Prioritizing interventions for cholera control in Kenya, 2015-2020.
Kenya has experienced cholera outbreaks since 1971, with the most recent wave beginning in late 2014. Between 2015-2020, 32 of 47 counties reported 30,431 suspected cholera cases. The Global Task Force for Cholera Control (GTFCC) developed a Global Roadmap for Ending Cholera by 2030, which emphasize...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Public Library of Science (PLoS)
2023-05-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0010928 |
| _version_ | 1827933924680007680 |
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| author | Waqo Boru Shaoming Xiao Patrick Amoth David Kareko Daniel Langat Ian Were Mohammad Ali David A Sack Elizabeth C Lee Amanda K Debes |
| author_facet | Waqo Boru Shaoming Xiao Patrick Amoth David Kareko Daniel Langat Ian Were Mohammad Ali David A Sack Elizabeth C Lee Amanda K Debes |
| author_sort | Waqo Boru |
| collection | DOAJ |
| description | Kenya has experienced cholera outbreaks since 1971, with the most recent wave beginning in late 2014. Between 2015-2020, 32 of 47 counties reported 30,431 suspected cholera cases. The Global Task Force for Cholera Control (GTFCC) developed a Global Roadmap for Ending Cholera by 2030, which emphasizes the need to target multi-sectoral interventions in priority cholera burden hotspots. This study utilizes the GTFCC's hotspot method to identify hotspots in Kenya at the county and sub-county administrative levels from 2015 through 2020. 32 of 47 (68.1%) counties reported cholera cases during this time while only 149 of 301 (49.5%) sub-counties reported cholera cases. The analysis identifies hotspots based on the mean annual incidence (MAI) over the past five-year period and cholera's persistence in the area. Applying a MAI threshold of 90th percentile and the median persistence at both the county and sub-county levels, we identified 13 high risk sub-counties from 8 counties, including the 3 high risk counties of Garissa, Tana River and Wajir. This demonstrates that several sub-counties are high level hotspots while their counties are not. In addition, when cases reported by county versus sub-county hotspot risk are compared, 1.4 million people overlapped in the areas identified as both high-risk county and high-risk sub-county. However, assuming that finer scale data is more accurate, 1.6 million high risk sub-county people would have been misclassified as medium risk with a county-level analysis. Furthermore, an additional 1.6 million people would have been classified as living in high-risk in a county-level analysis when at the sub-county level, they were medium, low or no-risk sub-counties. This results in 3.2 million people being misclassified when county level analysis is utilized rather than a more-focused sub-county level analysis. This analysis highlights the need for more localized risk analyses to target cholera intervention and prevention efforts towards the populations most vulnerable. |
| first_indexed | 2024-03-13T07:32:20Z |
| format | Article |
| id | doaj.art-4434cd1dd33b4a6b98590bf3f5b49213 |
| institution | Directory Open Access Journal |
| issn | 1935-2727 1935-2735 |
| language | English |
| last_indexed | 2024-03-13T07:32:20Z |
| publishDate | 2023-05-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj.art-4434cd1dd33b4a6b98590bf3f5b492132023-06-04T05:32:26ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352023-05-01175e001092810.1371/journal.pntd.0010928Prioritizing interventions for cholera control in Kenya, 2015-2020.Waqo BoruShaoming XiaoPatrick AmothDavid KarekoDaniel LangatIan WereMohammad AliDavid A SackElizabeth C LeeAmanda K DebesKenya has experienced cholera outbreaks since 1971, with the most recent wave beginning in late 2014. Between 2015-2020, 32 of 47 counties reported 30,431 suspected cholera cases. The Global Task Force for Cholera Control (GTFCC) developed a Global Roadmap for Ending Cholera by 2030, which emphasizes the need to target multi-sectoral interventions in priority cholera burden hotspots. This study utilizes the GTFCC's hotspot method to identify hotspots in Kenya at the county and sub-county administrative levels from 2015 through 2020. 32 of 47 (68.1%) counties reported cholera cases during this time while only 149 of 301 (49.5%) sub-counties reported cholera cases. The analysis identifies hotspots based on the mean annual incidence (MAI) over the past five-year period and cholera's persistence in the area. Applying a MAI threshold of 90th percentile and the median persistence at both the county and sub-county levels, we identified 13 high risk sub-counties from 8 counties, including the 3 high risk counties of Garissa, Tana River and Wajir. This demonstrates that several sub-counties are high level hotspots while their counties are not. In addition, when cases reported by county versus sub-county hotspot risk are compared, 1.4 million people overlapped in the areas identified as both high-risk county and high-risk sub-county. However, assuming that finer scale data is more accurate, 1.6 million high risk sub-county people would have been misclassified as medium risk with a county-level analysis. Furthermore, an additional 1.6 million people would have been classified as living in high-risk in a county-level analysis when at the sub-county level, they were medium, low or no-risk sub-counties. This results in 3.2 million people being misclassified when county level analysis is utilized rather than a more-focused sub-county level analysis. This analysis highlights the need for more localized risk analyses to target cholera intervention and prevention efforts towards the populations most vulnerable.https://doi.org/10.1371/journal.pntd.0010928 |
| spellingShingle | Waqo Boru Shaoming Xiao Patrick Amoth David Kareko Daniel Langat Ian Were Mohammad Ali David A Sack Elizabeth C Lee Amanda K Debes Prioritizing interventions for cholera control in Kenya, 2015-2020. PLoS Neglected Tropical Diseases |
| title | Prioritizing interventions for cholera control in Kenya, 2015-2020. |
| title_full | Prioritizing interventions for cholera control in Kenya, 2015-2020. |
| title_fullStr | Prioritizing interventions for cholera control in Kenya, 2015-2020. |
| title_full_unstemmed | Prioritizing interventions for cholera control in Kenya, 2015-2020. |
| title_short | Prioritizing interventions for cholera control in Kenya, 2015-2020. |
| title_sort | prioritizing interventions for cholera control in kenya 2015 2020 |
| url | https://doi.org/10.1371/journal.pntd.0010928 |
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