Top

Published in:

Open Access 01-12-2019 | Cholera | Research article

Health facility preparedness for cholera outbreak response in four cholera-prone districts in Cameroon: a cross sectional study

Authors: Jerome Ateudjieu, Martin Ndinakie Yakum, Andre Pascal Goura, Sonia Sonkeng Nafack, Anthony Njimbia Chebe, Joliette Nguefack Azakoh, Benjamin Azike Chukuwchindun, Eugene Joel Bayiha, Corine Kangmo, Gnodjom Victorin Boris Tachegno, Anne-Cécile Zoung Kanyi Bissek

Published in: BMC Health Services Research | Issue 1/2019

Abstract

Background

The risk of cholera outbreak remains high in Cameroon. This is because of the persistent cholera outbreaks in neighboring countries coupled with the poor hygiene and sanitation conditions in Cameroon. The objective of this study was to assess the readiness of health facilities to respond to cholera outbreak in four cholera-prone districts in Cameroon.

Methodology

A cross-sectional study was conducted targeting all health facilities in four health districts, labeled as cholera hotspots in Cameroon in August 2016. Data collection was done by interview with a questionnaire and by observation regarding the availability of resources and materials for surveillance and case management, access to water, hygiene, and sanitation. Data analysis was descriptive with STATA 11.

Principal findings

A total of 134 health facilities were evaluated, most of which (108/134[81%]) were urban facilities. The preparedness regarding surveillance was limited with 13 (50%) health facilities in the Far North and 22(20%) in the Littoral having cholera case definition guide. ORS for Case management was present in 8(31%) health facilities in the Far North and in 94(87%) facilities in the littoral. Less than half of the health facilities had a hand washing protocol and 7(5.1%) did not have any source of drinking water or relied on unimproved sources like lake. A total of 4(3.0%) health facilities, all in the Far North region, did not have a toilet.

Conclusions

The level of preparedness of health facilities in Cameroon for cholera outbreak response presents a lot of weaknesses. These are present in terms of lack of basic surveillance and case management materials and resources, low access to WaSH. If not addressed now, these facilities might not be able to play their role in case there is an outbreak and might even turn to be transmission milieus.

Available only for authorised users

Pena ES, Kakaiuml CG, Bompangueacute D, Cholera TK. Evolution of epidemiological situation in four French-speaking African countries from 2004 to 2013. West Afr J Med. 2014;33(4):245–51.PubMed

Djomassi LD, Gessner BD, Andze GO, Mballa GAE. National surveillance data on the epidemiology of cholera in Cameroon. J Infect Dis. 2013;208(Suppl 1):S92–7.CrossRef

Ngwa MC, Liang S, Kracalik IT, Morris L, Blackburn JK, Mbam LM, et al. Cholera in Cameroon, 2000-2012: spatial and temporal analysis at the operational (Health District) and sub climate levels. PLoS Negl Trop Dis [Internet]. 2016 Nov 17 [cited 2017 Aug 20];10(11). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5113893/ CrossRef

Munier A, Njanpop-Lafourcade B-M, Sauvageot D, Mhlanga RB, Heyerdahl L, Nadri J, et al. The African cholera surveillance network (Africhol) consortium meeting, 10–11 June 2015, Lomé, Togo. BMC Proc [Internet]. 2017 Jan 31 [cited 2017 Aug 18];11(Suppl 1). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5301166/

Ngwa MC, Liang S, Mbam L, Arabi M, Teboh A, Brekmo K, et al. Cholera Public Health Surveillance System in Cameroon. Online J Public Health Inform [Internet]. 2015 Feb 26 [cited 2017 Aug 20];7(1). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4512393/

Akoachere J-FTK, Omam L-A, Massalla TN. Assessment of the relationship between bacteriological quality of dug-wells, hygiene behaviour and well characteristics in two cholera endemic localities in Douala, Cameroon. BMC Public Health. 2013;13:692.CrossRef

Kaas RS, Ngandjio A, Nzouankeu A, Siriphap A, Fonkoua M-C, Aarestrup FM, et al. The Lake Chad Basin, an isolated and persistent reservoir of Vibrio cholerae O1: a genomic insight into the outbreak in Cameroon, 2010. PLoS One [Internet]. 2016 May 18 [cited 2017 Aug 20];11(5). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4871476/

The DHS program - Cameroon: 2011 - final report (French) [internet]. [cited 2017 Aug 20]. Available from: https://dhsprogram.com/pubs/pdf/FR260/FR260.pdf.

MICS4 Preliminary Findings - Cameroon 2014 MICS KFR_French.pdf [Internet]. [cited 2017 Aug 31]. Available from: https://mics-surveys-prod.s3.amazonaws.com/MICS5/West%20and%20Central%20Africa/Cameroon/2014/Key%20findings/Cameroon%202014%20MICS%20KFR_French.pdf

10.

WHO | Prevention and control of cholera outbreaks: WHO policy and recommendations [internet]. WHO. [cited 2017 Aug 20]. Available from: http://www.who.int/cholera/technical/prevention/control/en/.

11.

Bwire G, Malimbo M, Kagirita A, Makumbi I, Mintz E, Mengel MA, et al. Nosocomial Cholera outbreak in a mental hospital: challenges and lessons learnt from Butabika National Referral Mental Hospital, Uganda. Am J Trop Med Hyg. 2015;93(3):534–8.CrossRef

12.

George CM, Jung DS, Saif-Ur-Rahman KM, Monira S, Sack DA, Rashid M, et al. Sustained uptake of a hospital-based handwashing with soap and water treatment intervention (Cholera-hospital-based intervention for 7 days [CHoBI7]): a randomized controlled trial. Am J Trop Med Hyg. 2016;94(2):428–36.CrossRef

13.

Djouma FN, Ateudjieu J, Ram M, Debes AK, Sack DA. Factors associated with fatal outcomes following cholera-like syndrome in far north region of Cameroon: a community-based survey. Am J Trop Med Hyg. 2016;95(6):1287–91.CrossRef

14.

9789241508476_eng.pdf [Internet]. [cited 2018 Aug 29]. Available from: http://apps.who.int/iris/bitstream/handle/10665/154588/9789241508476_eng.pdf;jsessionid=7B58FB416DCF7144A8753808CD0AD73E?sequence=1

15.

Cronk R, Bartram J. Environmental conditions in health care facilities in low- and middle-income countries: coverage and inequalities. Int J Hyg Environ Health. 2018;221(3):409–22.CrossRef

16.

Ecodev Sàrl N. Resources - Water, sanitation and hygiene (WASH) [Internet]. [cited 2018 Aug 29]. Available from: https://www.washinhcf.org/evidence-research/resources/.

17.

Kohler P, Renggli S, Lüthi C. WASH and gender in health care facilities: the uncharted territory. Health Care Women Int. 2017 Nov 8:1–10.

18.

Guo A, Bowling JM, Bartram J, Kayser G. Water, sanitation, and hygiene in rural health-care facilities: a cross-sectional study in Ethiopia, Kenya, Mozambique, Rwanda, Uganda, and Zambia. Am J Trop Med Hyg. 2017;97(4):1033–42.CrossRef

19.

Djouma FN, Ateudjieu J, Ram M, Debes AK, Sack DA. Factors associated with fatal outcomes following Cholera-like syndrome in far north region of Cameroon: a community-based survey. Am J Trop Med Hyg. 2016;95(6):1287–91.CrossRef

20.

Ngwa MC, Liang S, Mbam LM, Mouhaman A, Teboh A, Brekmo K, et al. Cholera public health surveillance in the Republic of Cameroon-opportunities and challenges. Pan Afr Med J. 2016;24:222.CrossRef

21.

White P, Saketa S, Durand A, Vaai-Nielsen S, Leong-Lui TA, Naseri T, et al. Enhanced surveillance for the third United Nations conference on Small Island developing states, Apia, Samoa, September 2014. West Pac Surveill Response J. 2017;8:15–21.CrossRef

22.

Guerra J, Mayana B, Djibo A, Manzo ML, Llosa AE, Grais RF. Evaluation and use of surveillance system data toward the identification of high-risk areas for potential cholera vaccination: a case study from Niger. BMC Res Notes. 2012;5(1):231.CrossRef

23.

Johnston RB, Luby SP, Unicomb L, Islam MS, Halder AK, Huda TM, et al. Microbiological contamination of drinking water associated with subsequent child diarrhea. Am J Trop Med Hyg. 2015;93(5):904–11.CrossRef

24.

Bain R, Cronk R, Wright J, Yang H, Slaymaker T, Bartram J. Fecal contamination of drinking-water in low- and middle-income countries: a systematic review and meta-analysis. Hunter PR, editor PLoS Med. 2014;11(5):e1001644.CrossRef

25.

Nsagha DS, Atashili J, Fon PN, Tanue EA, Ayima CW, Kibu OD. Assessing the risk factors of cholera epidemic in the Buea Health District of Cameroon. BMC Public Health. 2015 Nov 14;15:1128.CrossRef

26.

Rakotoarisoa A, Randrianasolo L, Tempia S, Guillebaud J, Razanajatovo N, Randriamampionona L, et al. Evaluation of the influenza sentinel surveillance system in Madagascar, 2009–2014. Bull World Health Organ. 2017 May 1;95(5):375–81.CrossRef

27.

Nikolay B, Salje H, Sturm-Ramirez K, Azziz-Baumgartner E, Homaira N, Ahmed M, et al. Evaluating hospital-based surveillance for outbreak detection in Bangladesh: analysis of healthcare utilization data. PLoS Med [Internet] 2017 Jan 17 [cited 2017 Aug 20];14(1). Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5240927/.CrossRef

28.

Ngwa MC, Liang S, Mbam LM, Mouhaman A, Teboh A, Brekmo K, et al. Cholera public health surveillance in the Republic of Cameroon-opportunities and challenges. Pan Afr Med J [Internet]. 2016 Jul 12 [cited 2017 Aug 18];24. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5075464/

29.

Worrell CM, Wiegand RE, Davis SM, Odero KO, Blackstock A, Cuéllar VM, et al. A cross-sectional study of water, sanitation, and hygiene-related risk factors for soil-transmitted helminth infection in Urban School- and preschool-aged children in Kibera, Nairobi. Deribe K, editor PLOS ONE 2016;11(3):e0150744.

30.

WHO_CDS_CSR_ISR_2000.1.pdf [Internet]. [cited 2017 Aug 31]. Available from: http://apps.who.int/iris/bitstream/10665/66485/1/WHO_CDS_CSR_ISR_2000.1.pdf?ua=1.

31.

Harris JB, LaRocque RC, Qadri F, Ryan ET, Calderwood SB. Cholera. Lancet. 2012;379(9835):2466.CrossRef

32.

33.

Ohene S-A, Klenyuie W, Sarpeh M. Assessment of the response to cholera outbreaks in two districts in Ghana. Infect Dis Poverty [Internet]. 2016 Nov 2 [cited 2017 Aug 18];5. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5090876/

34.

Bwire G, Makumbi I, Mintz E, Malimbo M, Mengel MA, Kagirita A, et al. Nosocomial Cholera outbreak in a mental hospital: challenges and lessons learnt from Butabika National Referral Mental Hospital. Uganda Am J Trop Med Hyg. 2015;93(3):534–8.CrossRef

35.

Paul RC, Faruque ASG, Alam M, Iqbal A, Zaman K, Islam N, et al. Incidence of severe diarrhoea due to Vibrio cholerae in the catchment area of six surveillance hospitals in Bangladesh. Epidemiol Infect. 2016 Apr;144(05):927–39.CrossRef

36.

Yepez ES, Bovera MM, Rosenthal VD, Flores HAG, Pazmiño L, Valencia F, et al. Device-associated infection rates, mortality, length of stay and bacterial resistance in intensive care units in Ecuador: international nosocomial infection control Consortium’s findings. World J Biol Chem. 2017;8(1):95.CrossRef

37.

Ejemot-Nwadiaro RI, Ehiri JE, Arikpo D, Meremikwu MM, Critchley JA. Hand washing promotion for preventing diarrhoea. In: The Cochrane Collaboration, editor. Cochrane database of systematic reviews [internet]. Chichester, UK: John Wiley & Sons, Ltd; 2015 [cited 2017 Aug 18]. Available from: https://doi.org/10.1002/14651858.CD004265.pub3.

38.

Cartwright EJ, Patel MK, Mbopi-Keou FX, Ayers T, Haenke B, Wagenaar BH, et al. Recurrent epidemic cholera with high mortality in Cameroon: persistent challenges 40 years into the seventh pandemic. Epidemiol Infect. 2013 Oct;141(10):2083–93.CrossRef

39.

Clasen TF, Alexander KT, Sinclair D, Boisson S, Peletz R, Chang HH, et al. Interventions to improve water quality for preventing diarrhoea. In: The Cochrane Collaboration, editor. Cochrane Database of Systematic Reviews [Internet]. Chichester, UK: John Wiley & Sons, Ltd; 2015 [cited 2017 Aug 18]. Available from: https://doi.org/10.1002/14651858.CD004794.pub3

40.

Cameroon Ministry of Public Health. Arrêter Ministériel N° 0977/A/MINSANTE/SESP/SG/DROS/DE 18 AVRIL 2012 Portant la création organisation et fonctionnement des commîtes d'éthiques de recherches en sante humain dans les structures ministériel en charge de la sante public. Cameroon Ministry of Public Health.

Title: Health facility preparedness for cholera outbreak response in four cholera-prone districts in Cameroon: a cross sectional study
Authors: Jerome Ateudjieu
Martin Ndinakie Yakum
Andre Pascal Goura
Sonia Sonkeng Nafack
Anthony Njimbia Chebe
Joliette Nguefack Azakoh
Benjamin Azike Chukuwchindun
Eugene Joel Bayiha
Corine Kangmo
Gnodjom Victorin Boris Tachegno
Anne-Cécile Zoung Kanyi Bissek
Publication date: 01-12-2019
Publisher: BioMed Central
Keyword: Cholera
Published in: BMC Health Services Research / Issue 1/2019
Electronic ISSN: 1472-6963
DOI: https://doi.org/10.1186/s12913-019-4315-7

At a glance: The STEP trials

Springer Medicine

Health facility preparedness for cholera outbreak response in four cholera-prone districts in Cameroon: a cross sectional study

Abstract

Background

Methodology

Principal findings

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methodology

Principal findings

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2019

Improving outcomes for multi-drug-resistant tuberculosis in the Peruvian Amazon – a qualitative study exploring the experiences and perceptions of patients and healthcare professionals

Factors associated with post-acute discharge location after hospital stay: a cross-sectional study from a Swiss hospital

Estimating the effectiveness and cost-effectiveness of establishing additional endovascular Thrombectomy stroke Centres in England: a discrete event simulation

Does a transition to accountable care in Medicaid shift the modality of colorectal cancer testing?

Using concept mapping to inform the development of a transitional reintegration intervention program for formerly incarcerated people with HIV

Health care providers’ knowledge, attitude and perceived stigma regarding tuberculosis in a pastoralist community in Ethiopia: a cross-sectional study