Assessment of the response to cholera outbreaks in two districts in Ghana

Background:Despite recurring outbreaks of cholera in Ghana,very little has been reported on assessments of outbreak response activities undertaken in affected areas.This study assessed the response activities undertaken in two districts,Akatsi District in Volta Region and Komenda-Edina-Eguafo-Abirem(KEEA)Municipal in Central Region during the 2012 cholera epidemic in Ghana.Methods:We conducted a retrospective assessment of the events,strengths and weaknesses of the cholera outbreak response activities in the two districts making use of the WHO cholera evaluation tool.Information sources included surveillance and facility records,reports and interviews with relevant health personnel involved in the outbreak response from both district health directorates and health facilities.We collected data on age,sex,area of residence,date of reporting to health facility of cholera cases,district population data and information on the outbreak response activities and performed descriptive analyses of the outbreak data by person,time and place.Results:The cholera outbreak in Akatsi was explosive with a high attack rate(AR)of 374/100,000 and case fatality rate(CFR)of 1.2%while that in KEEA was on a relatively smaller scale AR of 23/100,000 but with a high case fatality rate of 18.8%.For both districts,we identified multiple strengths in the response to the outbreak including timely notification of the district health officials which triggered prompt investigation of the suspected outbreak facilitating confirmation of cholera and initiation of public health response activities.Others were coordination of the activities by multi-sectoral committees,instituting water,sanitation and hygiene measures and appropriate case management at health facilities.We also found areas that needed improvement in both districts including incomplete surveillance data,sub-optimal community based surveillance considering the late reporting and the deaths in the community and the inadequate community knowledge about cholera preventive measures.Conclusion:The assessment of the cholera outbreak response in the two districts highlighted strengths in the epidemic control activities.There was however need to strengthen preparedness especially in the area of improving community surveillance and awareness about cholera prevention and the importance of seeking prompt treatment in health facilities in the event of an outbreak.

Mobile biosafety level (BSL) 2 laboratories deployment: Strengthening the diagnostic facilities in Pakistan with emerging public health challenges and the way forward

Availability of mobile laboratories can facilitate rapid on-spot detection of pathogens,monitor its presence in certain populations and inform health authorities to take immediate remedial measures.Currently available biosafety and biosecurity guidelines and policies may not completely articulate the increased demand to manage mobile units in infectious disease outbreaks in remote parts of the country for rapid diagnosis,and also allows research and epidemiological study take place appropriately.The main objective of this study is to evaluate the current limitations and develop and implement biosafety and biosecurity guidelines as well as the protocols for operations,security,and response plan of mobile biosafety level 2 laboratories and their deployment.Keeping in view the sensitivity of it,a comprehensive plan was developed to address it in view of Global Health Security framework.Biosafety and biosecurity protocols were developed including Risk Assessment Tool(RAT)fitting the needs and strengthen the diagnostic and epidemiological capacity in the field covering remote parts of country to fill the gaps observed during the COVID-19 pandemic.Currently the biosafety and biosecurity best practices guidelines and biosecurity policy and regulations are directed mostly towards static laboratories.A biosafety and biosecurity manual developed to adopt and meet the requirements for MBSL 2.For acute health infectious threats including the COVID-19 outbreak and other epidemics,rapid diagnosis can curb and mitigate the problem before it gets out of its boundaries creating significant health risks for the public and economy.The deployment of mobile laboratories will certainly help in curbing these catastrophes.