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Formative Research for the Development of Evidence-Based Targeted Water, Sanitation, and Hygiene Interventions to Reduce Cholera in Hotspots in the Democratic Republic of the Congo

Preventative Intervention for Cholera for 7 Days (Picha7) Program

Bibliographic Data

ID15515641
AuthorsLucien Bisimwa (0000-0001-5570-5807, Johns Hopkins University), Camille Williams (0000-0001-9229-6280, Johns Hopkins University), Jean‐Claude Bisimwa (0009-0008-8906-7653, Johns Hopkins University), Presence Sanvura (0009-0007-8240-2562, Johns Hopkins University), Kelly Endres (0000-0003-3427-298X, Johns Hopkins University), Elizabeth Thomas (0000-0002-1616-681X), Elizabeth D Thomas (0000-0001-5728-6634, Johns Hopkins University), Jodi Perin (0000-0002-5482-6620, Johns Hopkins University), Cirhuza Cikomola (Université Catholique de Bukavu), Justin Bengehya (Ministry of Public Health), Ghislain Maheshe (0000-0003-2227-5999, Université Catholique de Bukavu), Alain Mwishingo (0000-0002-8743-4295, Johns Hopkins University), Christine Marie George (0000-0001-9219-0953, Johns Hopkins University, corresponding author)
Year2022
Volume19
Issue19
Pages12243-12243
Publication date2022-09-27
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph191912243
PMID36231546
OpenAlexW4297539410
LanguageEN
Citations received5
References cited17

Compared to the general public, household members of cholera patients are at a 100 times higher risk of contracting cholera during the 7-day high-risk period after a cholera patient has been admitted to a health facility for treatment. The Preventative-Intervention-for-Cholera-for-7-days (PICHA7) program aims to reduce household transmission of cholera during this 7-day high-risk period through a health facility-initiated water, sanitation, and hygiene (WASH) program promoting handwashing with soap, water treatment, and safe water storage. The PICHA7 program is delivered to cholera patient households through: (1) a pictorial flipbook delivered by a health promoter; (2) a cholera prevention package (handwashing station, drinking water vessel with lid and tap, and chlorine tablets); and (3) weekly WASH mobile messages sent to patient households in the Democratic Republic of the Congo (DRC). The objectives of this study were to conduct formative research to identify facilitators and barriers of the promoted WASH behaviors for cholera patient households and to tailor the PICHA7 program to target these facilitators and barriers. Formative research included 93 semi-structured interviews with diarrhea patient households and healthcare workers during exploratory research and a pilot study of 518 participants. Barriers to the promoted WASH behaviors identified during exploratory and pilot study interviews included: (1) low awareness of cholera transmission and prevention; (2) unaffordability of soap for handwashing; and (3) intermittent access to water limiting water for handwashing. For intervention development, narratives of the lived experiences of patient households in our study were presented by health promoters to describe cholera transmission and prevention, and soapy water and ash were promoted in the program flipbook and mobile messages to address the affordability of soap for handwashing. A jerry can was provided to allow for additional water storage, and a tap with a slower flow rate was attached to the handwashing station to reduce the amount of water required for handwashing. The pilot findings indicate that the PICHA7 program has high user acceptability and is feasible to deliver to cholera patients that present at health facilities for treatment in our study setting. Formative research allowed for tailoring this targeted WASH program for cholera patient households in the DRC

Cholera · Cholera vaccine · Environmental health · Hygiene · Psychological intervention · Public health · Sanitation · Vibrio cholerae · COVID-19 epidemiological studies · Medicine · Nursing · Vaccine Coverage and Hesitancy · Vibrio bacteria research studies

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Unique citing works5
Citations per year1,25
Citation span2022 - 2025 (4)
Citation velocityrecent
Highly citedNo
Citation typesNeutral: 5
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