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喀麦隆四个霍乱流行地区卫生机构应对霍乱疫情爆发的准备情况:一项横断面研究。

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

机构信息

M.A. SANTE (Meilleur accès aux soins de Santé), P.O. Box 33490, Yaoundé, Cameroon.

Department of Biomedical Sciences, University of Dschang, P.O. Box 067, Dschang, Cameroon.

出版信息

BMC Health Serv Res. 2019 Jul 8;19(1):458. doi: 10.1186/s12913-019-4315-7.

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.

摘要

背景

喀麦隆爆发霍乱的风险仍然很高。这是因为邻国持续爆发霍乱,加上喀麦隆卫生和环境卫生条件差。本研究的目的是评估喀麦隆四个霍乱流行地区卫生机构应对霍乱爆发的准备情况。

方法

2016 年 8 月,对喀麦隆四个被标记为霍乱热点的卫生区的所有卫生机构进行了横断面研究。通过访谈问卷和观察,收集资源和材料的可用性以及监测和病例管理、获得水、卫生和环境卫生方面的数据。数据分析采用 STATA 11 进行描述性分析。

主要发现

共评估了 134 个卫生机构,其中大部分(108/134[81%])为城市卫生机构。监测准备工作有限,在北部和滨海地区,分别只有 13(50%)和 22(20%)的卫生机构有霍乱病例定义指南。在北部和滨海地区,分别有 8(31%)和 94(87%)的卫生机构有病例管理用口服补液盐。不到一半的卫生机构有洗手方案,7(5.1%)没有任何饮用水源,依赖未改善的水源,如湖泊。在北部地区,总共有 4(3.0%)卫生机构没有厕所。

结论

喀麦隆卫生机构应对霍乱爆发的准备水平存在很多弱点。这表现在缺乏基本的监测和病例管理材料和资源,以及获得水和卫生设施的机会低。如果现在不加以解决,这些设施在发生疫情时可能无法发挥作用,甚至可能成为传播媒介。

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