Assessing Nurses knowledge on the management of cholera at Kumba District Hospital
Department: Nursing
No of Pages: 55
Project Code: NS2
References: Yes
Cost: 5,000XAF
Cameroonian
: $15 for International students
ABSTRACT
Objectives:
The objective of this study was to assess nurses’ knowledge on the management
of cholera in Kumba District Hospital.
Method:
A descriptive cross sectional study design was used to describe the knowledge
by nurses in Kumba District Hospital at
a single point in time, were data was collected from different individuals
aimed to assess nurses knowledge on the management of cholera in Kumba District
Hospital and the study was carry out for 1 month 3 weeks using nurses. A
well-structured questionnaire was administered to the participants and the
results analysed.
Result:
121 eligible nurses were identified for this study of which 60 of them
participated in the study, Most participants in this study had a global view on
nursing process on diagnosing cholera as a majority of them 43 (71.7%) knew
about nursing process and the steps involve in it.
With
a majority 23 (38.3%) had the nursing process in diagnosing cholera as
assessment, diagnosing, planning, implementation and evaluation. Nurses
intervention for the management of cholera, 46 (76.7%) of participants
administered medication on time since each drug has a half-life. 23 (38.3%)
agreed that treatment of cholera by fluid is the best method.
Educational
words nurses give patients before discharge,19(31.7%) do not counsel patients
before discharge and 41 (68.3%) counsel
patients
CHAPTER ONE
INTRODUCTION
1.0 Introduction
This
chapter presents the background of the study, problem of statement, objectives,
research questions, significance of the study, and scope of study and operational
definition of terms. Cholera is an acute intestinal infection caused by
bacterium Vibrio cholera leading to intestinal infection and diarrhoea.
It
can be transmitted through exposure to an environmental reservoir of Vibro
cholera or contaminated water sources regardless of previously persons or
facial contamination (food or infected person).
1.1 Background
Recent
Cholera health reports show a continual vulnerability of large population to
infectious diseases in relation to our environment (Ali et al, 2012) Cholera is
an epidemic and infectious disease which is of global and public health
significance. There is need to recognize and look for measures to address it.
Cholera
is an acute intestinal infection caused by a bacterium (Vibro cholerae) leading
to intestinal infection and diarrhoea. Infection is mainly by intake of
contaminated water and food. Transmission is due to the faecal contamination of
food and water because of poor sanitation.
The
bacterium can live naturally in any environment thus it remains global health
threat especially in developing countries where access to clean, safe drinking
water, and sufficient sanitation cannot be guaranteed. The disease is
characterised in its most severe form by sudden onset of acute diarrhoea that
can lead to death by severe dehydration and kidney failure.
The
extremely short incubation period (two to five days) enhances the potentially
explosive pattern of outbreaks, as the number of cases can rise very quickly.
About 75% of people infected with cholera do not develop symptoms.
However,
the pathogens stay in faeces up to 5 or 7 to 14 days and are sent back into the
environment, potentially infecting other individuals. It affects both children
and adults. Unlike other diarrhoea diseases, it can kill healthy adults within
hours. Individuals with low immunity, such as malnourished children or people
living with HIV, are at greater risk of death if infected by Cholera (WHO,
2014).
One
hundred and fifty years ago, Snow made the historic discovery that contaminated
water transmitted cholera. Koch cultured Vibro cholera, the bacterium about
which Snow could only speculate. (Haward et al,1984). They discovered the
enterotoxin produced by the bacterium resulting in massive outpouring of fluid.
(De SN.1959).
However
discoveries, by themselves, did not save the lives of cholera’s victims; 50% of
them died until intravenous hydration therapy began to be used in the early
1900s (Rogers et al, 1910). This hypertonic intravenous solution reduced the
case fatality rate, but not until the late 1950s and early 1960s were
consistently successful treatments implemented based on careful intake and
output balance studies. (Carpenter et
al, 1965) (Watten et al, 1959).
Global
spread of cholera, cholera cases and cholera deaths did not stop. In fact, the
seventh pandemic, cholera spread through Asia, then to Africa in 1970s (Goodgame
et al, 1957). And then on to Latin America in the 1990s (Vugia et al, 1992)
Cholera now persists in Sub-Saharan Africa leading to outbreaks which have
become more frequent and more severe in recent years. (Gaffga et al, 2007).
Fortunately,
the epidemic in Latin America, after spreading through most of the continent
has subsided, and no cholera has been reported in recent years from South or
Central America Surprisingly, the 1991 Latin American epidemic did not spread
to Haiti or the Caribbean Islands, but in October 2010, the Asian strain
appeared along the Artibonite River in Haiti. ( Clemens et al, 2009).
Regardless
of how it arrived in Haiti, the conditions were ideal for its rapid spread to
the entire country, leading to over 700000 cases, over half of whom were
hospitalized, and 8000 deaths (WHO, 2011 and 2013).
The
devastating epidemic in Haiti, which has now spread to Cuba and recently to
Mexico, dramatically demonstrated how dangerous cholera can be, and this
epidemic, so close to North America, has raised cholera’s profile but has also
led to a more concerted and coordinated effort to control the disease, not only
in Haiti but in Africa and Asia as well (Centers for disease control and
prevention, 2013).
About
2.8 million people are estimated to become ill with cholera each year, and
since asymptomatic infections are common, 5 to 10 times as many are infected.
The world death toll is estimated to be over 100000 annually, (Ali et al, 2012)
although only a fraction of these are reported.
To
deal with this global threat in Asia, Africa and the Caribbean, the strategy to
control cholera has primarily focused on wash interventions (improved water,
sanitation and hygiene) and ensuring proper case management with hydration and
antibiotics. These interventions are critical to the eventual control of
cholera, but clearly, they have not been sufficient.
Populations
most at risk of cholera are unlikely to have safe water and improved sanitation
for many decades. Although ‘point of use’ water treatment provides protection
when used properly, this has been difficult to sustain on a large scale, and
drinking pure water does not negate the risk from contaminated water which may
also be consumed. (Enger et al, 2013).
In
Cameroon, Cholera is a severe acute watery diarrheal disease caused by
toxigenic strains of Vibrio cholera. The causative bacterium may be free-living
in the environment, with environmental reservoirs well described in endemic
regions in Asia (Verma et al, 2012). The microorganism can live in both fresh-
(inland lakes) (Bwire et al, 2016) and salt-water (coastal, estuarine areas)
environments, illness tends to occur in seasonal patterns (Baumann et al,
2016).
With
seasonality often associated with environmental parameters such as rainfall
(WHO, 2019) and temperature (Department of Biostatistics,2017). While the
environmental link is important for maintaining the microorganism long-term
(including time between epidemics), once introduced into human populations
Vebro cholerae rapid (epidemic) transmission is associated with poor sanitation
household contamination, and contamination of food and potable water.
Epidemiologic
studies in Africa have clearly documented the association between environmental
exposures and occurrence of illness at the same time, there are also data
suggesting that a great deal of the transmission in Africa is due to direct
transmission among humans (WHO, 2013).
Understanding
these transmission patterns is a critical element in designing interventions as
part of national and global cholera control programs.Since 1817, seven cholera
pandemics have spread from South and Southeast Asia to the rest of the world,
and the seventh that began in 1961 in Indonesia is ongoing (Amicizia D, et
al.2019).
During
2014, 190,549 cholera cases and 2,231 deaths (case fatality ratio [CFR] of
1.17%) were reported to the World Health Organization (WHO) by the public
health authorities of 42 countries (Griffiths et al, 2021) Yet, the actual
disease burden is estimated to be much higher, in the range of 1.3 to 4.0
million cholera cases and 21,000–143,000 deaths per year worldwide (Kigen et
al, 2021).
Cholera
is a threat to public health globally, but its burden is biased towards
developing countries where poor water and sanitation provide added opportunities
for transmission. The current pandemic reached Africa in 1970, with the first
cases reported in Guinea-Bissau and Guinea Conakry Between 1980 and 2005, Africa accounted for
the majority of the reported global burden of cholera.(Daso et al, 2021).
From
2000 to 2014, African countries reported 2,139,424 cases of cholera, in
comparison to the 186,401 from Asia; 754,694 from the Americas; 16,291 from
Oceania; and the 417 from Europe. The four countries around the Lake Chad Basin
(Niger, Nigeria, Chad, and Cameroon) reported 62,762 cases in 2010; 65,401 in
2011; 6,784 in 2012; 7,215 in 2013; and 41,410 in 2014 Of these four countries,
Cameroon was responsible for 22,762 cases and 786 deaths (3.5% CFR) in 2011.
In
2014, Cameroon was among the four countries in Africa with a CFR >5% (WHO,
2020). far exceeding the WHO target of less-than 1%. (Mwape et al, 2020). Prevalence of cholera outbreak
in Cameroon is ongoing affecting four regions Littoral, South West, South and
Central Regions.
As
of 18 June 2020, there have been a total of 647cases and 34 deaths. Case
fatality ratio 5.3 percent of the deaths a total of 23 have been in treatment
centres and in the community 44case of cholera was present in Buea Health
District. (WHO,2021). Recently Cameroon has recorded 4,627 cases and 105 deaths
with case fatality rate of 2.3% in March 23 to April 05, 2022, according to the
Health Minister Manaouda Malachie.
1.2 Statement of problem
Cholera
is a bacterial infection cause by Vibrio cholera which is gotten from
contaminated food and water .
Various
measures have been put in place for the management of cholera such as the oral
rehydration therapy but despite this measures cholera still remains a troubling
health problem and global health problem especially in the management of
asymptomatic carriers thereby making it difficult for early clarification and
diagnosis of the disease that the carriers can be placed on treatment.
It
can easily or rather early be manage. Cholera remains a global threat to public
health and an indicator of inequity and lack of social development. Reseachers
have estimated that every year, there are roughly 1.3-4.0 million case, and
21000 to 143000 deaths worldwide due to cholera.(WHO, 2021). About 2.8 million
people are estimated to become ill with cholera each year, and since
asymptomatic infections are common, 5 to 10 times as many are infected.
The
world death toll is estimated to be over 100000 annually. (Ali et al,
2012).These interventions are critical to the eventual control of cholera, but
clearly they have not been sufficient. In fact, the seventh pandemic, cholera
spread through Asia, then to Africa in 1970s. (Goodgame et al, 1975). Cholera
is a diarrheal disease that remains an important global health problem with
sever hundreds of thousands of reported cases each year.
1.3 Objectives
General objective
- To assess nurses knowledge on the management of cholera in Kumba District Hospital.
Specific objective
- To assess nursing process in diagnosing cholera in Kumba District Hospital.
- To assess nursing intervention for the care and management of cholera patients in Kumba District Hospital.
- To assess nursing education to patients with cholera in Kumba District Hospital.
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