Mageto Lydia M, Mutono Nyamai, Aboge Gabriel, Gathura Peter, Okunga Emmanuel, Muange Annastacia, Mbae Cecilia Kathure, Thumbi Samuel M, Kariuki Samuel
Department of Public Health, Pharmacology and Toxicology, Faculty of Veterinary Medicine, University of Nairobi, P.O. Box 29053, 00625 Nairobi, Kenya.
Washington State University, Global Health Kenya, P.O. Box 72938-00200 Nairobi, Kenya.
Trans R Soc Trop Med Hyg. 2025 Jul 1;119(7):758-766. doi: 10.1093/trstmh/traf032.
Cholera is a public health challenge in Kenya. This study aimed at identifying the spatio-temporal pattern of cholera and its associated risk factors in high-risk areas to optimize resource use for targeted control.
The study was conducted in Mukuru, an informal settlement, Dadaab refugee camp and counties bordering Lake Victoria. Cholera line list data from 32 subcounties (2013-2022) was sourced from Kenya's Ministry of Health. Population and water, sanitation and hygiene data came from the 2019 census. Space-time scan statistic (SaTScan) were used to carry out spatio-temporal analysis and a zero-inflated negative binomial regression model evaluated cholera risk factors.
A total of 7316 cholera cases were reported across 22 (69%) subcounties, the highest numbers in 2015, 2016 and 2022 affecting 21, 12 and 3 subcounties, respectively, and none in 2014. Five high-risk space-time clusters encompassing 15 subcounties were identified, with Dadaab and Fafi showing persistent outbreaks. Improved sanitation was the only variable that suggested significant protective effects to cholera control (relative risk 0.9445, p=0.001).
Dadaab and Fafi subcounties were extremely high-risk and improved sanitation significantly reduced cholera outbreaks. These data inform cholera intervention policies in vulnerable regions.
霍乱是肯尼亚面临的一项公共卫生挑战。本研究旨在确定霍乱在高危地区的时空模式及其相关风险因素，以优化资源利用，进行针对性防控。
该研究在穆库鲁（一个非正式定居点）、达达布难民营以及与维多利亚湖接壤的各县开展。来自32个次级县（2013 - 2022年）的霍乱病例清单数据源自肯尼亚卫生部。人口以及水、环境卫生和个人卫生数据来自2019年人口普查。采用时空扫描统计法（SaTScan）进行时空分析，并使用零膨胀负二项回归模型评估霍乱风险因素。
在22个（69%）次级县共报告了7316例霍乱病例，2015年、2016年和2022年病例数最多，分别影响21个、12个和3个次级县，2014年无病例报告。确定了5个包含15个次级县的高危时空聚集区，达达布和法菲呈现持续疫情。改善环境卫生是唯一显示对霍乱防控有显著保护作用的变量（相对风险0.9445，p = 0.001）。
达达布和法菲次级县霍乱风险极高，改善环境卫生显著减少了霍乱疫情。这些数据为脆弱地区的霍乱干预政策提供了依据。
