Bull. W.H.O. (Print); 101 (3), 2023
Publication year: 2023
Objective To describe the implementation of case-area targeted interventions to reduce cholera transmission using a rapid, localized
response in Kribi district, Cameroon.
Methods We used a cross-sectional design to study the implementation of case-area targeted interventions. We initiated interventions
after rapid diagnostic test confirmation of a case of cholera. We targeted households within a 100–250 metre perimeter around the index
case (spatial targeting).
The interventions package included:
health promotion, oral cholera vaccination, antibiotic chemoprophylaxis for
nonimmunized direct contacts, point-of-use water treatment and active case-finding.
Findings We implemented eight targeted intervention packages in four health areas of Kribi between 17 September 2020 and 16 October
2020. We visited 1533 households (range: 7–544 per case-area) hosting 5877 individuals (range: 7–1687 per case-area). The average time
from detection of the index case to implementation of interventions was 3.4 days (range: 1–7). Oral cholera vaccination increased overall
immunization coverage in Kribi from 49.2% (2771/5621 people) to 79.3% (4456/5621 people). Interventions also led to the detection
and prompt management of eight suspected cases of cholera, five of whom had severe dehydration. Stool culture was positive for Vibrio
cholerae O1 in four cases. The average time from onset of symptoms to admission of a person with cholera to a health facility was 1.2 days.
Conclusion Despite challenges, we successfully implemented targeted interventions at the tail-end of a cholera epidemic, after which no
further cases were reported in Kribi up until week 49 of 2021. The effectiveness of case-area targeted interventions in stopping or reducing
cholera transmission needs further investigation