Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study

BackgroundYemen has recently faced the largest cholera outbreak in the world, which started at the end of 2016. By the end of 2017, the cumulative reported cases from all governorates reached 777,229 with 2134 deaths. Al Hudaydah was one of the most strongly affected areas, w...

Full description

Bibliographic Details
Main Authors: Abdulqawi Mohammed Qaserah, Mohammed Abdullah Al Amad, Abdulwahed Abduljabbar Al Serouri, Yousef Saleh Khader
Format: Article
Language:English
Published: JMIR Publications 2021-07-01
Series:JMIR Public Health and Surveillance
Online Access:https://publichealth.jmir.org/2021/7/e27627
_version_ 1797735895001989120
author Abdulqawi Mohammed Qaserah
Mohammed Abdullah Al Amad
Abdulwahed Abduljabbar Al Serouri
Yousef Saleh Khader
author_facet Abdulqawi Mohammed Qaserah
Mohammed Abdullah Al Amad
Abdulwahed Abduljabbar Al Serouri
Yousef Saleh Khader
author_sort Abdulqawi Mohammed Qaserah
collection DOAJ
description BackgroundYemen has recently faced the largest cholera outbreak in the world, which started at the end of 2016. By the end of 2017, the cumulative reported cases from all governorates reached 777,229 with 2134 deaths. Al Hudaydah was one of the most strongly affected areas, with 88,741 (18%) cases and 244 (12%) deaths reported. ObjectiveThe aim of this study was to determine the risk factors associated with cholera transmission in Al Hudaydah city, Yemen. MethodsFrom December 1, 2017 to January 10, 2018, a total of 104 patients with cholera (57 women and 47 men) who presented at cholera treatment centers in Al Hudaydah city with three or more watery stools in a 24-hour period and with moderate or severe dehydration were identified for inclusion in this study. Each case was matched by age and gender with two controls who were living in the neighboring house. A semistructured questionnaire was used to collect data on behavioral and environmental risk factors such as drinking water from public wells, storing water in containers, consumption of unwashed vegetables or fruits, and sharing a toilet. ResultsThe median age of the cases and controls was 20 years (range 5-80) and 23 years (range 5-85), respectively. Only 6% of cases and 4% of controls were employed. Multivariate analysis showed that eating unwashed vegetables or fruits (odds ratio [OR] 7.0, 95% CI 1.6-30.6, P=.01), storing water in containers (OR 3.0, 95% CI 1.3-7.3, P=.01), drinking water from a public well (OR 2.5, 95% CI 1.1-5.7, P=.02), and using a public toilet (OR 5.2, 95% CI 1.1-24.4, P=.04) were significantly associated with cholera infection risk. ConclusionsThe cholera transmission risk factors in Al Hudaydah city were related to water and sanitation hygiene. Therefore, increasing awareness of the population on the importance of water chlorination, and washing fruits and vegetables through a health education campaign is strongly recommended.
first_indexed 2024-03-12T13:05:41Z
format Article
id doaj.art-b325e3fceeb144548a8b80f2be897399
institution Directory Open Access Journal
issn 2369-2960
language English
last_indexed 2024-03-12T13:05:41Z
publishDate 2021-07-01
publisher JMIR Publications
record_format Article
series JMIR Public Health and Surveillance
spelling doaj.art-b325e3fceeb144548a8b80f2be8973992023-08-28T16:59:54ZengJMIR PublicationsJMIR Public Health and Surveillance2369-29602021-07-0177e2762710.2196/27627Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control StudyAbdulqawi Mohammed Qaserahhttps://orcid.org/0000-0002-6750-4284Mohammed Abdullah Al Amadhttps://orcid.org/0000-0002-1566-4964Abdulwahed Abduljabbar Al Serourihttps://orcid.org/0000-0002-4112-3467Yousef Saleh Khaderhttps://orcid.org/0000-0002-7830-6857 BackgroundYemen has recently faced the largest cholera outbreak in the world, which started at the end of 2016. By the end of 2017, the cumulative reported cases from all governorates reached 777,229 with 2134 deaths. Al Hudaydah was one of the most strongly affected areas, with 88,741 (18%) cases and 244 (12%) deaths reported. ObjectiveThe aim of this study was to determine the risk factors associated with cholera transmission in Al Hudaydah city, Yemen. MethodsFrom December 1, 2017 to January 10, 2018, a total of 104 patients with cholera (57 women and 47 men) who presented at cholera treatment centers in Al Hudaydah city with three or more watery stools in a 24-hour period and with moderate or severe dehydration were identified for inclusion in this study. Each case was matched by age and gender with two controls who were living in the neighboring house. A semistructured questionnaire was used to collect data on behavioral and environmental risk factors such as drinking water from public wells, storing water in containers, consumption of unwashed vegetables or fruits, and sharing a toilet. ResultsThe median age of the cases and controls was 20 years (range 5-80) and 23 years (range 5-85), respectively. Only 6% of cases and 4% of controls were employed. Multivariate analysis showed that eating unwashed vegetables or fruits (odds ratio [OR] 7.0, 95% CI 1.6-30.6, P=.01), storing water in containers (OR 3.0, 95% CI 1.3-7.3, P=.01), drinking water from a public well (OR 2.5, 95% CI 1.1-5.7, P=.02), and using a public toilet (OR 5.2, 95% CI 1.1-24.4, P=.04) were significantly associated with cholera infection risk. ConclusionsThe cholera transmission risk factors in Al Hudaydah city were related to water and sanitation hygiene. Therefore, increasing awareness of the population on the importance of water chlorination, and washing fruits and vegetables through a health education campaign is strongly recommended.https://publichealth.jmir.org/2021/7/e27627
spellingShingle Abdulqawi Mohammed Qaserah
Mohammed Abdullah Al Amad
Abdulwahed Abduljabbar Al Serouri
Yousef Saleh Khader
Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
JMIR Public Health and Surveillance
title Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
title_full Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
title_fullStr Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
title_full_unstemmed Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
title_short Risk Factors of Cholera Transmission in Al Hudaydah, Yemen: Case-Control Study
title_sort risk factors of cholera transmission in al hudaydah yemen case control study
url https://publichealth.jmir.org/2021/7/e27627
work_keys_str_mv AT abdulqawimohammedqaserah riskfactorsofcholeratransmissioninalhudaydahyemencasecontrolstudy
AT mohammedabdullahalamad riskfactorsofcholeratransmissioninalhudaydahyemencasecontrolstudy
AT abdulwahedabduljabbaralserouri riskfactorsofcholeratransmissioninalhudaydahyemencasecontrolstudy
AT yousefsalehkhader riskfactorsofcholeratransmissioninalhudaydahyemencasecontrolstudy