Cholera risk factors, Papua New Guinea, 2010
Cholera risk factors, Papua New Guinea, 2010
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DOI：
10.1186/1471-2334-12-287
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发表时间：
2012-11-05
影响因子：
3.7
通讯作者：
MacIntyre, C. Raina
中科院分区：
文献类型：
--
作者：
Rosewell, Alexander;Addy, Benita;MacIntyre, C. Raina
背景：霍乱是巴布亚新几内亚新近出现的疾病，但可能很快成为地方性疾病。确定霍乱的危险因素为有针对性的预防和控制措施提供了证据。方法：我们进行了一项以医院为基础的病例对照研究，以确定霍乱危险因素。以粪便培养为标准，对现场霍乱护理点试验进行了评价。结果：招募了176名参与者：54例病例和122例对照组。霍乱的独立危险因素是：年龄超过20岁（aOR为2.5；95%CI为1.1,5.4），在露天（或河中）排尿（aOR为4.5；95%CI为1.4,14.4），认识去过霍乱疫区的人（aOR为4.1；95%CI为1.6,10.7）；而家中可用肥皂洗手具有保护作用（aOR 0.41; 95% CI 0.19, 0.87）。那些报告家里有管道供水系统的人报告有肥皂洗手的可能性是其他人的两倍。快速检测的敏感性和特异性分别为72% （95% CI 47 ~ 90）和71% （95% CI 44 ~ 90%）。结论：改善人口对管道供水系统和卫生设施的使用，可能会通过加强卫生和限制水源污染来减少传播。在可获得传统实验室方法的医院环境中，一步霍乱弧菌O1/O139抗原检测对临床决策的效用有限。在巴布亚新几内亚，所有年龄组的定居居民和流动人口都应成为干预措施的目标。
Background: Cholera is newly emergent in Papua New Guinea but may soon become endemic. Identifying the risk factors for cholera provides evidence for targeted prevention and control measures.Methods: We conducted a hospital-based case-control study to identify cholera risk factors. Using stool culture as the standard, we evaluated a cholera point of care test in the field.Results: 176 participants were recruited: 54 cases and 122 controls. Independent risk factors for cholera were: being over 20 years of age (aOR 2.5; 95%CI 1.1, 5.4), defecating in the open air (or river) (aOR 4.5; 95% CI 1.4, 14.4) and knowing someone who travelled to a cholera affected area (aOR 4.1; 95% CI 1.6, 10.7); while the availability of soap for handwashing at home was protective (aOR 0.41; 95% CI 0.19, 0.87). Those reporting access to a piped water distribution system in the home were twice as likely to report the availability of soap for handwashing. The sensitivity and specificity of the rapid test were 72% (95% CI 47-90) and 71% (95% CI 44-90%).Conclusions: Improving population access to the piped water distribution system and sanitation will likely reduce transmission by enabling enhanced hygiene and limiting the contamination of water sources. The One step V. cholerae O1/O139 Antigen Test is of limited utility for clinical decision making in a hospital setting with access to traditional laboratory methods. Settlement dwellers and mobile populations of all age groups should be targeted for interventions in Papua New Guinea.