Uganda Public Health Fellowship Program - Field Epidemiology Track, Kampala, Uganda.
Ministry of Health Uganda, Kampala, Uganda.
PLoS One. 2018 Jun 27;13(6):e0198431. doi: 10.1371/journal.pone.0198431. eCollection 2018.
On 20 June 2015, a cholera outbreak affecting more than 30 people was reported in a fishing village, Katwe, in Kasese District, south-western Uganda. We investigated this outbreak to identify the mode of transmission and to recommend control measures. We defined a suspected case as onset of acute watery diarrhoea between 1 June and 15 July 2015 in a resident of Katwe village; a confirmed case was a suspected case with Vibrio cholerae cultured from stool. For case finding, we reviewed medical records and actively searched for cases in the community. In a case-control investigation we compared exposure histories of 32 suspected case-persons and 128 age-matched controls. We also conducted an environmental assessment on how the exposures had occurred. We found 61 suspected cases (attack rate = 4.9/1000) during this outbreak, of which eight were confirmed. The primary case-person had onset on 16 June; afterwards cases sharply increased, peaked on 19 June, and rapidly declined afterwards. After 22 June, eight scattered cases occurred. The case-control investigation showed that 97% (31/32) of cases and 62% (79/128) of controls usually collected water from inside a water-collection site "X" (ORM-H = 16; 95% CI = 2.4-107). The primary case-person who developed symptoms while fishing, reportedly came ashore in the early morning hours on 17 June, and defecated "near" water-collection site X. We concluded that this cholera outbreak was caused by drinking lake water collected from inside the lakeshore water-collection site X. At our recommendations, the village administration provided water chlorination tablets to the villagers, issued water boiling advisory to the villagers, rigorously disinfected all patients' faeces and, three weeks later, fixed the tap-water system.
2015 年 6 月 20 日，乌干达西南部卡塞塞区卡特韦村发生一起霍乱疫情，超过 30 人受到影响。我们对此次疫情进行了调查，以确定传播模式并提出控制措施。我们将疑似病例定义为 2015 年 6 月 1 日至 7 月 15 日期间在卡特韦村居住的出现急性水样腹泻的人；确诊病例是从粪便中培养出霍乱弧菌的疑似病例。为发现病例，我们查阅了医疗记录并在社区中主动搜索病例。在病例对照调查中，我们比较了 32 名疑似病例和 128 名年龄匹配对照者的暴露史。我们还对暴露是如何发生的进行了环境评估。此次疫情共发现 61 例疑似病例（发病率=4.9/1000），其中 8 例为确诊病例。首例病例于 6 月 16 日发病；之后病例急剧增加，于 6 月 19 日达到高峰，随后迅速减少。6 月 22 日后，又出现了 8 例散发病例。病例对照调查显示，97%（31/32）的病例和 62%（79/128）的对照者通常从一个名为“X”的集水点（OR=16；95%CI=2.4-107）收集水。首例发病前在湖中捕鱼，据报告于 6 月 17 日清晨上岸，在集水点“X”附近排便。我们的结论是，此次霍乱疫情是由饮用从湖边集水点“X”采集的湖水引起的。根据我们的建议，村行政当局向村民发放了氯片剂，向村民发布了饮水煮沸建议，对所有患者的粪便进行了严格消毒，三周后修复了自来水系统。
