Mwale Moses, Chipimo Peter Jay, Kalubula Precious, Hibusu Ladislas, Mulima Stella Mumba Chomba, Kapema Kafusha, Mwangilwa Kelvin, Mbewe Nyuma, Kapaya Fred
World Health Organization, Lusaka, Zambia
World Health Organization, Lusaka, Zambia.
BMJ Glob Health. 2025 Jan 22;10(1):e017055. doi: 10.1136/bmjgh-2024-017055.
Cholera has remained a persistent public health challenge in Zambia since the country's first reported outbreak in 1977. The recent outbreak, which began in October 2023 and is ongoing as of June 2024, is the most severe in Zambia's history and part of the larger 2022-2024 Southern Africa cholera outbreak, which has affected multiple countries in the region. This article describes the implementation of the integrated community strategy for cholera control (ICSCC) in three districts of the Copperbelt Province during this outbreak. The ICSCC is a comprehensive, community-centric public health approach that integrates surveillance, case management, water, sanitation and hygiene interventions, community engagement and infection prevention measures. The strategy's implementation involved deploying multidisciplinary technical teams, training community-based volunteers and healthcare workers in the affected communities. This approach led to a rapid reduction in cholera cases and mortality, largely due to enhanced surveillance, community education sessions and improved sanitation practices. The ICSCC also improved stakeholder coordination and enabled rapid communication for early response to cholera hotspots. Key lessons learnt include the importance of robust coordination, early community involvement and context-specific adaptations. The strategy's emphasis on data-driven decision-making and adaptation to local socio-cultural dynamics was crucial for its effectiveness. These findings underscore the potential of integrated community-based approaches in managing cholera outbreaks, enhancing public health preparedness and building long-term resilience. The ICSCC strategy offers a scalable model for regions facing similar public health challenges, providing valuable insights for policymakers and practitioners on the effectiveness of community involvement in managing public health crises.
自1977年赞比亚首次报告霍乱疫情以来，霍乱一直是该国持续面临的公共卫生挑战。最近一次疫情始于2023年10月，截至2024年6月仍在持续，是赞比亚历史上最严重的一次，也是2022 - 2024年南部非洲霍乱大疫情的一部分，该疫情影响了该地区多个国家。本文描述了此次疫情期间铜带省三个地区实施霍乱控制综合社区战略（ICSCC）的情况。ICSCC是一种以社区为中心的全面公共卫生方法，整合了监测、病例管理、水、环境卫生和个人卫生干预措施、社区参与及感染预防措施。该战略的实施包括部署多学科技术团队，培训受影响社区的社区志愿者和医护人员。这种方法使霍乱病例和死亡率迅速下降，这主要归功于加强了监测、开展了社区教育活动以及改善了卫生习惯。ICSCC还改善了利益相关者之间的协调，并实现了对霍乱热点地区的快速沟通以便早期应对。汲取的主要经验教训包括强有力协调、社区早期参与以及因地制宜调整的重要性。该战略强调数据驱动的决策制定以及适应当地社会文化动态对其有效性至关重要。这些发现凸显了基于社区的综合方法在管理霍乱疫情、加强公共卫生准备以及建立长期复原力方面的潜力。ICSCC战略为面临类似公共卫生挑战的地区提供了一个可扩展的模式，为政策制定者和从业者提供了关于社区参与管理公共卫生危机有效性的宝贵见解。
