WHY TREATMENT CENTERS FAILED TO PREVENT CHOLERA DEATHS AMONG RWANDAN REFUGEES IN GOMA, ZAIRE
WHY TREATMENT CENTERS FAILED TO PREVENT CHOLERA DEATHS AMONG RWANDAN REFUGEES IN GOMA, ZAIRE
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DOI：
10.1016/s0140-6736(95)90344-5
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发表时间：
1995-02-11
期刊：
影响因子：
168.9
通讯作者：
LASTON, S
中科院分区：
文献类型：
--
作者：
SIDDIQUE, AK;SALAM, A;LASTON, S
1994年7月，在扎伊尔东部戈马发生了近年来最严重的霍乱疫情之一，估计有12000名卢旺达难民死亡。霍乱弧菌菌株对治疗霍乱的常用药物四环素和强力霉素具有抗药性。尽管国际组织做出了努力，在戈马建立了治疗中心，提供了医疗救助，但该病的死亡率仍远高于预期。在难民最集中、医疗救援组织最为活跃的穆甘加难民营地区，单日报告最高病死率为48%。补液速度缓慢、口服补液疗法使用不当、静脉输液使用不当以及卫生工作者处理严重霍乱的经验不足被认为是导致疫情期间未能防止如此多死亡的一些因素。在病死率记录最严重的临时治疗中心之一，我们的团队表明，即使在灾难环境中，改善这些因素也可以增加霍乱患者的生存几率。
In July, 1994, in one of the worst cholera outbreaks in recent times, an estimated 12 000 Rwandan refugees died in Goma in eastern Zaire, The Vibrio cholerae strains were resistant to tetracycline and doxycycline, the commonly used drugs for cholera treatment. Despite the efforts of international organisations, which provided medical relief by establishing treatment centres in Goma, mortality from the disease was much higher than expected. In the area of Muganga camp, which had the largest concentration of refugees and where most of the medical aid organisations were active, the highest reported case-fatality ratio for a single day was 48%. The slow rate of rehydration, inadequate use of oral rehydration therapy, use of inappropriate intravenous fluids, and inadequate experience of health workers in management of severe cholera are thought to be some of the factors associated with the failure to prevent so many deaths during the epidemic. In one of the temporary treatment centres with the worst case-fatality record, our team showed that improvement of these factors could increase the odds of survival of cholera patients even in a disaster setting.