Rapid control of cholera outbreaks is a significant challenge in overpopulated urban areas. During late-2017, Kinshasa, the capital of the Democratic Republic of the Congo, experienced a cholera outbreak that showed potential to spread throughout the city. A novel targeted water and hygiene response strategy was implemented to quickly stem the outbreak. We describe the first implementation of the cluster grid response strategy carried out in the community during the cholera outbreak in Kinshasa, in which response activities targeted cholera case clusters using a grid approach. Interventions focused on emergency water supply, household water treatment and safe storage, home disinfection and hygiene promotion. We also performed a preliminary community trial study to assess the temporal pattern of the outbreak before and after response interventions were implemented. Cholera surveillance databases from the Ministry of Health were analyzed to assess the spatiotemporal dynamics of the outbreak using epidemic curves and maps. From January 2017 to November 2018, a total of 1712 suspected cholera cases were reported in Kinshasa. During this period, the most affected health zones included Binza Météo, Limeté, Kokolo, Kintambo and Kingabwa. Following implementation of the response strategy, the weekly cholera case numbers in Binza Météo, Kintambo and Limeté decreased by an average of 57% after 2 weeks and 86% after 4 weeks. The total weekly case numbers throughout Kinshasa Province dropped by 71% 4 weeks after the peak of the outbreak. During the 2017–2018 period, Kinshasa experienced a sharp increase in cholera case numbers. To contain the outbreak, water supply and hygiene response interventions targeted case households, nearby neighbors and public areas in case clusters using a grid approach. Following implementation of the response, the outbreak in Kinshasa was quickly brought under control. A similar approach may be adapted to quickly interrupt cholera transmission in other urban settings.

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在刚果民主共和国金沙萨2017-2018年霍乱爆发期间实施的目标供水和卫生应对策略的说明。

在人口稠密的城市地区，霍乱暴发的快速控制是一项重大挑战。在2017年末，刚果民主共和国的首都金夏沙经历了霍乱爆发，显示出有可能在整个城市蔓延。实施了针对性的新型水和卫生应对策略，以迅速阻止疫情爆发。我们描述了在金沙萨霍乱暴发期间在社区中实施的集群网格应对策略的首次实施，其中响应活动使用网格方法针对霍乱病例集群。干预措施的重点是紧急供水，家庭水处理和安全储存，家庭消毒和卫生促进。我们还进行了初步的社区试验研究，以评估实施应对干预措施之前和之后爆发的时间模式。分析了卫生部的霍乱监测数据库，使用流行曲线和地图评估了疫情的时空动态。从2017年1月到2018年11月，金沙萨总共报告了1712例霍乱疑似病例。在此期间，受影响最严重的卫生区包括BinzaMétéo，Limeté，Kokolo，Kintambo和Kingabwa。实施应对策略后，宾萨梅托，金特博和利梅特的每周霍乱病例数在2周后平均下降了57％，在4周后平均下降了86％。疫情爆发后的第四个星期，金沙萨省每周的总病例数下降了71％。在2017-2018年期间，金夏沙霍乱病例数急剧增加。为了控制疫情，供水和卫生应对干预措施使用网格方法针对案例群中的案例家庭，附近的邻居和公共区域。响应措施实施后，金沙萨的爆发很快得到控制。可以采用类似的方法来快速中断其他城市环境中的霍乱传播。