities were sensitized about cholera and its control measures in order to enlist community participation and involvement. This paper describes details of responses at various levels in order to achieve a quickened control of the epidemic in the district