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Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone

BACKGROUND AND OBJECTIVES: In 2012, Sierra Leone suffered a nationwide cholera epidemic which affected the capital Freetown and also the provinces. This study aims to describe the characteristics and clinical management of patients admitted to cholera isolation wards of the main referral hospital in...

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Autores principales: Blacklock, Alexander, Sesay, Andrew, Kamara, Abdul, Kamara, Mamud, Blacklock, Claire
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Co-Action Publishing 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286577/
https://www.ncbi.nlm.nih.gov/pubmed/25566807
http://dx.doi.org/10.3402/gha.v8.25266
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author Blacklock, Alexander
Sesay, Andrew
Kamara, Abdul
Kamara, Mamud
Blacklock, Claire
author_facet Blacklock, Alexander
Sesay, Andrew
Kamara, Abdul
Kamara, Mamud
Blacklock, Claire
author_sort Blacklock, Alexander
collection PubMed
description BACKGROUND AND OBJECTIVES: In 2012, Sierra Leone suffered a nationwide cholera epidemic which affected the capital Freetown and also the provinces. This study aims to describe the characteristics and clinical management of patients admitted to cholera isolation wards of the main referral hospital in the Northern Province and compare management with standard guidelines. DESIGN: All available clinical records of patients from the cholera isolation wards were reviewed retrospectively. There was no active case finding. The following data were collected from the clinical records after patients had left the ward: date of admission, demographics, symptoms, dehydration status, diagnoses, tests and treatments given, length of stay, and outcomes. RESULTS: A total of 798 patients were admitted, of whom 443 (55.5%) were female. There were 18 deaths (2.3%). Assessment of dehydration status was recorded in 517 (64.8%) of clinical records. An alternative or additional diagnosis was made for 214 patients (26.8%). Intravenous (IV) fluids were prescribed to 767 patients (96.1%), including 95% of 141 patients who had documentation of being not severely dehydrated. A history of vomiting was documented in 92.1% of all patients. Oral rehydration solution (ORS) was given to 629 (78.8%) patients. Doxycycline was given to 380 (47.6%) patients, erythromycin to 34 (4.3%), and other antibiotics were used on 247 occasions. Zinc was given to 209 (26.2%). DISCUSSION: This retrospective study highlights the need for efforts to improve the quality of triage, adherence to clinical guidance, and record keeping. CONCLUSIONS: Data collection and analysis of clinical practices during an epidemic situation would enable faster identification of those areas requiring intervention and improvement.
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spelling pubmed-42865772015-01-26 Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone Blacklock, Alexander Sesay, Andrew Kamara, Abdul Kamara, Mamud Blacklock, Claire Glob Health Action Original Article BACKGROUND AND OBJECTIVES: In 2012, Sierra Leone suffered a nationwide cholera epidemic which affected the capital Freetown and also the provinces. This study aims to describe the characteristics and clinical management of patients admitted to cholera isolation wards of the main referral hospital in the Northern Province and compare management with standard guidelines. DESIGN: All available clinical records of patients from the cholera isolation wards were reviewed retrospectively. There was no active case finding. The following data were collected from the clinical records after patients had left the ward: date of admission, demographics, symptoms, dehydration status, diagnoses, tests and treatments given, length of stay, and outcomes. RESULTS: A total of 798 patients were admitted, of whom 443 (55.5%) were female. There were 18 deaths (2.3%). Assessment of dehydration status was recorded in 517 (64.8%) of clinical records. An alternative or additional diagnosis was made for 214 patients (26.8%). Intravenous (IV) fluids were prescribed to 767 patients (96.1%), including 95% of 141 patients who had documentation of being not severely dehydrated. A history of vomiting was documented in 92.1% of all patients. Oral rehydration solution (ORS) was given to 629 (78.8%) patients. Doxycycline was given to 380 (47.6%) patients, erythromycin to 34 (4.3%), and other antibiotics were used on 247 occasions. Zinc was given to 209 (26.2%). DISCUSSION: This retrospective study highlights the need for efforts to improve the quality of triage, adherence to clinical guidance, and record keeping. CONCLUSIONS: Data collection and analysis of clinical practices during an epidemic situation would enable faster identification of those areas requiring intervention and improvement. Co-Action Publishing 2015-01-06 /pmc/articles/PMC4286577/ /pubmed/25566807 http://dx.doi.org/10.3402/gha.v8.25266 Text en © 2015 Alexander Blacklock et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Blacklock, Alexander
Sesay, Andrew
Kamara, Abdul
Kamara, Mamud
Blacklock, Claire
Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone
title Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone
title_full Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone
title_fullStr Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone
title_full_unstemmed Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone
title_short Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone
title_sort characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in sierra leone
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4286577/
https://www.ncbi.nlm.nih.gov/pubmed/25566807
http://dx.doi.org/10.3402/gha.v8.25266
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