School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia.
Front Public Health. 2022 May 6;10:845057. doi: 10.3389/fpubh.2022.845057. eCollection 2022.
Cholera remains a serious public health problem characterized by a large disease burden, frequent outbreaks, persistent endemicity, and high mortality, particularly in tropical and subtropical low-income countries including Ethiopia. The recent cholera outbreak in the Somali region began on 4 September to 1 November 2019. Cholera may spread rapidly through a population so that an early detection and reporting of the cases is mandatory. This study aimed to identify determinants of cholera infection among >5 years of age population in Somali region, Ethiopia.
A community-based unmatched case-control study was conducted among 228 (76 cases and 152 controls, 1:2 ratio) systematically selected population. Data were collected using a structured questionnaire administered by an interviewer and a record review. Descriptive statistics and multivariable logistic regression analysis was used to identify the determinants of the risk factors of cholera infection with a 95% confidence interval and statistical significance was declared a tap-value < 0.05.
A total of 228 participants (33.3% cases and 66.7% controls) were enrolled in this study. The majority of the cases were in the range of 20-49 years of age (69.7%). The odds of acquiring cholera infection increased significantly by drinking unsafe pipe water (AOR 4.3, 95% CI 1.65-11.2), not having a household level toilet/latrine (AOR 3.25, 95% CI 1.57-6.76), hand washing only sometimes after the toilet (AOR 3.04, 95% CI 1.58-5.86) and not using water purification methods (AOR 2.3, 95% CI 1.13-4.54).
Major risk factors for cholera infection were related to drinking water and latrine hygiene. Improvement in awareness creation about cholera prevention and control methods, including water treatment, hygiene and sanitation were crucial in combating this cholera outbreak. Primary public health actions are ensuring clean drinking water, delivery of water purification tablets, soap and hand sanitizers and provision of health care and outbreak response. Long term goals in cholera affected areas include comprehensive water and sanitation strategies. Overall, the strategic role of a multi-sectoral approach in the design and implementation of public health interventions aimed at preventing and controlling cholera are essential to avert cholera outbreaks. Preparedness should be highlighted in cholera prone areas like Somali region especially after drought periods.
霍乱仍然是一个严重的公共卫生问题，其特点是疾病负担大、疫情频繁、持续流行和死亡率高，尤其是在包括埃塞俄比亚在内的热带和亚热带低收入国家。最近在索马里地区爆发的霍乱始于 2019 年 9 月 4 日至 11 月 1 日。霍乱可能在人群中迅速传播，因此必须及早发现和报告病例。本研究旨在确定埃塞俄比亚索马里地区 5 岁以上人群霍乱感染的决定因素。
在索马里地区进行了一项基于社区的病例对照研究，共纳入 228 名（76 例病例和 152 名对照，1:2 比例）系统选择的人群。通过访谈者和病历回顾收集数据。采用描述性统计和多变量逻辑回归分析来确定霍乱感染风险因素的决定因素，置信区间为 95%，统计显著性以 tap 值<0.05 表示。
共有 228 名参与者（33.3%为病例，66.7%为对照）参加了这项研究。大多数病例发生在 20-49 岁年龄组（69.7%）。饮用不安全的管道水（优势比 4.3，95%置信区间 1.65-11.2）、家中没有厕所/便池（优势比 3.25，95%置信区间 1.57-6.76）、便后仅有时洗手（优势比 3.04，95%置信区间 1.58-5.86）和不使用水净化方法（优势比 2.3，95%置信区间 1.13-4.54）的情况下，霍乱感染的几率显著增加。
霍乱感染的主要危险因素与饮用水和厕所卫生有关。提高对霍乱预防和控制方法的认识，包括水处理、卫生和环境卫生，对于控制此次霍乱疫情至关重要。初级公共卫生行动是确保提供清洁饮用水、发放水净化片剂、肥皂和洗手液，并提供医疗保健和疫情应对。在受霍乱影响的地区，长期目标包括综合水和卫生战略。总的来说，多部门方法在设计和实施旨在预防和控制霍乱的公共卫生干预措施方面具有战略作用，对于避免霍乱疫情至关重要。在像索马里地区这样容易发生霍乱的地区，应强调做好准备，特别是在干旱期之后。
