Preliminary remarks on cholera kits

Specifications

The cholera kit 001 is specially designed for refugee camps.

It can also be used for urban or rural populations, altough being less adapted (in this case, small kits for 10 or 50 patients are to be made on the spot according to the needs and the available means).

This kit is meant for the treatment of 625 cholera cases, of which 75 % (500 cases) need IV and ORS, and 25 % (125 cases) need ORS only. These proportions are different from those recommended by the WHO and are based on the MSF experience showing an often high proportion of severely dehydrated cases. In urban or rural areas, only 20 % of the cholera cases need IV and ORS.

The antibiotics supplied cover all cholera cases plus 4 close contacts per case (2 500 contacts). MSF does not recommend chemoprophylaxis of close contacts, but supplies antibiotics for this purpose in case local circumstances demand their use (high secondary attack rate, political pressure, strategic reasons, etc.).

Components

The complete kit (KMEDKCHO1--) is composed of a medical part with 2 infusions modules (2000 l each) and a logistic part. If logistic modules are made locally, it is possible to order medical modules only:

  • (KMEDKCHO2M-) with 4000 l infusions
  • (KMEDKCHO3M-) with 2000 l infusions
  • (KMEDKCHO4M-) without infusions module

These two last kits are proposed because of the transport costs of infusions modules. If quality assured Ringer lactate (Hartmann) has been identified and validated by your section pharmacist or if you have quality assured Ringer lactate in your emergency stock, you can consider ordering the following kits: KMEDKCHO3M- or KMEDKCHO4M-.

NOTE

It is mandatory to have minimum 4000 l of Ringer Lactate (Hartmann) to one's disposal for the IV treatment of 500 cholera patients.

An underestimation of needs which could lead to infusion stocks running out during an epidemic is always more expensive than ordering 4000 l in the first place.

Instructions for use

Take 10 samples with the sample module 001 (KMEDMSAM1C-) and send them to headquarters for culture and sensitivity.

Supplies to be got locally if possible

  • Ringer lactate (Hartmann), after the medical/public health dpt's approval
  • Plastic sheeting (for shelters, insulation...)
  • Oral Rehydration Salt (ORS)
  • Blankets
  • Tent 27 m² (white)
  • Calcium Hypochlorite (HTH)
  • Watertight boots
  • Washing product (soap or powder)
  • Minimal medicine cabinet
  • Tubes (to make stretchers with plastic sheeting)

See Management of a cholera epidemic, MSF, 2018