Social mobilization for cholera prevention & control in India: Building on the existing framework

Effectiveness and quality of risk communication process in Ethiopia: The case of risk communication during cholera outbreak in Addis Ababa, Ethiopia

BACKGROUND

WHO states risk communication as the conversation of actual information, guidance, and thoughts between specialists and people fronting risks to their well-being, economic or social safety. As risk communication activities are complex and costly usually, evaluation assessment are the best approach to advance risk communication interventions. This study aims to evaluate the effectiveness of risk communication and the quality of health communication materials developed during the 2019 cholera outbreak at Addis Ababa, Ethiopia.

METHODS

A community-based parallel mixed design was conducted from May to June 2020 at Addis Ababa. A total of 605 adults were selected randomly from Addis Ketema sub-city and ten purposely selected adults were interviewed for qualitative data. In addition eight health communication materials on cholera were randomly selected for evaluation. The quantitative data were analyzed using SPSS version 25. After audio recorded interviews transcribed verbatim and translated into English the qualitative data were entered into open code version 4.02 for analysis. And then the data were analyzed using thematic analysis.

RESULT

Respondents exposed for cholera related messages and outbreak information were 71.8% and 52.7% respectively. Respondents have moderate knowledge for cholera with (M = 14.72 and SD ±4.02) with (0-34) scale range. Both Television and radio spots were found as simple and easy to understand and printed health communication materials score low quality. Poor documentation, lack of data management system and less attention for risk communication activities were identified as a gaps in risk communication in the study settings.

CONCLUSION

this study revealed the positive effects of risk communication messages in increasing individuals' knowledge. Even though the risk communication spots were found to be simple and easy to understand, the quality of printed materials was low and less attention was given for the risk-communication activities. Thus, strengthening the quality of risk communication and materials development process is very important to bring desired effects in disease prevention strategies and for effective emergency responses in the future.

Cholera Outbreaks in India, 2011–2020: A Systematic Review

Fecal contamination of water sources and open defecation have been linked to cholera outbreaks in India. However, a systematic review on the drivers responsible for these outbreaks has yet to be published. Here, we systematically review the published literature on cholera outbreaks in India between 2011 and 2020. We searched studies in English in three databases (MEDLINE, EMBASE, and Web of Science) and the Integrated Disease Surveillance Program that tracks cholera outbreaks throughout India. Two authors independently extracted data and assessed the quality of the included studies. Quantitative data on the modes of transmission reviewed in this study were assessed for any change over time between 2011–2015 and 2016–2020. Our search retrieved 10823 records initially, out of which 81 full-text studies were assessed for eligibility. Among these 81 studies, 20 were eligible for inclusion in this review. There were 565 reported outbreaks between 2011 and 2020 that led to 45,759 cases and 263 deaths. Outbreaks occurred throughout the year; however, they exploded with monsoons (June through September). In Tamil Nadu, a typical peak of cholera outbreaks was observed from December to January. Seventy-two percent (33,089/45,759) of outbreak-related cases were reported in five states, namely Maharashtra, West Bengal, Punjab, Karnataka, and Madhya Pradesh. Analysis of these outbreaks highlighted the main drivers of cholera including contaminated drinking water and food, inadequate sanitation and hygiene (including open defecation), and direct contact between households. The comparison between 2011–2015 and 2016–2020 showed a decreasing trend in the outbreaks that arose due to damaged water pipelines. Many Indians still struggle with open defecation, sanitation, and clean water access. These issues should be addressed critically. In addition, it is essential to interrupt cholera short-cycle transmission (mediated by households, stored drinking water and foodstuffs) during an outbreak. As cholera is associated with deprivation, socio-economic development is the only long-term solution.

Systems Dynamics Modeling of Pandemic Influenza for Strategic Policy Development: a Simulation-Based Analysis of the COVID-19 Case

The novel coronavirus disease 2019 (COVID-19) is a truly wicked problem which has remained a stubborn issue plaguing multiple countries worldwide. The continuously increasing number of infections and deaths has driven several countries to implement control and response strategies including community lockdowns, physical distancing, and travel bans with different levels of success. However, a disease outbreak and the corresponding policies can cause disastrous economic consequences due to business closures and risk minimization behaviors. This paper develops a system dynamics framework of a disease outbreak system covering various policies to evaluate their effectiveness in mitigating transmission and the resulting economic burden. The system dynamics modeling approach captures the relationships, feedbacks, and delays in such a system, revealing meaningful insights on the dynamics of several response strategies.