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Management of a cholera epidemic - Practical guide for doctors, nurses, laboratory technicians, medical auxiliaries, water and sanitation specialists and logisticians
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Médecins Sans Frontières MFS (2023) CC

Cholera is a transmissible diarrhoeal infection caused by Vibrio cholerae. Endemic and/or epidemic in over 40 countries (mainly in Africa and Asia), cholera continues to be a major global public health issue. The World Health Organization (WHO) estimates that the number of cases reported worldwid...e represents in reality only 5 to 10% of actual cases. This guide is intended for medical and non-medical staff responding to a cholera outbreak. It attempts to provide concrete answers to the questions and problems faced by staff, based on the recommendations of reference organisations, such as WHO and UNICEF, as well as Médecins Sans Frontières’ experience in the field. It is divided into 8 chapters. Chapter 1, Cholera overview, outlines the epidemiological and clinical features of cholera. Chapter 2, Outbreak investigation, explains the method and stages of a field investigation, from the alert to implementation of initial activities. Chapter 3, Cholera control measures, details measures and tools to prevent and/or control cholera transmission and mortality in populations affected, or at risk of being affected, by an epidemic (curative care, prevention means and health promotion activities). Chapter 4, Strategies for epidemic response, addresses the roll-out strategies of the measures described in Chapter 3 which depend on context (e.g. urban, rural, endemic, non-endemic setting, etc.), resources and particular constraints. Chapter 5, Cholera case management, details the different stages of cholera treatment, from diagnosis through to cure. Chapter 6, Setting up cholera treatment facilities, focuses on the installation of treatment facilities that vary in size and complexity according to operational requirements (treatment centres and units and oral rehydration points). Chapter 7, Organisation of cholera treatment facilities, describes the organisation of these specialized facilities in terms of human resources, supply, water, hygiene and sanitation, etc. Chapter 8, Monitoring and evaluation, presents the key data to be collected and analysed during an epidemic to facilitate a tailored response and evaluate its quality and effectiveness. The guide includes various practical tools in the appendices to facilitate activities (e.g. water quality tests, job descriptions, documents, etc.). Moreover, the toolbox also contains additional tools in editable formats (individual patient file, cholera case register, pictograms). Despite all efforts, it is possible that certain errors may have been overlooked in this guide. Please inform the authors of any errors detected. To ensure that this guide continues to evolve while remaining adapted to field realities, please send any comments or suggestions. more

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Cardiovascular disease risk profile and management practices in 45 low-income and middle-income countries: A cross-sectional study of nationally representative individual-level survey data

Peiris, D.; Ghosh, A.; Manne-Goehler, J. et al. PLoS Medicine (2021) CC

Global cardiovascular disease (CVD) burden is high and rising, especially in low-income and middle-income countries (LMICs). Focussing on 45 LMICs, we aimed to determine (1) the adult population’s median 10-year predicted CVD risk, including its variation within countries by socio-demographic char... more

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Epidemiology, Pathophysiology, Diagnosis and Treatment of Heart Failure in Diabetes

Park, J.J. Diabetes & Metabolism Journal (2021) CC

The cardiovascular disease continuum begins with risk factors such as diabetes mellitus (DM), progresses to vasculopathy and myocardial dysfunction, and finally ends with cardiovascular death. Diabetes is associated with a 2- to 4-fold increased risk for heart failure (HF). Moreover, HF patients wit... more

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Clinical management of diphtheria: guideline

World Health Organization WHO (2024) C_WHO

WHO has published the first-ever guidance on the clinical management of diphtheria. The only previously available guidance was an operational protocol. The new guidance followed the rigorous process for developing guidance at WHO. It addresses the use of Diphtheria Antitoxin (DAT) in the treatmen... more

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Public knowledge of cardiovascular disease and response to acute cardiac events in three municipalities in Brazil

Bartlett, E. S.; Flor, L.S.; Souto Medeiros, D. et al. Open Heart (2020) CC

Objective: To conduct a landscape assessment of public knowledge of cardiovascular disease risk factors and acute myocardial infarction symptoms, cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) awareness and training in three underserved communities in Brazil. Metho... more

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Prevention and management of CVD in LMICs: why do ethnicity, culture, and context matter?

Anand, S.; Bradshaw, C.; Prabhakaran, D. BMC Medicine (2020) CC

Background Low- and middle-income countries now experience the highest prevalence and mortality rates of cardiovascular disease. Main text While improving the availability and delivery of proven, effective therapies will no doubt mitigate this burden, we posit that studies evaluating cardiovasc... more

Experience of living with type 1 diabetes in a low-income country: a qualitative study from Liberia

Adler, A.J.; Trujillo, C.; Schwartz, L.; et al. BMJ Journals (2021) CC

While epidemiological data for type 1 diabetes (T1D) in low/middle-income countries, and particularly low-income countries (LICs) including Liberia is lacking, prevalence in LICs is thought to be increasing. T1D care in LICs is often impacted by challenges in diagnosis and management. These challeng... more

Prevention, Screening and Control of Common Non-Communicable Diseases: Hypertension, Diabetes an Common Cancers (Oral, Breast, Cervix)

National Health Mission (2016) CC

Comprehensive Primary Health Care has an important role in the primary and secondary prevention of several disease conditions, including non-communicable diseases which today contribute to over 60% of the mortality in India. The provision of Comprehensive primary health care reduces morbidity, disab... more

اإلرشادات التوجيهية لرعاية األطفال الناجين من اإلساءة الجنسية

UN Children's Fund UNICEF (2024) CC

Produced by UNICEF and IRC, with the support of the German Corporation for International Cooperation GmbH (GIZ) and the generous funding from the German Federal Ministry of Economic Cooperation and Development (BMZ), the Caring for Child Survivors of Sexual Abuse (CCS) Resource Package (Second Editi... more

Guidelines for the management of asthma in adults and adolescents: Position statement of the South African Thoracic Society – 2021 update

Lalloo, U.G.; Kalla, I.S.; Abdool-Gaffar, S. et al. African Journal of Thoracic and Critical Care Medicine (2021) CC

sthma prevalence is increasing worldwide, and surveys indicate that most patients in developed and developing countries, including South Africa, do not receive optimal care and are therefore not well controlled. Standard management guidelines adapted to in-country realities are important to support ... more

Kenya National Guidelines for Cardiovascular Diseases Management

Ministry of Health Kenya Republic of Kenya (2018) CC

The Kenya Health Policy 2014-2030 aims at attaining the highest possible standard of health in a manner responsive to the health needs of our population. One of the major policy directions towards realizing the intentions of this policy is to halt and reverse the rising burden of non-communicable d... more

A household-based community health worker programme for non-communicable disease, malnutrition, tuberculosis, HIV and maternal health: a stepped-wedge cluster randomised controlled trial in Neno Distr

Wroe, E.B.; Nhlema, B.; Dunbar, E.L. et al. BMJ Global Health (2021) CC

Background: Community health worker (CHW) programmes are a valuable component of primary care in resource-poor settings. The evidence supporting their effectiveness generally shows improvements in disease-specific outcomes relative to the absence of a CHW programme. In this study, we evaluated expan... more

Guidelines for Management of Type 1 Diabetes

Indian Council of Medical Research (2022) CC2

The ICMR type 1 diabetes guidelines come at a time when the SARS-CoV-2 pandemic has disproportionately affected people with diabetes population, exposing them to a high risk for severe illness and mortality. Globally, diabetes was responsible for over fourmillion deaths in the year 2019. It was th... more

Qualitative assessment of community health workers’ perspective on their motivation in community-based primary health care in rural Malawi

Ndambo, M.K.; Munyaneza, F.; Aron, M.B. et al. BMC Health Services Research (2022) CC

Background: Community Health Workers (CHWs) have a positive impact on the provision of community-based primary health care through screening, treatment, referral, psychosocial support, and accompaniment. With a broad scope of work, CHW programs must balance the breadth and depth of tasks to mainta...in CHW motivation for high-quality care delivery. Few studies have described the CHW perspective on intrinsic and extrinsic motivation to enhance their programmatic activities. Methods: We utilized an exploratory qualitative study design with CHWs employed in the household model in Neno District, Malawi, to explore their perspectives on intrinsic and extrinsic motivators and dissatisfiers in their work. Data was collected in 8 focus group discussions with 90 CHWs in October 2018 and March–April 2019 in seven purposively selected catchment areas. All interviews were audiotaped, transcribed verbatim, coded, and analyzed using Dedoose. Results: Themes of complex intrinsic and extrinsic factors were generated from the perspectives of the CHWs in the focus group discussions. Study results indicate that enabling factors are primarily intrinsic factors such as positive patient outcomes, community respect, and recognition by the formal health care system but can lead to the chal- lenge of increased scope and workload. Extrinsic factors can provide challenges, including an increased scope and workload from original expectations, lack of resources to utilize in their work, and rugged geography. However, a posi- tive work environment through supportive relationships between CHWs and supervisors enables the CHWs. Conclusion: This study demonstrated enabling factors and challenges for CHW performance from their perspec- tive within the dual-factor theory. We can mitigate challenges through focused efforts to limit geographical distance, manage workload, and strengthen CHW support to reinforce their recognition and trust. Such programmatic empha- sis can focus on enhancing motivational factors found in this study to improve the CHWs’ experience in their role. The engagement of CHWs, the communities, and the formal health care system is critical to improving the care provided to the patients and communities, along with building supportive systems to recognize the work done by CHWs for the primary health care systems. more

Enhancing Pharmacovigilance in Sub‑Saharan Africa Through Training and Mentoring: A GSK Pilot Initiative in Malawi

Jusot, V.; Chimimba, F.; Dzabala, N. et al. Drug Safety (2020) CC

Introduction Pharmacovigilance (PV) systems to monitor drug and vaccine safety are often inadequate in sub-Saharan Africa. In Malawi, a PV enhancement initiative was introduced to address major barriers to PV. Objective The objective of this initiative was to improve reporting of adverse events (A... more

Health Technology MANUAL: Improving the Integrated Management of Chronic Diseases at the First Level of Health Care Services

Pan American Health Organization PAHO; World Health Organization WHO (2017) C_WHO

Care for persons with noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, cancer, and chronic obstructive pulmonary disease, is a major health priority for most countries worldwide, particularly for low-middle income countries where the problem seems to be worsening. Globally,... more

Challenges in the diagnosis of asthma in children, what are the solutions? A scoping review of 3 countries in sub Saharan Africa

Magwenzi, P.; Rusakaniko, S.; Sibanda, E.N. et al. Respiratory Research (2022) CC

The article is a scoping review that explores the challenges in diagnosing asthma in children in three sub-Saharan African countries: Nigeria, South Africa, and Uganda. It identifies key barriers, such as a lack of community awareness, inadequate healthcare access, limited diagnostic tools like spir... more

The increasing burden of asthma in South African children: A call to action

Masekela, R.; Gray, C.L.; Green, R.J. et al. The South African Medical Journal (2018) CC

BACKGROUND. Asthma is a heterogeneous condition characterised by chronic inflammation and variable expiratory airflow limitation, as well as airway reversibility. The burden of asthma in children is increasing in low- and middle-income countries and remains under-recognised and poorly managed. OBJE... more

Understanding and controlling asthma in Latin America: A review of recent research informed by the SCAALA programme

Cooper, P. J.; Figueiredo, C. A.; Rodriguez, A.; et al. (2023) CC2

Asthma is the most common chronic respiratory disease (CRD) worldwide and is estimated to affect 262 million causing significant mortality and morbidity, and has emerged as an important public health problem in many Latin American (LA) countries over the last 30 or so years. LA is a highly diverse r... more

A worldwide charter for all children with asthma

Szefler, S. J.; Fitzgerald, D. A.; Adachi, Y.; (2020) CC2

Asthma is the commonest chronic childhood disease and encompasses a spectrum of airway diseases with similar symptoms. Inaccurate diagnosis remains common, especially in younger children, with failure to characterize the different “asthmas.” Children worldwide repeatedly suffer symptoms which se... more

Management of a cholera epidemic - Practical guide for doctors, nurses, laboratory technicians, medical auxiliaries, water and sanitation specialists and logisticians recommended

Management of a cholera epidemic - Practical guide for doctors, nurses, laboratory technicians, medical auxiliaries, water and sanitation specialists and logisticians
recommended