6.2 Cholera treatment units (CTU)

Like CTCs, CTUs are designed to treat both simple cases of cholera (oral treatment) and severe cases (IV treatment) and function 24 hours a day.

CTUs are, however, much smaller than CTCs. The capacity of a CTU varies according to the context and needs. In certain situations, a CTU may have only 2 beds, but a CTU can have 10 and up to 30 beds [1] Citation 1. UNICEF Cholera Toolkit, 2013.
https://www.unicef.org/cholera/Cholera-Toolkit-2013.pdf [2] Citation 2. Haiti cholera training manual: a full course for healthcare providers. Ministry of Health and Population in Haiti/ U.S. Centers for Disease Control and Prevention. January 2011.
https://www.cdc.gov/cholera/pdf/haiticholera_trainingmanual_en.pdf .

A CTU is a simpler facility than a CTC in terms of installations.

6.2.1 Choice of site and premises

The criteria for choosing a site are the same as for a CTC (Section 6.1.1).

6.2.2 Area required

A bedridden patient requires about 4 m² and a seated patient about 2 m².

6.2.3 Layout and equipment

The main layout principles (isolation, entry/exit restrictions, and separation of “clean” and “contaminated” zones) are the same as for a CTC (Section 6.1) but, because of the fewer number of patients treated:

1) The facility is simpler than a CTC:

• Different patients (oral or IV treatment, adults or children, etc.) can be installed in the same space, whereas they would be in separate areas in a CTC. The sectorisation principle is however the same as in a CTC, e.g. children are preferably grouped together in the same area of the room or tent to facilitate surveillance.
• Infrastructures such as the kitchen or laundry can be reduced to a minimum, for example:
  • The CTU provides dry rations or a space for attendants to cook for patients and attendants, or families may bring meals every day for patients depending on the context.
  • The CTU provides a washing area equipped with a water point and the attendants wash the laundry or dishes.
• Besides these minimum provisions, the CTU must have its own latrines, showers, waste area and morgue.

2) The equipment is adapted to needs, for example:

• The storage of potable water can consist in a small water bladder (2000 litres) or 120 litres containers.
• For lighting, a small generator can be used (800 VA - 3.3 KVA) or solar or kerosene lamps and medical staff can be provided with headlamps.

6.2.4 Signage

• Near the entrance to the CTU

If the CTU is within the grounds of a hospital, post signs giving directions to the CTU so as to avoid cholera patients entering other services.

• Inside the CTU
  • Put up signs indicating the zone forbidden to patients.
  • Label contents of containers: ORS, potable water, 0.05% chlorine solution for hand-washing.
  • Put up signs indicating men’s/women’s showers and latrines
  • Put up a No Entry sign to the excreta pit (it must not be used by patients).
  • Put up signs indicating the laundry or dish washing area, if applicable.