Cholera outbreak preparedness in public sector hospitals from Lahore, Pakistan: a cross-sectional assessment
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Abstract
Objective: To assess the level of preparedness for cholera outbreaks in public sector hospitals of Lahore and to evaluate the knowledge of designated cholera focal persons at these facilities.
Methods: This cross-sectional study was conducted in July 2023 in 12 public sector hospitals of Lahore, Pakistan, designated as cholera treatment centers. Hospital preparedness was assessed using a structured proforma based on the WHO Global Strategic Preparedness, Readiness and Response Plan for Cholera, limited to hospital-level domains. Five domains were evaluated: Infection Prevention and Control (IPC) & Water, Sanitation and Hygiene (WaSH); healthcare professionals’ appointment and training; clinical management; testing facilities; and data management and reporting. Each indicator was scored as fulfilled or not fulfilled, and pooled domain scores were calculated. A knowledge survey was conducted among 15 nominated cholera focal persons (5 doctors, 10 senior nurses). Descriptive analysis was performed using Epi Info™ version 7.2.6.
Results: The highest preparedness scores were observed in clinical management (95.8%) and data management and reporting (91.6%). IPC and WaSH (85.4%) and healthcare professionals’ appointment and training (81.3%) demonstrated moderate preparedness. Testing facility domain showed the poorest performance (45.8%), as only one-third of hospitals had on-site laboratory capacity for cholera testing. Knowledge related to clinical management was satisfactory among focal persons; however, deficiencies were noted in epidemiological understanding, outbreak definition and asymptomatic carriage.
Conclusion: While public sector hospitals in Lahore show reasonable preparedness in clinical management and surveillance for cholera outbreaks, gaps in laboratory diagnostic capacity and targeted training of focal persons require urgent attention.
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