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Cholera Toolkit 2013

Cholera Toolkit 2013

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Cholera is on the rise with an estimated 1.4 billion people at risk in endemic countries and an estimated 3 million to 5 million cases and 100,000-120,000 deaths per year worldwide.1 In many endemic countries, children under 5 account for more than half of the global incidence and deaths. Cholera has remained endemic in some Asian countries for centuries, has become endemic in an increasing number of African countries with epidemics throughout the years, and has recently returned to the Americas with on-going transmission in Haiti and the Dominican Republic. New, more virulent and drug-resistant strains of Vibrio cholerae continue to emerge, and the frequency of large protracted outbreaks with high case fatality ratios has increased, reflecting the lack of early detection, prevention and access to timely health care. These trends are concerning, signal a growing public health emergency and have gained the interest and investment of UNICEF at all levels.

UNICEF currently provides strategic technical support and guidance, surge capacity, training, supplies and logistical support for cholera and diarrhoeal disease outbreak prevention, preparedness and response worldwide. Its multi-sector approach – health, water, sanitation and hygiene (WASH), nutrition, education, protection and other sectors as well as services for emergency operations and supply management– offers the possibility of an integrated effort towards risk reduction, preparedness, capacity building and response in cholera and diarrhoeal disease outbreaks.

Multiple resources – both internal and external – are compiled and consolidated in this UNICEF Cholera Toolkit, to make them easily accessible and widely available for use by UNICEF and partners globally.
Cholera is on the rise with an estimated 1.4 billion people at risk in endemic countries and an estimated 3 million to 5 million cases and 100,000-120,000 deaths per year worldwide.1 In many endemic countries, children under 5 account for more than half of the global incidence and deaths. Cholera has remained endemic in some Asian countries for centuries, has become endemic in an increasing number of African countries with epidemics throughout the years, and has recently returned to the Americas with on-going transmission in Haiti and the Dominican Republic. New, more virulent and drug-resistant strains of Vibrio cholerae continue to emerge, and the frequency of large protracted outbreaks with high case fatality ratios has increased, reflecting the lack of early detection, prevention and access to timely health care. These trends are concerning, signal a growing public health emergency and have gained the interest and investment of UNICEF at all levels.

UNICEF currently provides strategic technical support and guidance, surge capacity, training, supplies and logistical support for cholera and diarrhoeal disease outbreak prevention, preparedness and response worldwide. Its multi-sector approach – health, water, sanitation and hygiene (WASH), nutrition, education, protection and other sectors as well as services for emergency operations and supply management– offers the possibility of an integrated effort towards risk reduction, preparedness, capacity building and response in cholera and diarrhoeal disease outbreaks.

Multiple resources – both internal and external – are compiled and consolidated in this UNICEF Cholera Toolkit, to make them easily accessible and widely available for use by UNICEF and partners globally.

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Published by: The United Nations Children's Fund on May 22, 2013
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Cholera Toolkit
UNICEF
 
Cholera Toolkit
UNICEF
UNICEF - Programme Division3 United Nations PlazaNew York, NY 10017 USAwww.unice.orgCommentaries represent the personal views o the authors and do not necessarily reectthe positions o the United Nations Children’s Fund.The designations employed in this publication and the presentation o the material donot imply on the part o the United Nations Children’s Fund (UNICEF) the expression oany opinion whatsoever concerning the legal status o any country or territory, or o itsauthorities or the delimitations o its rontiers.
This document is accompanied by a USBdevice containing the three componentso the UNICEF Cholera Toolkit: the MainDocument, the Annexes and Additionalresources. These components are meant towork together to make the best use o the Toolkit.
2013
 
1. Introduction
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
6
1.1.
Background to the Toolkit
 ...........................................
6
1.2.
UNICEF’s roles and responsibilities
................................
7
1.3.
Purpose, target audience and structure o the Toolkit
.............
2. Cholera the basics

2.1.
Overview o Chapter 2
.............................................
2.2.
Cholera: history, classifcations and mechanism o action
...........
2.3.
Epidemiology & risk actors
........................................
3. Understanding the situation and monitoring
......................
3.1.
Overview o Chapter 3
.............................................
3.2.
Cholera-related assessment and monitoring
........................
3.3.
Determining an outbreak and its magnitude and scale
..............
3.4.
Monitoring when there are no cases
..............................
4. Cholera prevention
.............................................
4.1.
Overview o Chapter 4
............................................
4.2.
How to prevent cholera through improved water,sanitation and hygiene
.............................................
4.3.
Use o cholera vaccines
...........................................
4.4.
Incorporating cholera prevention into development / regular programming
...............................................
5. Coordination, responsibilities andinormation management
.......................................
5.1.
Overview o Chapter 5
.............................................
5.2.
Co-ordination or cholera prevention, preparedness and response
......
5.3.
Stakeholder responsibilities related to cholera
.....................
5.4.
Data and Inormation Management
.................................
6. Cholera preparedness
..........................................
6.1.
Overview o Chapter 6
............................................
6.2.
National policies, strategies and guidelines
.........................
6.3.
Preparedness & response planning
.................................
6.4.
Human resources
..................................................
6.5.
Supplies / stockpiles
..............................................
6.6.
Resource mobilization
.............................................
7. Communicating or cholera preparednessand response
..................................................
7.1.
Overview o Chapter 7
............................................
7.2.
Introduction to communication or cholera
..........................
7.3.
How to develop a communication strategy and plan
...............
7.4.
Developing messages; visual aids, relevant IEC and othercommunication materials
.........................................
7.5.
Mobilising or community action
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8. Case management and inection control inhealth acilities and treatment sites
............................
8.1.
Overview o Chapter 8
............................................
8.2.
Clinical assessment
...............................................
8.3.
Treatment
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
8.4.
Health acilities and treatment sites
..............................
8.5.
Inormation or patients and their caregivers, psychosocialsupport and protection.
..........................................
9. Community ocussed interventions
.............................
9.1.
Overview o Chapter 9
...........................................
9.2.
Improving access to adequate quantity and quality osae water supplies
..............................................
9.3.
Improving ood saety and hygiene
...............................
9.4.
Improving access to and use o sae excreta disposal
.............
9.5.
Improving handwashing practices
................................
9.6.
Disinection o vomit and aeces in householdsand transport vehicles
............................................
9.7.
Promotion o sae handling o the dead
...........................
9.8.
Provision o supplies / Non-ood items
............................
9.9.
Good environmental hygiene in markets and other public places
.....
9.10.
Cholera response in institutions and other public settings
.........
9.11.
Community Case Management
..................................
9.12.
Accountability to communities
...................................
10. UNICEF procedures or emergency preparednessand response
.................................................
10.1.
Overview o Chapter 10
..........................................
10.2.
Human resources
................................................
10.3.
UNICEF implementation arrangements or generalemergency response
.............................................
10.4.
UNICEF supply procurement
.....................................
173
10.5.
Resource mobilization
............................................
176
Contents

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