This document has been prepared to share the 10-year experience, from 2010 to 2020, that UNICEF staff and their partners have accumulated in fighting cholera in Haiti. This guidance document has the objective of providing WASH, Health, Communication for Development and Emergency sectors staff with insights and tools in dealing with a wide-scale cholera epidemic. Although the case of Haiti is particular in many respects, the implemented strategy and lessons learnt from the alert-response approach will be applicable in a number of contexts.
Psychosocial Factors Mediating the Effect of the CHoBI7 Mobile Health Program on Handwashing With Soap and Household Stored Water Quality: A Randomized Controlled Trial
Household members of diarrhea patients are at higher risk of developing diarrheal diseases (>100 times for cholera) than the general population during the 7 days after the diarrhea patient is admitted at a health facility. There is growing evidence demonstrating that theory-driven water, sanitation, and hygiene (WASH) interventions are likely to yield greater behavior change than those based on health education alone.
Usability of rapid cholera detection device (OmniVis) for Water Quality Workers in Bangladesh: iterative convergent mixed methods study
Background: Cholera poses a significant global health burden. In Bangladesh, cholera is endemic and causes more than 100,000 cases each year. Established environmental reservoirs leave millions at risk of infection through the consumption of contaminated water. The Global Task Force for Cholera Control has called for increased environmental surveillance to detect contaminated water sources prior to human infection in an effort to reduce cases and deaths.
This operational guideline authored by UNICEF WASH Gregory Bulit and Monica Ramos, supports the establishment of case area targeted interventions (CATI) with dedicated community outbreak response teams (CORT) in a country affected by cholera. Annexes include tools to set-up, implement, monitor and evaluate the team responses. Inquiries: Greg Bulit and Laure Anquez.
Household spraying in cholera outbreaks: Insights from three exploratory, mixed-methods field effectiveness evaluations
Household spraying is a commonly implemented, yet an under-researched, cholera response intervention where a response team sprays surfaces in cholera patients’ houses with chlorine. We conducted mixed-methods evaluations of three household spraying pro- grams in the Democratic Republic of Congo and Haiti, including 18 key informant interviews, 14 household surveys and observations, and 418 surface samples collected before spray- ing, 30 minutes and 24 hours after spraying.
Distribution of hygiene kits during a cholera outbreak in Kasaï-Oriental, Democratic Republic of Congo: a process evaluation
Background: Cholera remains a leading cause of infectious disease outbreaks globally, and a major public health threat in complex emergencies. Hygiene kits distributed to cholera case-households have previously shown an effect in reducing cholera incidence and are recommended by Médecins Sans Frontières (MSF) for distribution to admitted patients and accompanying household members upon admission to health care facilities (HCFs).
Improved chlorination and rapid water quality assessment in response to an outbreak of acute watery diarrhea in Somali Region, Ethiopia
Somali Region of Ethiopia has been affected by drought for several years. Drought conditions have led to food and water scarcity and a humanitarian crisis in the region. In January 2017, an outbreak of acute watery diarrhea (AWD) was declared in the region. AWD prevention and control activities include strengthening water, sanitation, and hygiene (WASH) services. Access to safe drinking water is critical in preventing transmission of AWD and chlorine is an effective chemical to disinfect water supplies.
Global Review of Water, Sanitation and Hygiene (WASH) Components in Rapid Response Mechanisms and Rapid Response Teams in Cholera Outbreak Settings
In recent outbreak settings, the use of rapid response teams (RRTs) to support the WASH sector has increased.
RRTs have been used as part of the response to cholera outbreaks in countries such as Haiti, Yemen, Somalia, South Sudan and the Democratic Republic of the Congo, with the scope of these teams varying widely. As the
presence of RRTs becomes more common in outbreak settings, it is important to better understand and document
the different types of models in use.
Strengthening Market Systems that Provide Water and Hygiene Items for Cholera Mitigation and Emergency Preparedness in Haiti
In the context of the cholera epidemics in Haiti, a pre-crisis market analysis (PCMA) was conducted in Artibonite to study the supply of and demand for various water- and hygiene-related items. The market analysis found that the majority of households already purchase soap from local traders, but very few have handwashing facilities in their home. A good uptake of chlorine-based disinfection products was observed, including specific products to treat water for drinking.
Prevention and control of cholera with household and community water, sanitation and hygiene (WASH) interventions: A scoping review of current international guidelines
Introduction. Cholera remains a frequent cause of outbreaks globally, particularly in areas with inadequate water, sanitation and hygiene (WASH) services. Cholera is spread through faecaloral routes, and studies demonstrate that ingestion of Vibrio cholerae occurs from consuming contaminated food and water, contact with cholera cases and transmission from contaminated environmental point sources.