Coping with Cholera: the Importance of Coordinated Planning

Cholera epidemics in Zimbabwe; Haiti; and Nigeria have grabbed worldwide headlines in the last couple of years as beleagured health agencies battled to contain a rising tide of patients. Is this resurgence a pathological issue; or simply the consequence of poor public health provision? Superficially there should be little excuse for the epidemics of the size we have witnessed recently (more than 1500 died in the outbreak in Nigeria in 2010); cholera is not a mystery illness; and measures to contain an outbreak are known. But the logistics can be daunting and if health systems are weak; they can quickly become overwhelmed. Can one prepare? Of course. and in fact it is a must. As with all infectious diseases; lessons from one campaign will educate and illuminate actions for another. Hospitals and communities should be undertaking regular risk assessments; and providing quality training and resources to enable swift and decisive action the moment a problem is identified. Until the 1980s most outbreaks were managed at the local level using the best available common sense. Apart from in the most densely populated areas; this was largely successful. Slowly; public health experts started comparing notes and the compilation of guidelines for the control of cholera outbreaks started to emerge with epidemiologists from WHO helping to `join up the dots' between experiences in different continents and countries

Epidemie de cholera a Bukavu (R.D.Congo) de 2006-2007: donnees epidemiologiques et de controle

Contexte : Bukavu est une des sept zones sanctuaires du cholera a l'est de la de la Republique Democratique du Congo. Cette etude a examine les aspects epidemiologiques et de controle de l'epidemie de 2006-2007. Methodes : Cette etude descriptive a porte sur les donnees de 3348 malades; collectees dans les registres du centre de traitement de cholera de l'Hopital Provincial General de Reference de Bukavu. Les donnees ont ete traitees par le logiciel Epi Info version 6.04d. Resultats : etalee sur 175 jours avec un taux d'attaque de 5;37 pour mille; l'epidemie a touche les sujets d'une moyenne d'age de 16 ans et un sex-ratio H/F de 1;05. La zone de sante la plus touchee etait celle de Kadutu (50;7). La source probable de contamination a ete hydrique (90;1). La symptomatologie clinique etait dominee par la diarrhee aqueuse (95;5). A l'admission; 63;4des malades presentaient une deshydratation severe. La duree moyenne d'hospitalisation etait de 3 jours. La letalite etait de 0;3. Conclusion : Le cholera a Bukavu a touche principalement les sujets jeunes provenant d'un conglomerat des quartiers populaires au sud de la ville. L'acces derisoire a l'eau potable et l'insuffisance des latrines ont vraisemblablement joue un role capital. La letalite etait faible ce qui denote entre autre d'une bonne prise en charge medicale des cas. Les mesures preventives semblaient etre mises en oeuvre tardivement et timidement. Cette etude fait renaitre la problematique de la rehabilitation du reseau d'adduction d'eau potable et l'hygiene de Bukavu

Colera em Mocambique no seculo XIX : II. tratamento utilizado na epoca

Este e o segundo artigo de uma serie de tres; relativa a epidemia de colera que assolou a Ilha de Mocambique; de Fevereiro a Marco no ano de 1859. No presente artigo apresentam-se e analisam-se aspectos relacionados com o diagnostico e tipo de tratamento utilizado; os recursos humanos e materiais existentes e o estabelecimento de um sistema de organizacio sanitaria onde participaram para alem do pessoal de saude; elementos da comunidade para apoio ao tratamento domiciliar dos casos. O aspecto mais importante; tendo em conta outras epidemias ocorridas durante o mesmo periodo na Europa e America; foi a participacio activa da populacio em relacio as medidas de tratamento preconizado palas autoridades de saude