Clinical Guidelines. Diagnosis and Treatment Manual.
Guide pratique à l’usage des médecins, infirmiers, techniciens de laboratoire, auxiliaires de santé, techniciens sanitaires et logisticiens
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
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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.
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Report: A survey conducted among the 27 high MDR-TB burden countries.
March – July 2015
Stop TB Partnership in collaboration with Medecins Sans Fronti
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eres (MSF).
Accessed November 2017.
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Infection prevention and control (IPC) in a CTC/ CTU IPC are all practical measures taken in the healthcare facility to prevent harm caused by infections to patients, health workers and communities.
The main goal of IPC in the cholera response is to
• To reduce transmission of health care-as
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sociated infections of cholera and any other infectious disease
• To enhance the safety of staff, patients and visitors
• To enhance the ability of the organization/health care facility to respond to an outbreak
• To reduce the risk of the hospital (health care facility) itself amplifying the outbreak
Water, Sanitation and Hygiene (WASH)
WASH are all measures taken to guarantee environmental hygiene, safe water of all used within the health facility. It encompasses water, sanitation, waste management, cleaning within the health facility which in this case is CTU/C. A complete WASH package in the CTU/CTC reduces the risk of spread of Vibrio cholerae inside and outside the CTC/CTU.
The probability of spreading or acquiring cholera through a CTC/CTU can be highly reduced when proper IPC and WASH measures are respected, followed and monitored. These measures are, in principle, valid in CTC/CTUs and ORPs, although they need to be adapted to the specific characteristics of the facility concerned.
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15 July 2021
Dans un nouveau rapport, Médecins Sans Frontières (MSF) tire la sonnette d'alarme quant au manque de soutien mis à la disposition
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des personnes ayant survécu à des violences sexuelles en République démocratique du Congo (RDC). Face à l'ampleur de ces violences et à leur impact, MSF appelle les autorités congolaises et leurs partenaires à agir au plus vite afin d'assurer une réponse médicale, socio-économique et juridique à la hauteur des besoins constatés sur le terrain.
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7-й симпозиум по вопросам лечения туберкулеза — Министерство здравоохранения Кыргызской Республики и «Врачи без границ» / Médecins
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Sans Frontières
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Journal of the International AIDS Society 2017, 20(Suppl 4):21644
National AIDS Programme in Myanmar has made significant progress in scaling up antiretroviral treatment (ART) services and recognizes the importance of differentiated care for people living with HIV. Indeed, long centred around t
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he hospital and reliant on physicians, the country's HIV response is undergoing a process of successful decentralization with HIV care increasingly being integrated into other health services as part of a systematic effort to expand access to HIV treatment. This study describes implementation of differentiated care in Médecins Sans Frontières (MSF)‐supported programmes and reports its outcomes.
https://doi.org/10.7448/IAS.20.5.21644
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This Spotlight presents an in-depth analysis including opinions, facts and figures, and key resources. It features commentary by Sylvie Briand of the WHO, Rosamund Southgate of Médecins Sans
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Frontières and Annie Wilkinson of the Institute of Development Studies.
It includes first-hand accounts by researchers with experience in the field, and interviews with social science expert Melissa Leach and communications managers at Médecins Sans Frontières-UK and BBC Media Action.
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Technical Update
Areas of Africa endemic for Buruli ulcer (BU), caused by Mycobacterium ulcerans, also have a high prevalence of human immunodeficiency virus (HIV), with adult prevalence rates between 1% and 5% (Maps). However, there is limited information on the prevalence of BU–HIV coinfection.
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Preliminary
evidence suggests that HIV infection may increase the risk of BU disease (1–3). In the Médecins Sans Frontières project in Akonolinga, Cameroon, HIV prevalence was approximately 3–6 times higher among BU patients than the regional estimated HIV prevalence (2). Similarly in Benin and Ghana, BU
patients were 8 times and 3 times respectively more likely to have HIV infection than those without BU (1, 3). Further study is needed to clarify this association and enhance knowledge about the prevalence ofBU–HIV coinfection in endemic areas.
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Cutaneous Leishmaniasis (CL) is a painful disease that exerts a serious toll on societies around the world that are afflicted by it. Although not life-threatening, the skin ulcers and scars it causes can lead to isolation and psychosocial pathologies due to social stigma, and its occurrence is often
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associated with regional conflicts. The Cutaneous Leishmaniasis Research Meeting was held on December 7, 2020, with participation by basic researchers, clinical researchers, and drug discovery experts involved in research and development related to CL under the auspices of the Joint Usage/Research Center on Tropical Disease, Institute of Tropical Medicine. In addition, the CL Webinar was held on March 5, 2021, hosted by the Graduate School of Tropical Medicine and Global Health, co-hosted by the Institute of Tropical Medicine, and supported by Médecins Sans Frontières and DNDi.
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PLoS ONE 7(12): e52986. doi:10.1371/journal.pone.0052986. Opern Access please download from the website
Trop Med Int Health. 2015 Apr; 20(4): 448–454. Open Access
Tropical Medicine and International Health volume 21 no 1 pp 101-107 january 2016
Данное руководство содержит детальное описание стратегии диагностики и ведения пациентов с лекарственно-устойчивыми формами ТБ, прежде всего с туберкулезом с мн
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жественной лекарственной устойчивостью (МЛУ-ТБ). Оно составлено с учетом важных изменений, отмеченных за последние годы, и предназначено для практикующих медицинских работников и программ борьбы с ТБ в странах с умеренными и ограниченными ресурсами.
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