title: Characteristics and clinical management of patients admitted to cholera wards in a regional referral hospital during the 2012 epidemic in Sierra Leone.
abstract: OBJECTIVE
  In 2012, Sierra Leone suffered a nationwide cholera epidemic which affected the capital Freetown and also the provinces. This study aims to describe the characteristics and clinical management of patients admitted to cholera isolation wards of the main referral hospital in the Northern Province and compare management with standard guidelines.
  
  
  METHODS
  All available clinical records of patients from the cholera isolation wards were reviewed retrospectively. There was no active case finding. The following data were collected from the clinical records after patients had left the ward: date of admission, demographics, symptoms, dehydration status, diagnoses, tests and treatments given, length of stay, and outcomes.
  
  
  RESULTS
  A total of 798 patients were admitted, of whom 443 (55.5%) were female. There were 18 deaths (2.3%). Assessment of dehydration status was recorded in 517 (64.8%) of clinical records. An alternative or additional diagnosis was made for 214 patients (26.8%). Intravenous (IV) fluids were prescribed to 767 patients (96.1%), including 95% of 141 patients who had documentation of being not severely dehydrated. A history of vomiting was documented in 92.1% of all patients. Oral rehydration solution (ORS) was given to 629 (78.8%) patients. Doxycycline was given to 380 (47.6%) patients, erythromycin to 34 (4.3%), and other antibiotics were used on 247 occasions. Zinc was given to 209 (26.2%).
  
  
  CONCLUSIONS
  This retrospective study highlights the need for efforts to improve the quality of triage, adherence to clinical guidance, and record keeping.
  
  
  CONCLUSIONS
  Data collection and analysis of clinical practices during an epidemic situation would enable faster identification of those areas requiring intervention and improvement.
authors.affiliation: Makeni Government Hospital, Bombali District, Sierra Leone.
authors.forename: Alexander
authors.initials: A
authors.lastname: Blacklock
authors.affiliation: Makeni Government Hospital, Bombali District, Sierra Leone; Binkolo Peripheral Health Unit, Bombali District, Sierra Leone.
authors.forename: Andrew
authors.initials: A
authors.lastname: Sesay
authors.affiliation: Central Public Health Reference Laboratory, Ministry of Health and Sanitation, Freetown, Sierra Leone.
authors.forename: Abdul
authors.initials: A
authors.lastname: Kamara
authors.affiliation: Makeni Government Hospital, Bombali District, Sierra Leone.
authors.forename: Mamud
authors.initials: M
authors.lastname: Kamara
authors.affiliation: Makeni Government Hospital, Bombali District, Sierra Leone; Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom; claire.blacklock@phc.ox.ac.uk.
authors.forename: Claire
authors.initials: C
authors.lastname: Blacklock
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001639:Bicarbonates / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000150:complications* / Q000628:therapy*; D003681:Dehydration / Q000209:etiology* / Q000628:therapy*; D004196:Disease Outbreaks; D005260:Female; D005947:Glucose / Q000627:therapeutic use; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation; D011189:Potassium Chloride / Q000627:therapeutic use; D012189:Retrospective Studies; D012807:Sierra Leone / Q000453:epidemiology; D012959:Socioeconomic Factors; D012965:Sodium Chloride / Q000627:therapeutic use; D055815:Young Adult; D015032:Zinc / Q000627:therapeutic use
chemical_list: D000900:Anti-Bacterial Agents; D001639:Bicarbonates; C044142:World Health Organization oral rehydration solution; D012965:Sodium Chloride; D011189:Potassium Chloride; D005947:Glucose; D015032:Zinc
keywords: Sierra Leone; cholera; dehydration; epidemic; triage