Cholera prevention and control in refugee settings: Successes and continued challenges

PLoS Neglected Tropical Diseases
http://www.plosntds.org/
(Accessed 22 Jun 2019)

 

Policy Platform
Cholera prevention and control in refugee settings: Successes and continued challenges
Kerry Shannon, Marisa Hast, Andrew S. Azman, Dominique Legros, Heather McKay, Justin Lessler
| published 20 Jun 2019 PLOS Neglected Tropical Diseases
https://doi.org/10.1371/journal.pntd.0007347
…For these situations in which crises may overwhelm the capacity to provide appropriate services and the risk of cholera is thought to be high, the use of the OCV is an emerging strategy, endorsed by WHO, to supplement other cholera prevention and control efforts [58]. In 2013, WHO established a global stockpile of OCV, which was first used in an emergency setting in 2014 in two IDP camps in South Sudan [57]. As of July 2017, more than 25 million doses have been deployed from this stockpile, and availability has been increasing each year [59]. Although investment in water, sanitation, and healthcare infrastructure, supplies, and service provision will have the most impact on prevention and control of cholera and other diarrheal diseases, the vaccine is a potentially powerful tool that can be used when minimum standards are challenging to meet in a timely manner because of the severity or complexity of a humanitarian emergency….
Conclusions
Cholera continues to be a significant problem in humanitarian settings, with recent outbreaks in displaced populations in South Sudan, Yemen, Cameroon, Nigeria, Tanzania, Uganda, Haiti, and Iraq. The success of cholera prevention and control in refugee camps over the past 2 decades highlights the possibility of managing this deadly disease, even in complicated humanitarian crises. Sphere standards and associated control strategies have been shown to be effective in humanitarian crisis settings, dramatically reducing the number and size of outbreaks seen in refugee camps after the North Kivu disaster. Although other vulnerable populations, particularly IDPs, continue to suffer from a substantial cholera burden, application of these strategies in combination with supplementary tools such as OCV have the potential to substantially reduce cholera cases and deaths in line with the 2030 goal of reducing cholera deaths by 90% worldwide.