Assessing the preparedness of primary healthcare facilities during a cholera outbreak in Kinshasa, Democratic Republic of the Congo, 2018

Objective: During the 2017-2018 cholera outbreak in Kinshasa, many patients initially reported to primary healthcare centers (HCs) before being transferred to the nearest cholera treatment centers. This study aims to assess the level of preparedness of HCs in responding to cholera outbreaks.

Study design: Descriptive cross-sectional survey.

Methods: We conducted a descriptive cross-sectional survey in 180 of 374 primary HCs in Kinshasa. We collected data on 14 cholera preparedness criteria and described their prevalence among HCs. We used logistic regression to assess the association between each preparedness criteria and previous reporting of cholera cases by HCs.

Results: The median number of preparedness criteria met by HCs was 5 [range: 0-11]. Five percent (n = 9) of HCs [95% confidence interval (CI): 2.3%-9.3%] met at least 10 criteria. HCs that previously reported ≥3 cholera cases were less likely to meet the criteria for 'presence of an isolation unit' (adjusted odds ratio [aOR]: 0.12; 95% CI [0.03-0.61]) and 'availability of sufficient quantity of chlorine' (aOR: 0.13; 95% CI [0.02-0.64]).

Conclusions: Despite past experience of cholera cases, health facilities in Kinshasa exhibit a low level of cholera preparedness. There is a need to prioritize the reinforcement of the preparedness of primary HCs to prevent future cholera outbreaks.