Pathology and Laboratory Medicine

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Cholera Outbreak Investigation in Four Districts of Kirkos Sub-city in Addis Ababa, Ethiopia: A Case-Control Study

Received: Dec. 02, 2019    Accepted: Dec. 17, 2019    Published: Apr. 23, 2020
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Abstract

Cholera is becoming a big problem in the world especially in African region including Ethiopia. The disease is very common in areas where there is inequity and lack of social development. The diseases affected the whole districts of the kirkos-sub-city, Addis Ababa. Hence, we are enforced to assess risk factors associated with cholera. Unmatched 1:2 case-control study on 50 confirmed cases and 100 controls was conducted from June 09, 2016 to September 2016. Data were collected through direct interviews using semi-structured and pre-tested questionnaires. Two data collectors and one supervisor were involved in data collection. Cases were selected from cholera treatment center line list and controls were selected from neighborhood of case using lottery method. Data were entered by Epi Info and analyzed using SPSS version 21 software. Logistic regression was used to compute the crude and adjusted odds ratios for the factors associated with acquiring the AWD. A p-value of < 0.05 at 95%CI was considered to be statistically significant. The median and mode age in the study groups was 35.5 and 60 years old respectively with interquartile range from 28 to 54.25 years. The highest peak period for the outbreak was on July 4, 2016. Eating partially roasted meat [AOR=4.14, CI=1.11-15.46] and being male [AOR=8.57, CI=2.21-33.25] had significantly associated with the risk factors of accruing cholera. Whereas, regular hand washing with soap after defecation [AOR=0.23, CI=0.06-0.91], treating water before drinking by aqua tabs [AOR=0.08, CI=0.01-0.95] and boiling [AOR=0.23, CI=0.06-0.95] disposing house hold refuse at municipal site [AOR=0.11, CI=0.02-0.69] were protective against cholera. Eating partially roasted meat, regular hand washing with soap after defecation, disposing house hold refuse at municipal site, treating water before drinking by aqua tabs and boiling were possible risk factors associated with the outbreak. Hence, water, sanitation and hygiene offices should strictly work on the hygiene and availability of safe water at all levels.

DOI 10.11648/j.plm.20200401.12
Published in Pathology and Laboratory Medicine ( Volume 4, Issue 1, June 2020 )
Page(s) 7-14
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This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Cholera, Outbreak, Risk Factors, Kirkos Sub-city, Addis Ababa, Ethiopia

References
[1] Ali M, Nelson AR, Lopez AL, Sack DA. Updated global burden of cholera in endemic countries. PLoS Negl Trop Dis. 2015; 9.
[2] Kirigia JM, Sambo LG, Yokouide A, Soumbey-Alley E, Muthuri LK, Kirigia DG. Economic burden of cholera in the WHO African region. BMC Int Health Hum Rights. 2009; 9.
[3] Assembly WH, Est S-, Tl L. Weekly epidemiological record Cholera, 2010. Relev ??pid??miologique Hebd / Sect d’hygi??ne du Secr??tariat la Soci??t?? des Nations=Wkly Epidemiol Rec / Heal Sect Secr Leag Nations. 2011; 86 (31): 325–39.
[4] Garcia E, Yactayo S, Nishino K, Millot V, Perea W, Briand S, et al. Weekly epidemiological record Relevé épidémiologique hebdomadaire. 2016; (7): 73–88.
[5] Scrascia M, Pugliese N, Maimone F, Mohamud KA, Ali IA, Grimont PAD, et al. Cholera in Ethiopia in the 1990s: Epidemiologic patterns, clonal analysis, and antimicrobial resistance. Int J Med Microbiol [Internet]. 2009; 299 (5): 367–72. Available from: http://dx.doi.org/10.1016/j.ijmm.2008.10.004.
[6] Ethiopian Federal Ministry of Health. Annual Performance Report of HSDPIII. 2007; 1999 (October).
[7] 7Zifan A. Köppen climate classification. World Köppen Classif. 2016.
[8] Dunkle SE, Mba-Jonas A, Loharikar A, Fouché B, Peck M, Ayers T, et al. Epidemic cholera in a crowded urban environment, Port-au-prince, Haiti. Emerg Infect Dis. 2011; 17 (11): 2143–6.
[9] Ethiopian Health and Nutrition Reaserch Institute E. Guideline on CHOLERA OUTBREAK MANAGEMENT Ethiopia Ethiopian Health and Nutrition Research Institute Federal Democratic Republic of Ethiopia. 2011; Available from: https://www.ephi.gov.et/images/guidelines/national-cholera-guideline.pdf.
[10] Beyene BB, Tumato M, Abera B, Maskai O, Luce R. Epidemiology of Acute Watery Diarrhea Outbreak and Challenges of Control — Afar, Ethiopia, 2009. 2014; 1 (10): 162–9.
[11] Carrier, John W. Cholera Outbreak. Assessing the outbreak response and improving prepardness. Br J Sociol. 2004; 28 (4): 520.
[12] Ohene S, Klenyuie W, Sarpeh M. Assessment of the response to cholera outbreaks in two districts in Ghana. Infect Dis Poverty. 2016; 1–11.
[13] Dalhat MM, Isa AN, Nguku P, Nasir SG, Urban K, Abdulaziz M, et al. Descriptive characterization of the 2010 cholera outbreak in Nigeria. BMC Public Health. 2014; 14 (1): 1–7.
[14] Ujjiga TTA, Wamala JF, Mogga JJH, Othwonh TO, Mutonga D, Kone-Coulibaly A, et al. Risk factors for sustained cholera transmission, Juba County, South Sudan, 2014. Emerg Infect Dis. 2015; 21 (10): 1849–52.
[15] Mridha P, Biswas AK, Ramakrishnan R, Murhekar M V. The 2010 outbreak of cholera among workers of a Jute Mill in Kolkata, West Bengal, India. J Heal Popul Nutr. 2011; 29 (1): 9–13.
[16] Nsagha DS, Atashili J, Fon PN, Tanue EA, Ayima CW, Kibu OD. Assessing the risk factors of cholera epidemic in the Buea Health District of Cameroon. BMC Public Health [Internet]. 2015; 15 (1): 1–7. Available from: http://dx.doi.org/10.1186/s12889-015-2485-8.
[17] Maponga BA, Chirundu D, Gombe NT, Tshimanga M, Shambira G, Takundwa L. Risk factors for contracting watery diarrhoea in Kadoma City, Zimbabwe, 2011: A case control study. BMC Infect Dis. 2013; 13 (1): 1–8.
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  • APA Style

    Tamiru Tadesse, Belay Zawdie. (2020). Cholera Outbreak Investigation in Four Districts of Kirkos Sub-city in Addis Ababa, Ethiopia: A Case-Control Study. Pathology and Laboratory Medicine, 4(1), 7-14. https://doi.org/10.11648/j.plm.20200401.12

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    ACS Style

    Tamiru Tadesse; Belay Zawdie. Cholera Outbreak Investigation in Four Districts of Kirkos Sub-city in Addis Ababa, Ethiopia: A Case-Control Study. Pathol. Lab. Med. 2020, 4(1), 7-14. doi: 10.11648/j.plm.20200401.12

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    AMA Style

    Tamiru Tadesse, Belay Zawdie. Cholera Outbreak Investigation in Four Districts of Kirkos Sub-city in Addis Ababa, Ethiopia: A Case-Control Study. Pathol Lab Med. 2020;4(1):7-14. doi: 10.11648/j.plm.20200401.12

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  • @article{10.11648/j.plm.20200401.12,
      author = {Tamiru Tadesse and Belay Zawdie},
      title = {Cholera Outbreak Investigation in Four Districts of Kirkos Sub-city in Addis Ababa, Ethiopia: A Case-Control Study},
      journal = {Pathology and Laboratory Medicine},
      volume = {4},
      number = {1},
      pages = {7-14},
      doi = {10.11648/j.plm.20200401.12},
      url = {https://doi.org/10.11648/j.plm.20200401.12},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.plm.20200401.12},
      abstract = {Cholera is becoming a big problem in the world especially in African region including Ethiopia. The disease is very common in areas where there is inequity and lack of social development. The diseases affected the whole districts of the kirkos-sub-city, Addis Ababa. Hence, we are enforced to assess risk factors associated with cholera. Unmatched 1:2 case-control study on 50 confirmed cases and 100 controls was conducted from June 09, 2016 to September 2016. Data were collected through direct interviews using semi-structured and pre-tested questionnaires. Two data collectors and one supervisor were involved in data collection. Cases were selected from cholera treatment center line list and controls were selected from neighborhood of case using lottery method. Data were entered by Epi Info and analyzed using SPSS version 21 software. Logistic regression was used to compute the crude and adjusted odds ratios for the factors associated with acquiring the AWD. A p-value of < 0.05 at 95%CI was considered to be statistically significant. The median and mode age in the study groups was 35.5 and 60 years old respectively with interquartile range from 28 to 54.25 years. The highest peak period for the outbreak was on July 4, 2016. Eating partially roasted meat [AOR=4.14, CI=1.11-15.46] and being male [AOR=8.57, CI=2.21-33.25] had significantly associated with the risk factors of accruing cholera. Whereas, regular hand washing with soap after defecation [AOR=0.23, CI=0.06-0.91], treating water before drinking by aqua tabs [AOR=0.08, CI=0.01-0.95] and boiling [AOR=0.23, CI=0.06-0.95] disposing house hold refuse at municipal site [AOR=0.11, CI=0.02-0.69] were protective against cholera. Eating partially roasted meat, regular hand washing with soap after defecation, disposing house hold refuse at municipal site, treating water before drinking by aqua tabs and boiling were possible risk factors associated with the outbreak. Hence, water, sanitation and hygiene offices should strictly work on the hygiene and availability of safe water at all levels.},
     year = {2020}
    }
    

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  • TY  - JOUR
    T1  - Cholera Outbreak Investigation in Four Districts of Kirkos Sub-city in Addis Ababa, Ethiopia: A Case-Control Study
    AU  - Tamiru Tadesse
    AU  - Belay Zawdie
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    DO  - 10.11648/j.plm.20200401.12
    T2  - Pathology and Laboratory Medicine
    JF  - Pathology and Laboratory Medicine
    JO  - Pathology and Laboratory Medicine
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    PB  - Science Publishing Group
    SN  - 2640-4478
    UR  - https://doi.org/10.11648/j.plm.20200401.12
    AB  - Cholera is becoming a big problem in the world especially in African region including Ethiopia. The disease is very common in areas where there is inequity and lack of social development. The diseases affected the whole districts of the kirkos-sub-city, Addis Ababa. Hence, we are enforced to assess risk factors associated with cholera. Unmatched 1:2 case-control study on 50 confirmed cases and 100 controls was conducted from June 09, 2016 to September 2016. Data were collected through direct interviews using semi-structured and pre-tested questionnaires. Two data collectors and one supervisor were involved in data collection. Cases were selected from cholera treatment center line list and controls were selected from neighborhood of case using lottery method. Data were entered by Epi Info and analyzed using SPSS version 21 software. Logistic regression was used to compute the crude and adjusted odds ratios for the factors associated with acquiring the AWD. A p-value of < 0.05 at 95%CI was considered to be statistically significant. The median and mode age in the study groups was 35.5 and 60 years old respectively with interquartile range from 28 to 54.25 years. The highest peak period for the outbreak was on July 4, 2016. Eating partially roasted meat [AOR=4.14, CI=1.11-15.46] and being male [AOR=8.57, CI=2.21-33.25] had significantly associated with the risk factors of accruing cholera. Whereas, regular hand washing with soap after defecation [AOR=0.23, CI=0.06-0.91], treating water before drinking by aqua tabs [AOR=0.08, CI=0.01-0.95] and boiling [AOR=0.23, CI=0.06-0.95] disposing house hold refuse at municipal site [AOR=0.11, CI=0.02-0.69] were protective against cholera. Eating partially roasted meat, regular hand washing with soap after defecation, disposing house hold refuse at municipal site, treating water before drinking by aqua tabs and boiling were possible risk factors associated with the outbreak. Hence, water, sanitation and hygiene offices should strictly work on the hygiene and availability of safe water at all levels.
    VL  - 4
    IS  - 1
    ER  - 

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Author Information
  • Travel and Border Health Service Directorate, Ethiopian Public Health Institute, Addis Ababa, Ethiopia

  • School of Biomedical Sciences, Jimma University, Jimma, Ethiopia

  • Section