Published Date: 2009-07-12 13:30:52
Subject: PRO/EAFR> Cholera - Uganda: (Kasese), ex DR Congo
Archive Number: 20090712.200530

CHOLERA - UGANDA: (KASESE), ex DR CONGO
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International Society for Infectious Diseases
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Date: 10 Jul 2009
Source: Relief web.com [edited]
http://www.reliefweb.int/rw/rwb.nsf/db900sid/NSPR-7TTFDB/$File/full_report.pdf

The [Uganda] Ministry of Health confirmed an outbreak of cholera in
Kasese District, South Western Uganda. On 8 Mar 2009, the 1st case of
cholera was admitted in Bwera Hospital Cholera Treatment Centre (CTC)
originating from Karambi Sub County. More cases were received from
Nyakiyumbu, Kitholhu, Ihandiro and Bwera sub-counties in Bukonzo West
constituency.

In this reporting period, (12 May to 25 May 2009), the number of new
cases increased to 60, hence a cumulative figure of 189 cases and 3
deaths. The increase in the number of new cases is as a result of the
spread of the disease to Health Sub District (HSD) where Red Cross is
not intervening. This outbreak is said to have started in the western
part of Democratic Republic of Congo (DRC) into the neighbouring
areas of Karambi and spreading to the other affected sub counties.
However, there is a decrease in the number of admissions per day
compared to the last reporting period (from an average of 7 to 4
cases per day). The number of cases admitted as of 25 May 2009 is 4.
This is attributed to the intervention made by Red Cross through the
community based Participatory Hygiene and Sanitation Transformation
in Emergency Response (PHASTER) approach. Massive sensitization is
continuously being carried out by the PHASTER groups at village level
in the affected areas through home to home visits, with much
attention being put on supervision and monitoring of the formation of
model homes in communities.

The community has developed their own control measures such as hand
washing, and water treatment using the Hygiene and Sanitation
promotion materials that were distributed by Uganda Red Cross Society (URCS).

However, the health units still lack capacity to respond to the
epidemic, hence referring all suspected cases of cholera to Bwera
Hospital Cholera Treatment Centre (CTC), where facilities are
inadequate, hence the district's request to the branch to give
support in the following areas: provision of disinfectants, medical
supplies like IV [Intravenous] fluids and extending the PHASTER
concept to Bukonzo East HSD.

The disease that had affected 5 sub-counties totaling 18 412
households and a population of 143 597 people has now crossed to
Munkunyu sub-county in Bukonzo East Constituency (6 cases). This
indicates that it is likely to spread and even attack other
neighboring sub-counties.

On top of the District and HSD joint coordination meetings that were
held in the last reporting period, a District Health Management
Committee meeting was held, and top on the agenda was laying out
strategies for wiping out cholera. The partners in the District
Health Management Committee included the district political
leadership (the health sectoral committee), the District Health
Office staff, Heads of HSD's District Water Office and stakeholders
in the health sector. The URCS was fully represented by the branch
Field Coordinator and the Regional programme officer (Organisational
Development and Disaster Management). This committee reviews progress
of health related interventions in the District and lays down
strategies for effective implementation. These meetings take place on
a quarterly basis rotating in all the 4 HSD's. The URCS got the
opportunity to share their field experiences with the other
stakeholders in the health sector, and the district authorities
pledged to work on some of the challenges, like asking local leaders
at the parish and village level to enforce adherence to by-laws and ordinances.

The Uganda Peoples Defence Force (UPDF) Health Department in Rusese
Barracks joined URCS in the cholera prevention intervention by
assigning one of their Health Staff to work with URCS, and this
person has been actively participating in the sensitization of the
community. This has helped the URCS volunteers to access 4 military
detaches in the constituency, equipping the combatants with the
PHASTER concept.

272 842 Swiss Francs [USD 251 000] was allocated from the
Federation's Disaster Relief Emergency Fund (DREF) in April 2009 to
support the national society in delivering assistance to some 18 412
households in 5 sub counties of Ihandiro, Kitholhu, Karambi, Bwera
and Nyakiyumbu, Bukonzo West Constituency, Kasese District.

Since the initiation of the control activities, key achievements such
as mobilization, training and deployment of community PHASTER
trainers -- facilitating them to conduct training of PHASTER groups
-- distribution of hygiene and sanitation promotion materials, social
mobilization, health education, active case search and referral
activities have been made. This has led to increased public awareness
on the disease and its control measures and a general decline in the
infection rate of cholera in 4 sub counties out of 5.

This operation is expected to be implemented in 2 months time and
completed by mid June 2009. In line with federation reporting
standards, the final report (narrative and financial) is due 90 days
after the end of the operation (by 31 Sep 2009).

--
Communicated by:
ProMED-EAFR

[This outbreak of cholera, 1st reported 4 months ago in Kasese
district located in southwestern Uganda and bordering eastern
Democratic Republic of Congo, is finally on the decline after the
underlying cases were addressed. Long term control of cholera
outbreaks in the district will, therefore, depend on establishing
sustainable sources of safe water and improving sanitation and
hygiene practices in the district. This is what the multi-sectoral
response committee led by the Ministry of Health in partnership with
the local authorities and partner agencies are focusing on.

The HealthMap/ProMED-mail map of Uganda showing Kasese is available
at
http://healthmap.org/promed/en?name=Kasese%20District,%20Kasese,%20Uganda&g=&v=0.247,30.086,8.

For additional background information on cholera available from the
general ProMED-mail list, the below postings can be found at
http://www.promedmail.org. - Mod.JFW]

See Also

Cholera, diarrhea & dysentery update 2009 (18) 20090709.2469
Cholera, diarrhea & dysentery update (2009) (17) 20090429.1620
Cholera, diarrhea & dysentery update 2009 (16) 20090310.0991
Cholera, diarrhea & dysentery update 2009 (15) 20090212.0632
Cholera, diarrhea & dysentery update 2009 (14) 20090210.0604
Cholera, diarrhea & dysentery update 2009 (13) 20090204.0491
Cholera, diarrhea & dysentery update 2009 (12) 20090203.0474
Cholera, diarrhea & dysentery update 2009 (11) 20090128.0393
Cholera, diarrhea & dysentery update 2009 (10) 20090126.0355
Cholera, diarrhea & dysentery update 2009 (09) 20090122.0275
Cholera, diarrhea & dysentery update 2009 (08) 20090120.0245
Cholera, diarrhea & dysentery update 2009 (07) 20090116.0182
Cholera, diarrhea & dysentery update 2009 (06) 20090113.0140
Cholera, diarrhea & dysentery update 2009 (05) 20090112.0124
Cholera, diarrhea & dysentery update 2009 (04) 20090110.0107
Cholera, diarrhea & dysentery update 2009 (03) 20090107.0061
Cholera, diarrhea & dysentery update 2009 (02) 20090105.0038
Cholera, diarrhea & dysentery update 2009 (01) 20090102.0015
2008
----
Cholera, diarrhea & dysentery update 2008 (57) 20081231.4125
Cholera, diarrhea & dysentery update 2008 (56) 20081229.4094
Cholera, diarrhea & dysentery update 2008 (55) 20081223.4040
Cholera, diarrhea & dysentery update 2008 (54) 20081218.3988
Cholera, diarrhea & dysentery update 2008 (53) 20081216.3949
Cholera, diarrhea & dysentery update 2008 (52) 20081215.3940
Cholera, diarrhea & dysentery update 2008 (51) 20081212.3906
Cholera, diarrhea & dysentery update 2008 (50) 20081208.3854
Cholera, diarrhea & dysentery update 2008 (49) 20081203.3803
Cholera, diarrhea & dysentery update 2008 (48) 20081201.3776
Cholera, diarrhea & dysentery update 2008 (47) 20081125.3716
Cholera, diarrhea & dysentery update 2008 (46) 20081124.3708
Cholera, diarrhea & dysentery update 2008 (45) 20081120.3662
Cholera, diarrhea & dysentery update 2008 (44) 20081118.3641
Cholera, diarrhea & dysentery update 2008 (43): Congo DR 20081114.3597
Cholera, diarrhea & dysentery update 2008 (42) 20081112.3563
Cholera, diarrhea & dysentery update 2008 (41) 20081023.3347
Cholera, diarrhea & dysentery update 2008 (40) 20081014.3253
Cholera, diarrhea & dysentery update 2008 (39) 20081007.3174
Cholera, diarrhea & dysentery update 2008 (38) 20081001.3099
Cholera, diarrhea & dysentery update 2008 (37) 20080922.2981
Cholera, diarrhea & dysentery update 2008 (36) 20080915.2882
Cholera, diarrhea & dysentery update 2008 (35) 20080908.2804
Cholera, diarrhea & dysentery update 2008 (34) 20080904.2765
Cholera, diarrhea & dysentery update 2008 (33) 20080825.2646
Cholera, diarrhea & dysentery update 2008 (32) 20080811.2477
Cholera, diarrhea & dysentery update 2008 (31) 20080730.2334
Cholera, diarrhea & dysentery update 2008 (30) 20080702.2019
Cholera, diarrhea & dysentery update 2008 (29) 20080627.1983
Cholera, diarrhea & dysentery update 2008 (28) 20080617.1896
Cholera, diarrhea & dysentery update 2008 (27) 20080602.1764
Cholera, diarrhea & dysentery update 2008 (26) 20080516.1637
Cholera, diarrhea & dysentery update 2008 (25) 20080508.1572
Cholera, diarrhea & dysentery update 2008 (24) 20080425.1446
Cholera, diarrhea & dysentery update 2008 (23) 20080418.1394
Cholera, diarrhea & dysentery update 2008 (22) 20080415.1359
Cholera, diarrhea & dysentery update 2008 (21) 20080409.1305
Cholera, diarrhea & dysentery update 2008 (20) 20080404.1240
Cholera, diarrhea & dysentery update 2008 (19) 20080331.1191
Cholera, diarrhea & dysentery update 2008 (18) 20080325.1116
Cholera, diarrhea & dysentery update 2008 (17) 20080320.1064
Cholera, diarrhea & dysentery update 2008 (16) 20080314.1020
Cholera, diarrhea & dysentery update 2008 (15) 20080312.0997
Cholera, diarrhea & dysentery update 2008 (14) 20080304.0882
Cholera, diarrhea & dysentery update 2008 (13) 20080229.0830
..................................................jfw/be/msp

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