Community-operated treatment centres prevented many cholera deaths

Abstract

In December 1979,,a community-operated Diarrhoea Treatment Centre was set up at Shataki, Matlab Thana, a rural area of Bangladesh. Over time, the Centre demonstrated that a community-operated centre could effectively handle the endemic patient load. Following the Shataki model, another community-operated centre was opened at Kaltrbazar, Matlab Thana, in June 1982^ In October 1982, a cholera outbreak was identified in Matlab and neighboring thanas (districts.) With the onset of the epidemic, the catchment areas of the centres expanded, and between October and December about 2,000 patients were treated by these two centres Despite increased severity and case loads, case fatality rates during the pre-epidemic and epidemic periods were almost equal. It was estimated that during the 1 982 cholera epidemic, the two community-operated centres averted approximately 820-1,000 deaths. With the current state of knowledge, in the absence of primary prevention, establishment of community-operated treatment centres with provisions for intravenous fluids is highly effective in reducing mortality from cholera and other acute diarrhoeal diseases.