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Practical Strategies for Cholera Control - The Case of Mampong Municipal
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INTRODUCTION

As of 14th November 2014, cumulatively,26,858 cases including 214 deaths (Case fatality rate of 0.8%) have been reported from 123 districts in all the 10 regions in the country as indicated below

Table 2: Cumulative Cases and Deaths of Cholera by Region, Ghana, as of14thNovember 2014

Region

Cases

Deaths

CFR (%)

Number of Districts reporting

Ashanti

219

2

1.0

27

Brong-Ahafo

922

23

2.5

15

Central

3,258

36

1.1

15

Eastern

1,863

6

0.3

18

Greater Accra

19,292

120

0.6

16

Northern

96

2

2.6

4

Upper East

294

9

3.1

8

Upper West

34

1

3.0

3

Volta

519

8

1.6

7

Western

361

7

1.9

10

Total (Ghana)

26,858

214

0.8

123

                       

Mampong Municipal is one of the two districts in Ashanti region which did not record any indigenous cholera case and the essence of the write up is to give an idea of what can be done to achieve similar results

There were 3 intervention strategies used:

1)  Aborting potential incubation phase challenges

2) Aborting effective hand washing challenges

3)   Controlling water bourne challenges

 

INCUBATION PHASE ABORTION

Cholera has an incubation phase of between 12-48 hours before symptoms appear after initial infection  and as the focal infection could be traced to Greater Accra, the municipal strategized and when tertiary  schools re opened, schools with students coming from known sites in greater Accra were met, the incubation issues discussed, see such students as potential bombs and

motivated to introduce a 2 day treatment using tetracycline. Based on the above, the cape coast incident where when school re opened, 250 students were affected with 2 deaths was averted. Though the municipal had 10 suspected cholera cases from surrounding districts, there was no indigenous cholera due to

·         Treatment of primary and secondary contacts identified using relevant antibiotics eg co-trimoxazole

·         Treatment of people coming from known cholera sites also linked to suspected cases

ABORTING EFFECTIVE HAND WASHING CHALLENGES:

 Secondly, veronica buckets were placed at the entrance of wards and all relatives visiting diarrheal related cases were motivated to facilitate effective hand washing as they EXITED the facility not as they entered

The GPRTU also instituted a measure where all vehicles had carbolic soap and any individual who had diarrhea in the course of the journey would have to do effective hand washing before you were allowed to re board the vehicle

CONTROLLING WATER BOURNE CHALLENGES:

Thirdly, nearby districts which had cholera like Ejura which had a total of 52 cases in one week at its peak, and which a minimum of 400 people from our district visit as a result of market activities. At the peak of their cholera challenge, such visitors were advised not to patronize any CHECHERE water and restrict themselves to the use of purified water and also assisted surrounding districts to purify household wells which was a major source of water contamination for districts with household wells using calcium hypochlorite or chlorine derivatives

Now that the incidence of cholera has reduced, there is the need to mop up using the incubation phase abortion method and if possible decontaminate areas where indiscriminate defeacation occurs through periodic spraying with disinfectants eg IZAL

Gloria.quansahasare@ghsmail.org/ Glorasare1@yahoo.com

By: Jacob Amoah