{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,1]],"date-time":"2026-11-01T03:08:42Z","timestamp":1793502522371,"version":"4.5.0"},"reference-count":58,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2020,1,28]],"date-time":"2020-01-28T00:00:00Z","timestamp":1580169600000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1148763"],"award-info":[{"award-number":["OPP1148763"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"name":"European Commission's Humanitarian Aid Office"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Glob Health"],"accepted":{"date-parts":[[2020,1,13]]},"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>In August 2017, a cholera outbreak started in Muna Garage Internally Displaced Persons camp, Borno state, Nigeria and &gt;5000 cases occurred in six local government areas. This qualitative study evaluated perspectives about the emergency response to this outbreak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted 39 key informant interviews and focus group discussions, and reviewed 21 documents with participants involved with surveillance, water, sanitation, hygiene, case management, oral cholera vaccine (OCV), communications, logistics and coordination. Qualitative data analysis used thematic techniques comprising key words in context, word repetition and key sector terms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Authorities were alerted quickly, but outbreak declaration took 12 days due to a 10-day delay waiting for culture confirmation. Outbreak investigation revealed several potential transmission channels, but a leaking latrine around the index cases\u2019 house was not repaired for more than 7 days. Chlorine was initially not accepted by the community due to rumours that it would sterilise women. Key messages were in Hausa, although Kanuri was the primary local language; later this was corrected. Planning would have benefited using exercise drills to identify weaknesses, and inventory sharing to avoid stock outs. The response by the Rural Water Supply and Sanitation Agency was perceived to be slow and an increased risk from a religious festival was not recognised. Case management was provided at treatment centres, but some partners were concerned that their work was not recognised asking, \u2018Who gets the glory and the data?\u2019 Nearly one million people received OCV and its distribution benefited from a robust infrastructure for polio vaccination. There was initial anxiety, rumour and reluctance about OCV, attributed by many to lack of formative research prior to vaccine implementation. Coordination was slow initially, but improved with activation of an emergency operations centre (EOC) that enabled implementation of incident management system to coordinate multisectoral activities and meetings held at 16:00 hours daily. The synergy between partners and government improved when each recognised the government\u2019s leadership role.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite a timely alert of the outbreak, delayed laboratory confirmation slowed initial response. Initial responses to the outbreak were not well coordinated but improved with the EOC. Understanding behaviours and community norms through rapid formative research should improve the effectiveness of the emergency response to a cholera outbreak. OCV distribution was efficient and benefited from the polio vaccine infrastructure.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjgh-2019-002000","type":"journal-article","created":{"date-parts":[[2020,1,29]],"date-time":"2020-01-29T05:29:22Z","timestamp":1580275762000},"page":"e002000","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["The multi-sectorial emergency response to a cholera outbreak in Internally Displaced Persons camps in Borno State, Nigeria, 2017"],"prefix":"10.1136","volume":"5","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1359-6267","authenticated-orcid":false,"given":"Moise Chi","family":"Ngwa","sequence":"first","affiliation":[{"name":"International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alemu","family":"Wondimagegnehu","sequence":"additional","affiliation":[{"name":"World Health Organisation, Nigeria Country Office, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ifeanyi","family":"Okudo","sequence":"additional","affiliation":[{"name":"World Health Organisation, Nigeria Country Office, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8001-6878","authenticated-orcid":false,"given":"Collins","family":"Owili","sequence":"additional","affiliation":[{"name":"World Health Organisation, Nigeria Country Office, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uzoma","family":"Ugochukwu","sequence":"additional","affiliation":[{"name":"World Health Organisation, Nigeria Country Office, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Clement","sequence":"additional","affiliation":[{"name":"World Health Organisation, Nigeria Country Office, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Devaux","sequence":"additional","affiliation":[{"name":"World Health Organization, Maiduguri, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Pezzoli","sequence":"additional","affiliation":[{"name":"World Health Organization, Geneve, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chikwe","family":"Ihekweazu","sequence":"additional","affiliation":[{"name":"Nigeria Centre for Disease Control, Abuja, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammed Abba","family":"Jimme","sequence":"additional","affiliation":[{"name":"Geography, University of Maiduguri Faculty of Social Science, Maiduguri, Nigeria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8569-5507","authenticated-orcid":false,"given":"Peter","family":"Winch","sequence":"additional","affiliation":[{"name":"International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9338-5119","authenticated-orcid":false,"given":"David A","family":"Sack","sequence":"additional","affiliation":[{"name":"International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, Maryland, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,1,28]]},"reference":[{"key":"2025073013434678000_5.1.e002000.1","doi-asserted-by":"crossref","unstructured":"Ali M , Nelson AR , Lopez AL , et al . 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