Preliminary remarks on cholera kits

Specifications

The cholera kit 001 is specially designed for use in refugee camps.

It can also be used in urban or rural settings, although it is less well adapted for these contexts In such cases, smaller kits for 10 or 50 patients should be assembled on site according to needs and available resources.

This kit is intended for the treatment of 625 cholera cases, of which 75% (500 cases) require IV fluids and ORS, and 25% (125 cases) require ORS only. These proportions differ from WHO recommendations and are based on MSF's experience, which shows a frequently high proportion of severely dehydrated cases. In urban or rural areas, only 20 % of cholera cases require IV fluids and ORS.

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

Components

The complete kit (KMEDKCHO1--) is composed of a medical part with 2 infusions modules (2000 l each) and a logistic part. If the 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

The last two kits are proposed due to the transport costs associated with infusions modules. If quality-assured Ringer lactate (Hartmann) has been identified and validated by your section pharmacist, or if you already have quality-assured Ringer lactate in your emergency stock, you may consider ordering the following kits KMEDKCHO3M- or KMEDKCHO4M-.

NOTE

It is mandatory to have a minimum of 4000 l of Ringer Lactate (Hartmann) available for the IV treatment of 500 cholera patients.

Underestimating needs - resulting in infusion stocks running out during an epidemic - is always more costly than ordering 4000 l from the outset..

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