Data from: First wave of the 2016-17 cholera outbreak in Hodeidah city, Yemen - ACF experience and lessons learned

Introduction: Although cases were reported only in 2010 and 2011, cholera is probably endemic in Yemen. In the context of a civil war, a cholera outbreak was declared in different parts of the country October 6th, 2016. This paper describes the ACF outbreak response in Hodeidah city from October 28th, 2016 to February 28th, 2017 in order to add knowledge to this large outbreak.

Methods: The ACF outbreak response in Hodeidah city included a case management component and prevention measures in the community. In partnership with the Ministry of Public Health and Population of Yemen (MoPHP), the case management component included a Cholera Treatment Center (CTC) implemented in the Al Thoraw hospital, 11 Oral Rehydration Therapy Corners (ORTCs) and an active case finding system. In partnership with other stakeholders, prevention measures in the community, including access to safe water and hygiene promotion, were implemented in the most affected communities of the city.

Results: From October 28th, 2016 until February 28th, 2017, ACF provided care to 8,270 Acute Watery Diarrhea (AWD) cases, of which 5,210 (63%) were suspected cholera cases, in the CTC and the 11 ORTCs implemented in Hodeidah city. The attack rate was higher among people living in Al Hali district, with a peak in November 2016. At the CTC, 8% of children under 5 years-old also presented with Severe Acute Malnutrition (SAM). The Case-Fatality Rate (CFR) was low (0.07%) but 15% of admitted cases defaulted for cultural and security reasons. Environmental management lacked the information to appropriately target affected areas. Financial resources did not allow complete coverage of the city.

Conclusion: Response to the first wave of a large cholera outbreak in Hodeidah city was successful in maintaining a CFR <1% in the CTC. However, considering the actual context of Yemen and its water infrastructure, much more efforts are needed to control the current outbreak resurgence.

引言：尽管目前仅见2010年与2011年的霍乱病例报告，但也门境内的霍乱大概率已呈地方性流行态势。在内战背景下，该国多地于2016年10月6日正式宣布暴发霍乱疫情。本研究详述了2016年10月28日至2017年2月28日期间，ACF在荷台达市开展的霍乱疫情应对工作，以期为此次大规模霍乱疫情的防控积累经验数据。

方法：ACF在荷台达市的疫情应对工作包含病例管理模块与社区防控措施两部分。本项目与也门公共卫生与人口部（Ministry of Public Health and Population of Yemen, MoPHP）合作，病例管理模块具体包括在Al Thoraw医院设立的霍乱治疗中心（Cholera Treatment Center, CTC）、11个口服补液治疗点（Oral Rehydration Therapy Corners, ORTCs）以及主动病例搜寻系统。此外，项目组联合其他利益相关方，在该市受疫情影响最严重的社区落实了社区防控措施，包括安全饮水保障与卫生宣教工作。

结果：2016年10月28日至2017年2月28日期间，ACF在荷台达市设立的CTC与11个ORTC中，共为8270例急性水样腹泻（Acute Watery Diarrhea, AWD）病例提供诊疗服务，其中5210例（63%）为疑似霍乱病例。Al Hali地区居民的罹患率更高，疫情在2016年11月达到峰值。在CTC收治的病例中，8%的5岁以下儿童同时合并重度急性营养不良（Severe Acute Malnutrition, SAM）。本次疫情的病例病死率（Case-Fatality Rate, CFR）较低，仅为0.07%，但有15%的收治病例因文化与安全因素中途放弃治疗。环境防控工作缺乏精准定位受影响区域所需的相关信息，且财政资源不足，无法实现全市范围的全面覆盖。

结论：荷台达市首次大规模霍乱疫情第一波暴发的应对工作取得了成功，CTC内的病例病死率控制在1%以下。然而，考虑到也门当前的局势与水利基础设施现状，仍需投入更多力量以遏制当前疫情的反弹。