Diarrheal disease is a major health problem especially in emergency situations and refugee camps. It is an important cause of morbidity and mortality in the developing world. Of infectious causes of death in children, it is the second highest in the world after acute respiratory infection, causing an estimated 1.87 million deaths in children under 5.  The morbidity and mortality associated with diarrhea for adults is not well documented, but unsafe water, sanitation and hygiene, which are the main risk factors for diarrhea, cause an estimated 54,158 disability adjusted life years (DALY).

Experiences like the Goma health disaster in 1994 show that there is a strong demand for training on how to handle Cholera or Shigellosis outbreaks, especially in emergency situations. Experts from ICDDR,B in Dhaka, Bangladesh, created in cooperation with the Swiss Tropical Institute the COTS program to bring together more than 30 years of expertise to provide a „to the point“ guideline as an effective means of preventing failures like those in Goma.

The goal is to transfer the basic tools required to conquer emergency situations in the future. The program is distributed on CD-ROM as it is based on evidence based medicine and consists of basic knowledge which is not very much evolving. A CD-ROM can be used without internet access or to prepare somewhere on the way to an outbreak.
 
The learning program consists of 3 major parts. A knowledge base provides an overview of the basic science, clinical management and public health related to cholera and shigellosis. Second part is a virtual hospital which can be explored to learn how to run a diarrheal disease outbreak hospital, including sections, staff and skills. Third part is the virtual classroom providing exercises and case studies. The learning program comes in a package with the CD-ROM itself and printed cards containing job descriptions and fact sheets of the most important issues. Tests for self-assessment complete each chapter of the learning program.

The COTS program was funded by the Office of U.S. Foreign Disaster Assistance (OFDA), a division within USAID responsible for facilitating and coordinating U.S. Government emergency assistance overseas. A first version will be ready in summer 2008. The date of publication will be announced on the webpage of the Swiss Tropical Institute (www.sti.ch) where it also can be ordered as soon as it is available.

Dr. Joachim Pelikan

 

back to mainpage

 

the pictures below show screenshots from the different parts of the program (click to enlarge)