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Feasibility of a Comprehensive Targeted Cholera Intervention in The Kathmandu Valley, Nepal.
Roskosky, Mellisa; Acharya, Bhim; Shakya, Geeta; Karki, Kshitij; Sekine, Kazutaka; Bajracharya, Deepak; von Seidlein, Lorenz; Devaux, Isabelle; Lopez, Anna Lena; Deen, Jacqueline; Sack, David A.
Afiliación
  • Roskosky M; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
  • Acharya B; Epidemiology Disease Control Division, Department of Health Services, Ministry of Health, Kathmandu, Nepal.
  • Shakya G; National Public Health Laboratory, Department of Health Services, Ministry of Health, Kathmandu, Nepal.
  • Karki K; Group for Technical Assistance, Kathmandu, Nepal.
  • Sekine K; United Nations International Children's Emergency Fund (UNICEF) Sierra Leone, Freetown, Sierra Leone.
  • Bajracharya D; Group for Technical Assistance, Kathmandu, Nepal.
  • von Seidlein L; Nuffield Department of Medicine, Centre for Tropical Medicine and Global Health, University of Oxford, Oxford, United Kingdom.
  • Devaux I; Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
  • Lopez AL; Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
  • Deen J; Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines.
  • Sack DA; Institute of Child Health and Human Development, National Institutes of Health, University of the Philippines, Manila, Philippines.
Am J Trop Med Hyg ; 100(5): 1088-1097, 2019 05.
Article en En | MEDLINE | ID: mdl-30887946
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 Vibrio cholerae 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.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cólera / Brotes de Enfermedades / Diarrea / Intervención Médica Temprana Tipo de estudio: Prognostic_studies Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Am J Trop Med Hyg Año: 2019 Tipo del documento: Article

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Cólera / Brotes de Enfermedades / Diarrea / Intervención Médica Temprana Tipo de estudio: Prognostic_studies Límite: Adolescent / Adult / Child / Female / Humans / Male / Middle aged País/Región como asunto: Asia Idioma: En Revista: Am J Trop Med Hyg Año: 2019 Tipo del documento: Article