WHO and partners support diphtheria treatment centres in Cox's Bazar
As part of its response to the diphtheria outbreak among Rohingya in Cox’s Bazar, Bangladesh, WHO is training local and international doctors, intensive care nurses and other healthcare professionals working in the camps.
“One of the main challenges is that diphtheria is an old infectious disease that many doctors have never seen,” said Dr Janet Victoria Diaz, Clinical Management Leader. “We’ve prioritized training health workers to ensure they know how to distinguish diphtheria from an ordinary sore throat and how to correctly administer diphtheria antitoxins.”
Online learning for clinical management staff of respiratory diphtheria in Cox’s Bazar, Bangladesh
WHO has supported the Rohingya crisis response in Cox’s Bazar through various public health interventions. At the core of this work was clinical management of diphtheria.
In December 2017, the WHO Health Emergencies Programme launched an online learning for clinical staff on respiratory diphtheria through the OpenWHO.org platform. The 4-hour course targets clinicians caring for patients during outbreaks in vulnerable settings, such as in Cox’s Bazar. It is also applicable to clinicians working in settings that share similar challenges.
What is clinical management?
Clinical Management is an essential pillar of WHO's interdisciplinary response to outbreaks of emerging and re-emerging infectious diseases. WHO's clinical management team provides rapid technical and operational guidance, clinical training, quality assurance and support for operational research to ensure the delivery of safe, high quality, and equitable care to those suffering from infectious diseases.
During outbreaks, WHO works under the Acute Emergency System and collaborates closely with partners and colleagues from disease-specific as well as cross-cutting programmes that support outbreak response.
During outbreaks, WHO develops timely and rapid operational guidance on case management that can be used and adapted immediately to the field, with simplified tools for triage, infection prevention and control and supportive management. Rapid guides are created using expert peer review process according to Guideline Review Committee (GRC) standards. After the outbreak, guidance is reviewed again and updated based on new evidence and experiences. WHO's aim is to provide evidence-based, high quality guidance that is also practical to the front-line clinicians who will be caring for the sick patients. During non-outbreak times, WHO selects key diseases and conducts more extensive grading and systematic reviews to make guideline recommendations.
During outbreaks, WHO deploys expert clinicians to lead the case management pillar of the outbreak response. This entails bridging the technical with the operational aspects of outbreak response, and ensuring staff, supplies and systems are in place to provide safe and good quality care of the patients. WHO works in close collaboration with its partners, the Emergency Medical Teams, the GOARN network and others.
WHO provides clinical training before, during and after outbreaks to prepare for a better response. The trainings use adult-learning methodology and various platforms, including online training using the openwho.org training platform, as well as face-to-face trainings. Impact is measured by numbers trained, quizzes, tests as well as satisfaction surveys.
WHO develops and supports operational research during outbreaks of infectious diseases and works closely with the R&D groups. WHO works in collaboration with many academic partners from our EDCARN and GOARN networks. A major focus of work over the past few years has been the development of clinical characterization protocols and case record forms to operationalize the standard collection of clinical data from patients affected in outbreaks of emerging or re-emerging infectious diseases.
The Emerging Diseases Clinical Assessment and Response Network (EDCARN) comprises collaborating centres and individuals from governmental and nongovernmental organizations, academia, WHO and other stakeholders aimed at sharing information and experience to enhance clinical care and scientific understanding of emerging infectious diseases (EIDs). EDCARN strengthens the essential link among front-line health workers, global clinical experts and researchers to provide technical expertise at the clinical interface of EIDs, contributing to the capacity of clinicians worldwide to detect and treat these diseases safely and effectively.