Cholera and HIV

AROUND 1,6 million Zimbabweans are living with HIV. The country is currently bedevilled with cholera and people living with HIV (PLHIV), and their care givers need to protect themselves from contracting cholera. It is very important that those who are living with HIV keep themselves cholera-free as the effects of the disease can badly affect them due to a compromised immune system that some of them may have.

There are a lot of people who do not know their HIV status. These are at a higher risk of contracting cholera because they are likely to have a compromised immune system but do not know it.

Symptoms of cholera infection may

include:

Diarrhoea. Cholera-related diarrhoea comes on suddenly and may quickly cause dangerous fluid loss — as much as a quart (about 1 litre) an hour. Diarrhoea due to cholera often has a pale, milky appearance that resembles water in which rice has been rinsed (rice-water stool).

Nausea and vomiting. Occurring especially in the early stages of cholera, vomiting may persist for hours at a time.

Dehydration. Dehydration can develop within hours after the onset of cholera symptoms. Depending on how many body fluids have been lost, dehydration can range from mild to severe. A loss of 10 percent or more of total body weight indicates severe dehydration.

Signs and symptoms of cholera dehydration include irritability, lethargy, sunken eyes, a dry mouth, extreme thirst, dry and shrivelled skin that’s slow to bounce back when pinched into a fold, little or no urine output, low blood pressure, and an irregular heartbeat (arrhythmia).

Dehydration may lead to a rapid loss of minerals in your blood (electrolytes) that maintain the balance of fluids in your body. This is called an electrolyte imbalance.

An electrolyte imbalance can lead to serious signs and symptoms such as:

Muscle cramps. These result from the rapid loss of salts such as sodium, chloride and potassium.

Shock. This is one of the most serious complications of dehydration. It occurs when low blood volume causes a drop in blood pressure and a drop in the amount of oxygen in your body. If untreated, severe hypovolemic shock can cause death in a matter of minutes. Signs and symptoms of cholera in

children

In general, children with cholera have the same signs and symptoms adults do, but they are particularly susceptible to low blood sugar (hypoglycemia) due to fluid loss, which may cause:

An altered state of consciousness Seizures

Coma

The following are key in the management of cholera among people living with HIV:

If you are HIV positive and on ART and you are hospitalised due to cholera, you need

to continue with your medication.

Home Based Care (HBC) givers need to be particularly careful in terms hygiene. Hands should be thoroughly washed and the environment kept clean to protect both the caregiver and the person being cared for.

Ensure that you continue to get the correct nutrition during the period that you are being treated for cholera and after.

There is NO need to separate PLHIV from other patients in a ward, this only provokes stigma.

Should a care giver be hospitalised, he or she must be quickly replaced to safeguard the PLHIV.

Wash your hands with soap before and after handling food.