World Health Organization, Port Moresby, Papua New Guinea.
BMC Infect Dis. 2012 Nov 5;12:287. doi: 10.1186/1471-2334-12-287.
Cholera is newly emergent in Papua New Guinea but may soon become endemic. Identifying the risk factors for cholera provides evidence for targeted prevention and control measures.
We conducted a hospital-based case-control study to identify cholera risk factors. Using stool culture as the standard, we evaluated a cholera point of care test in the field.
176 participants were recruited: 54 cases and 122 controls. Independent risk factors for cholera were: being over 20 years of age (aOR 2.5; 95%CI 1.1, 5.4), defecating in the open air (or river) (aOR 4.5; 95% CI 1.4, 14.4) and knowing someone who travelled to a cholera affected area (aOR 4.1; 95%CI 1.6, 10.7); while the availability of soap for handwashing at home was protective (aOR 0.41; 95%CI 0.19, 0.87). Those reporting access to a piped water distribution system in the home were twice as likely to report the availability of soap for handwashing. The sensitivity and specificity of the rapid test were 72% (95% CI 47-90) and 71% (95%CI 44-90%).
Improving population access to the piped water distribution system and sanitation will likely reduce transmission by enabling enhanced hygiene and limiting the contamination of water sources. The One step V. cholerae O1/O139 Antigen Test is of limited utility for clinical decision making in a hospital setting with access to traditional laboratory methods. Settlement dwellers and mobile populations of all age groups should be targeted for interventions in Papua New Guinea.
霍乱在巴布亚新几内亚新出现，但可能很快成为地方病。确定霍乱的危险因素为有针对性地预防和控制措施提供了依据。
我们进行了一项基于医院的病例对照研究，以确定霍乱的危险因素。我们使用粪便培养作为标准，评估了现场的霍乱即时检测。
共招募了 176 名参与者：54 例病例和 122 例对照。霍乱的独立危险因素为：年龄超过 20 岁（OR2.5；95%CI1.1,5.4）、在露天或河流中排便（OR4.5；95%CI1.4,14.4）和认识有去过霍乱疫区的人（OR4.1；95%CI1.6,10.7）；而家中有肥皂用于洗手则具有保护作用（OR0.41；95%CI0.19,0.87）。那些报告家中有管道供水分配系统的人，报告有肥皂用于洗手的可能性是其两倍。快速检测的灵敏度和特异性分别为 72%（95%CI47-90）和 71%（95%CI44-90）。
改善人口获得管道供水分配系统和卫生设施的机会将可能通过增强卫生和限制水源污染来减少传播。在有传统实验室方法的医院环境中，一步法 V. cholerae O1/O139 抗原检测对于临床决策的用途有限。定居居民和各年龄段的流动人口应成为巴布亚新几内亚干预的目标。
