Last data update: Nov 11, 2024. (Total: 48109 publications since 2009)
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Notes from the Field: Cholera outbreak - Zimbabwe, September 2018-March 2019
Winstead A , Strysko J , Relan P , Conners EE , Martinsen AL , Lopez V , Arons M , Masunda KPE , Mukeredzi I , Manyara J , Duri C , Mashe T , Phiri I , Poncin M , Sreenivasan N , Aubert RD , Fuller L , Balachandra S , Mintz E , Manangazira P . MMWR Morb Mortal Wkly Rep 2020 69 (17) 527-528 During September 5–6, 2018, a total of 52 patients in Harare, Zimbabwe, were hospitalized with suspected cholera, an acute bacterial infection characterized by watery diarrhea. Rapid diagnostic testing was positive for Vibrio cholerae O1, and on September 6, Zimbabwe’s Ministry of Health and Child Care (MOHCC) declared an outbreak of cholera. From September 4, 2018, (date of the first reported cases) through March 12, 2019, a total of 10,730 cases and 69 (0.64%) deaths were reported nationally from nine of Zimbabwe’s 10 provinces (Figure). Most cases (94%) were reported from Harare Province, the country’s largest province, with a population of approximately 2 million. |
Strengthening healthcare facilities through Water, Sanitation, and Hygiene (WASH) Improvements: A Pilot Evaluation of "WASH FIT" in Togo
Weber N , Martinsen AL , Sani A , Assigbley EKE , Azzouz C , Hayter A , Ayite K , Baba AAB , Davi KM , Gelting R . Health Secur 2018 16 S54-s65 Water, sanitation, and hygiene (WASH) services in healthcare facilities are essential to ensure quality health care and to facilitate infection, prevention, and control practices. They are critical to responding to outbreaks and preventing healthcare-associated infections and, therefore, critical to global health security. Many healthcare facilities in low- and middle-income settings have limited WASH services. One tool to address this issue is the World Health Organization (WHO) and United Nations Children's Fund (UNICEF) Water and Sanitation for Health Facility Improvement Tool, or "WASH FIT." WASH FIT is a continuous improvement tool based on key WHO environmental health and infection, prevention, and control standards. While using WASH FIT, internal teams regularly perform self-assessments at their facilities, using up to 65 WASH indicators to develop and implement an improvement plan. The Ministry of Health and Social Protection (MSPS) in Togo, with support from WHO and the US Centers for Disease Control and Prevention (CDC), piloted this tool in 3 healthcare facilities. The pilot included facility assessments at 3 time points and in-depth interviews and document review 7 months after initiating WASH FIT. Facilities made improvements without significant external financial or material support. On average, pilot facilities improved from 18% of total indicators meeting standards at baseline to 44% after 7 months. Examples included improved drinking water supply, medical waste segregation, and increased soap at handwashing stations. Participants reported improvements in staff and patient satisfaction, hand hygiene, and occupational safety. Findings suggest that WASH FIT, coupled with training and supervision, may help facilities improve WASH services and practices, thus contributing to global health security. Based on these findings, the Togolese MSPS plans to scale up nationwide. Les services d'eau, d'assainissement, et d'hygiene (WASH) dans les etablissements de sante sont essentiels pour assurer des soins de qualite et faciliter les pratiques de prevention et controle des infections. Ils sont essentiels pour repondre aux epidemies et prevenir les infections associees aux soins de sante, et donc a la securite sanitaire mondiale. De nombreux pays a revenu faible ou intermediaire ont des services WASH limites dans les etablissements de soins. Un outil recemment publie pour remedier cette situation est l'outil WASH FIT [Water and Sanitation for Health Facility Improvement Tool] de l'Organisation mondiale de la Sante (OMS) et le Fonds des Nations Unies (UNICEF) pour l'amelioration de l'eau et l'assainissement dans les formations sanitaires. WASH FIT est un outil d'amelioration continue base sur les normes de l'OMS en matiere de sante environnementale et de prevention et controle des infections. Lors de l'utilisation de WASH FIT, les equipes internes effectuent regulierement des auto-evaluations dans leurs installations en utilisant jusqu'a 65 indicateurs pour elaborer et mettre en oeuvre leur plan d'amelioration. Le ministere de la Sante et de la Protection Sociale (MSPS) du Togo, avec le soutien de l'OMS et les Centres pour le controle et la prevention des maladies (CDC), a fait un pilotage de cet outil dans 3 centres de sante. Ce pilotage comprenait 3 evaluations dans chaque formation sanitaire, des interviews approfondies, et une revue documentaire, 7 mois apres l'initiation du WASH FIT. Les formations sanitaires ont realise des progres, sans aide financiere ou materielle exterieure. En moyenne, les formations sanitaires sont passees de 18% des indicateurs atteignant les standards au depart, a 44% apres 7 mois. Les exemples incluent l'approvisionnement en eau potable, le tri des dechets medicaux, et le savon aux points de lavage des mains. Les participants ont signale des ameliorations dans la satisfaction du personnel et des patients, l'hygiene des mains, et la securite au travail. Les resultats indiquent que WASH FIT, associe a la formation et a la supervision, pourrait etre un outil pour aider les formations sanitaires a ameliorer les services et pratiques WASH, contribuant ainsi a la securite sanitaire mondiale. Sur la base de ces resultats, le MSPS prevoit une extension a l'echelle nationale. |
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