Médecins Sans Frontières, Yaounde, Cameroon.
World Health Organization, PO Box 155, Yaounde, Cameroon.
Bull World Health Organ. 2023 Mar 1;101(3):170-178. doi: 10.2471/BLT.22.288885. Epub 2023 Jan 18.
To describe the implementation of case-area targeted interventions to reduce cholera transmission using a rapid, localized response in Kribi district, Cameroon.
We used a cross-sectional design to study the implementation of case-area targeted interventions. We initiated interventions after rapid diagnostic test confirmation of a case of cholera. We targeted households within a 100-250 metre perimeter around the index case (spatial targeting). The interventions package included: health promotion, oral cholera vaccination, antibiotic chemoprophylaxis for nonimmunized direct contacts, point-of-use water treatment and active case-finding.
We implemented eight targeted intervention packages in four health areas of Kribi between 17 September 2020 and 16 October 2020. We visited 1533 households (range: 7-544 per case-area) hosting 5877 individuals (range: 7-1687 per case-area). The average time from detection of the index case to implementation of interventions was 3.4 days (range: 1-7). Oral cholera vaccination increased overall immunization coverage in Kribi from 49.2% (2771/5621 people) to 79.3% (4456/5621 people). Interventions also led to the detection and prompt management of eight suspected cases of cholera, five of whom had severe dehydration. Stool culture was positive for O1 in four cases. The average time from onset of symptoms to admission of a person with cholera to a health facility was 1.2 days.
Despite challenges, we successfully implemented targeted interventions at the tail-end of a cholera epidemic, after which no further cases were reported in Kribi up until week 49 of 2021. The effectiveness of case-area targeted interventions in stopping or reducing cholera transmission needs further investigation.
描述在喀麦隆克里比地区使用快速局部响应实施病例区域靶向干预以减少霍乱传播的情况。
我们使用横断面设计研究病例区域靶向干预的实施情况。在霍乱确诊病例后，我们立即启动干预措施。我们以指数病例周围 100-250 米范围内的家庭为目标（空间靶向）。干预措施包包括：健康促进、口服霍乱疫苗接种、未免疫的直接接触者的抗生素化学预防、现场用水处理和主动病例发现。
我们在 2020 年 9 月 17 日至 10 月 16 日期间在克里比的四个卫生区实施了八个靶向干预包。我们访问了 1533 个家庭（每个病例区 7-544 个家庭），共接待了 5877 人（每个病例区 7-1687 人）。从发现指数病例到实施干预的平均时间为 3.4 天（范围为 1-7 天）。口服霍乱疫苗接种使克里比的整体免疫覆盖率从 49.2%（2771/5621 人）提高到 79.3%（4456/5621 人）。干预措施还发现并及时治疗了 8 例疑似霍乱病例，其中 5 例有严重脱水。4 例粪便培养对 O1 呈阳性。从出现症状到霍乱患者被送往医疗机构的平均时间为 1.2 天。
尽管存在挑战，但我们在霍乱疫情末期成功实施了靶向干预措施，此后，直到 2021 年第 49 周，克里比都没有再报告霍乱病例。病例区域靶向干预在阻止或减少霍乱传播方面的有效性需要进一步调查。
