Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015
Epidemiology of cholera outbreaks and socio-economic characteristics of the communities in the fishing villages of Uganda: 2011-2015
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DOI：
10.1371/journal.pntd.0005407
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发表时间：
2017-03-01
影响因子：
3.8
通讯作者：
Mengel, Martin A.
中科院分区：
文献类型：
--
作者：
Bwire, Godfrey;Munier, Aline;Mengel, Martin A.
背景非洲五大湖地区，特别是乌干达的渔村社区经常爆发霍乱，导致相当大的死亡率和发病率。我们评估了霍乱的流行病学和人口特征，在乌干达的渔村，以更好地针对预防和控制干预措施的霍乱，并有助于消除这些community.Methodology/Principal findingsWe之间进行了前瞻性研究2011-15在乌干达的渔村。我们收集、审查和记录了发生在沿着非洲五大湖和乌干达尼罗河的渔业社区的10起霍乱疫情的流行病学和社会经济数据。这些疫情造成1，827例疑似霍乱病例和43例死亡，病死率为2.4%。虽然渔村社区仅占乌干达人口的5-10%，但他们承担着最大的霍乱负担，占研究期间乌干达所有报告病例和死亡病例的58%和55%。男性的CFR显著高于女性（3.2% vs. 1.3%，p = 0.02）。疫情是季节性的，大多数病例发生在4月至5月。5岁以下和5-9岁的男童风险增加。霍乱在一些有明确“热点”的村庄流行。使社区容易爆发霍乱的做法包括：使用受污染的湖水、环境卫生和个人卫生条件差。其他因素包括：结论/SignificanceCholera暴发是乌干达渔业社区发病率和死亡率的主要原因。除了改善水、环境卫生和个人卫生外，口服霍乱疫苗还可以在预防和控制这些疫情方面发挥重要作用，特别是针对高风险地区和人群时。促进和便利获得社会服务，包括教育和减贫，应有助于在这些社区预防、控制和消灭霍乱。
BackgroundThe communities in fishing villages in the Great Lakes Region of Africa and particularly in Uganda experience recurrent cholera outbreaks that lead to considerable mortality and morbidity. We evaluated cholera epidemiology and population characteristics in the fishing villages of Uganda to better target prevention and control interventions of cholera and contribute to its elimination from those communities.Methodology/Principal findingsWe conducted a prospective study between 2011-15 in fishing villages in Uganda. We collected, reviewed and documented epidemiological and socioeconomic data for 10 cholera outbreaks that occurred in fishing communities located along the African Great Lakes and River Nile in Uganda. These outbreaks caused 1,827 suspected cholera cases and 43 deaths, with a Case-Fatality Ratio (CFR) of 2.4%. Though the communities in the fishing villages make up only 5-10% of the Ugandan population, they bear the biggest burden of cholera contributing 58% and 55% of all reported cases and deaths in Uganda during the study period. The CFR was significantly higher among males than females (3.2% vs. 1.3%, p = 0.02). The outbreaks were seasonal with most cases occurring during the months of April-May. Male children under age of 5 years, and 5-9 years had increased risk. Cholera was endemic in some villages with well-defined "hotspots". Practices predisposing communities to cholera outbreaks included: the use of contaminated lake water, poor sanitation and hygiene. Additional factors were: ignorance, illiteracy, and poverty.Conclusions/SignificanceCholera outbreaks were a major cause of morbidity and mortality among the fishing communities in Uganda. In addition to improvements in water, sanitation, and hygiene, oral cholera vaccines could play an important role in the prevention and control of these outbreaks, particularly when targeted to high-risk areas and populations. Promotion and facilitation of access to social services including education and reduction in poverty should contribute to cholera prevention, control and elimination in these communities.