Feasibility of a comprehensive targeted cholera intervention in the Kathmandu valley, Nepal

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 wer...

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Main Authors: Roskosky, M, Acharya, B, Shakya, G, Karki, K, Sekine, K, Bajracharya, D, von Seidlein, L, Devaux, I, Lopez, AL, Deen, J, Sack, DA
Format: Journal article
Language:English
Published: American Society of Tropical Medicine and Hygiene 2019
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author Roskosky, M
Acharya, B
Shakya, G
Karki, K
Sekine, K
Bajracharya, D
von Seidlein, L
Devaux, I
Lopez, AL
Deen, J
Sack, DA
author_facet Roskosky, M
Acharya, B
Shakya, G
Karki, K
Sekine, K
Bajracharya, D
von Seidlein, L
Devaux, I
Lopez, AL
Deen, J
Sack, DA
author_sort Roskosky, M
collection OXFORD
description 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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spelling oxford-uuid:6fc46b50-0f65-4c5a-815e-858b70d2e7182022-03-26T19:32:52ZFeasibility of a comprehensive targeted cholera intervention in the Kathmandu valley, NepalJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:6fc46b50-0f65-4c5a-815e-858b70d2e718EnglishSymplectic ElementsAmerican Society of Tropical Medicine and Hygiene2019Roskosky, MAcharya, BShakya, GKarki, KSekine, KBajracharya, Dvon Seidlein, LDevaux, ILopez, ALDeen, JSack, DAA 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.
spellingShingle Roskosky, M
Acharya, B
Shakya, G
Karki, K
Sekine, K
Bajracharya, D
von Seidlein, L
Devaux, I
Lopez, AL
Deen, J
Sack, DA
Feasibility of a comprehensive targeted cholera intervention in the Kathmandu valley, Nepal
title Feasibility of a comprehensive targeted cholera intervention in the Kathmandu valley, Nepal
title_full Feasibility of a comprehensive targeted cholera intervention in the Kathmandu valley, Nepal
title_fullStr Feasibility of a comprehensive targeted cholera intervention in the Kathmandu valley, Nepal
title_full_unstemmed Feasibility of a comprehensive targeted cholera intervention in the Kathmandu valley, Nepal
title_short Feasibility of a comprehensive targeted cholera intervention in the Kathmandu valley, Nepal
title_sort feasibility of a comprehensive targeted cholera intervention in the kathmandu valley nepal
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