TY - JOUR
T1 - Protracted cholera outbreak in the Central Region, Ghana, 2016
AU - Issahaku, Gyesi R.
AU - Asiedu-Bekoe, Franklin
AU - Kwashie, Samuel
AU - Broni, Francis
AU - Boateng, Paul
AU - Alomatu, Holy
AU - Houphouet, Ekua E.
AU - Asante, Afua A.
AU - Ameme, Donne K.
AU - Kenu, Ernest
N1 - Publisher Copyright:
© RCN Publishing Company Limited 2020.
PY - 2020/8
Y1 - 2020/8
N2 - Objective: On 24th October 2016, the Central Regional Health Directorate received report of a suspected cholera outbreak in the Cape Coast Metropolis (CCM). We investigated to confirm the diagnosis, identify risk factors and implement control measures. Design: We used a descriptive study followed by 1:2 unmatched case-control study. Data source: We reviewed medical records, conducted active case search and contact tracing, interviewed case-patients and their contacts and conducted environmental assessment. Case-patients' stool samples were tested with point of care test kits (SD Bioline Cholera Ag 01/0139) and sent to the Cape Coast Teaching Hospital Laboratory for confirmation. Main outcomes: Cause of outbreak, risk factors associated with spread of outbreak Results: Vibrio cholerae serotype Ogawa caused the outbreak. There was no mortality. Of 704 case-patients, 371(52.7%) were males and 55(7.8%) were aged under-five years. The median age was 23 years (interquartile range: 16-32 years). About a third 248(35.2%) of the case patients were aged 15-24 years. The University of Cape Coast subdistrict was the epicenter with 341(48.44%) cases. Compared to controls, cholera case-patients were more likely to have visited Cholera Treatment Centers (CTC) (aOR=12.1, 95%CI: 1.5-101.3), drank pipe-borne water (aOR=11.7, 95%CI: 3.3-41.8), or drank street-vended sachet water (aOR=11.0, 95%CI: 3.7-32.9). Open defecation and broken sewage pipes were observed in the epicenter. Conclusion: Vibrio cholerae serotype Ogawa caused the CCM cholera outbreak mostly affecting the youth. Visiting CTC was a major risk factor. Prompt case-management, contact tracing, health education, restricting access to CTC and implementing water sanitation and hygiene activities helped in the control.
AB - Objective: On 24th October 2016, the Central Regional Health Directorate received report of a suspected cholera outbreak in the Cape Coast Metropolis (CCM). We investigated to confirm the diagnosis, identify risk factors and implement control measures. Design: We used a descriptive study followed by 1:2 unmatched case-control study. Data source: We reviewed medical records, conducted active case search and contact tracing, interviewed case-patients and their contacts and conducted environmental assessment. Case-patients' stool samples were tested with point of care test kits (SD Bioline Cholera Ag 01/0139) and sent to the Cape Coast Teaching Hospital Laboratory for confirmation. Main outcomes: Cause of outbreak, risk factors associated with spread of outbreak Results: Vibrio cholerae serotype Ogawa caused the outbreak. There was no mortality. Of 704 case-patients, 371(52.7%) were males and 55(7.8%) were aged under-five years. The median age was 23 years (interquartile range: 16-32 years). About a third 248(35.2%) of the case patients were aged 15-24 years. The University of Cape Coast subdistrict was the epicenter with 341(48.44%) cases. Compared to controls, cholera case-patients were more likely to have visited Cholera Treatment Centers (CTC) (aOR=12.1, 95%CI: 1.5-101.3), drank pipe-borne water (aOR=11.7, 95%CI: 3.3-41.8), or drank street-vended sachet water (aOR=11.0, 95%CI: 3.7-32.9). Open defecation and broken sewage pipes were observed in the epicenter. Conclusion: Vibrio cholerae serotype Ogawa caused the CCM cholera outbreak mostly affecting the youth. Visiting CTC was a major risk factor. Prompt case-management, contact tracing, health education, restricting access to CTC and implementing water sanitation and hygiene activities helped in the control.
KW - Cape Coast Metropolis
KW - Cholera outbreak
KW - Cholera treatment center
KW - Vibrio cholerae serotype Ogawa
KW - Water sanitation and hygiene
UR - http://www.scopus.com/inward/record.url?scp=85094106968&partnerID=8YFLogxK
U2 - 10.4314/GMJ.V54I2S.8
DO - 10.4314/GMJ.V54I2S.8
M3 - Review article
C2 - 33536668
AN - SCOPUS:85094106968
SN - 0016-9560
VL - 54
SP - 45
EP - 52
JO - Ghana Medical Journal
JF - Ghana Medical Journal
IS - 2
ER -