1921
Volume 95, Issue 6
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

This study demonstrates that most cholera deaths in this region of Cameroon occur out of hospital. This is a region which is prone to cholera, and interventions are needed to improve access to emergency medical care, especially during cholera outbreaks. Cameroon has experienced 14 cholera epidemics during the last 20 years, and these have had high case fatality rates. This study attempted to assess the effect of delays in seeking care and the locations of care as possible risk factors for cholera mortality. The study used data from a community-based survey regarding the circumstances of 97 fatal cases and 197 control (nonfatal) cases following a cholera-like syndrome in villages with cholera-like diseases during cholera outbreaks in Cameroon during 2009–2011. Deaths occurred in one of four environments: the community, in a temporary community treatment center (TCTC), in transit to a treatment center, or in a hospital (39%, 32%, 5%, and 24%, respectively). Using a case–control analysis, factors associated with deaths included the nonuse of a cholera treatment center, receiving health care in a TCTC instead of a hospital, and greater than 4 hours delay between the onset of symptoms and the decision to go to a treatment center (odds ratios of 17.1 [confidence interval (CI): 7.0–41.8], 2.5 [CI: 1.2–5.0], and 2.2 [CI: 1.0–4.6], respectively). During cholera epidemics, a higher proportion of deaths are still occurring in communities. The nonuse and delays in deciding to go a treatment center, and treatment at TCTC rather than a hospital were risk factors for death among patients with cholera-like syndrome in Cameroon. Informing people on community management of cholera-like syndrome and improving care in all health facilities are needed to reduce deaths during cholera epidemics.

Loading

Article metrics loading...

/content/journals/10.4269/ajtmh.16-0300
2016-12-07
2018-04-21
Loading full text...

Full text loading...

/deliver/fulltext/14761645/95/6/1287.html?itemId=/content/journals/10.4269/ajtmh.16-0300&mimeType=html&fmt=ahah

References

  1. Sack DA, Sack RB, Nair GB, Siddique AK, , 2004. Cholera. Lancet 363: 223233.[Crossref]
  2. Ali M, Nelson AR, Lopez AL, Sack DA, , 2015. Updated global burden of cholera in endemic countries. PLoS Negl Trop Dis 9: e0003832.[Crossref]
  3. Djomassi LD, Gessner BD, Andze GO, Mballa GA, , 2013. National surveillance data on the epidemiology of cholera in Cameroon. J Infect Dis 208 (Suppl 1): S92S97.[Crossref]
  4. World Health Organization (WHO), 2004. Cholera Outbreak. Assessing the Outbreak Response and Improving Preparedness. Geneva, Switzerland: WHO.
  5. Siddique AK, Ahmed S, Iqbal A, Sobhan A, Poddar G, Azim T, Sack DA, Rahman M, Sack RB, , 2011. Epidemiology of rotavirus and cholera in children aged less than five years in rural Bangladesh. J Health Popul Nutr 29: 18.[Crossref]
  6. Clemens JD, Sack DA, Chakraborty J, Rao MR, Ahmed F, Harris JR, van Loon F, Khan MR, Yunis M, Huda S, Stanton BF, Kay BA, Svennerholm A-M, Holmgren J, , 1990. Field trial of oral cholera vaccines in Bangladesh: evaluation of anti-bacterial and anti-toxic breast-milk immunity in response to ingestion of the vaccines. Vaccine 8: 469472.[Crossref]
  7. Sircar BK, Saha MR, Deb BC, Singh PK, Pal SC, , 1990. Effectiveness of oral rehydration salt solution (ORS) in reduction of death during cholera epidemic. Indian J Public Health 34: 6870.
  8. Mahalanabis D, Choudhuri AB, Bagchi NG, Bhattacharya AK, Simpson TW, , 1973. Oral fluid therapy of cholera among Bangladesh refugees. Johns Hopkins Med J 132: 197205.
  9. Maine D, , 1997. The strategic model for the PMM Network. Int J Gynaecol Obstet 59 (Suppl 2): S23S25.[Crossref]
  10. Gunnlaugsson G, Angulo FJ, Einarsdottir J, Passa A, Tauxe RV, , 2000. Epidemic cholera in Guinea-Bissau: the challenge of preventing deaths in rural west Africa. Int J Infect Dis 4: 813.[Crossref]
  11. Quick RE, Vargas R, Moreno D, Mujica O, Beingolea L, Palacios AM, Seminario L, Tauxe RV, , 1993. Epidemic cholera in the Amazon: the challenge of preventing death. Am J Trop Med Hyg 48: 597602.
  12. Morof D, Cookson ST, Laver S, Chirundu D, Desai S, Mathenge P, Shambare D, Charimari L, Midzi S, Blanton C, Handzel T, , 2013. Community mortality from cholera: urban and rural districts in Zimbabwe. Am J Trop Med Hyg 88: 645650.[Crossref]
  13. Siddique AK, , 1995. Failure of treatment centres to prevent cholera deaths in Goma. Lancet 346: 379.[Crossref]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.16-0300
Loading
/content/journals/10.4269/ajtmh.16-0300
Loading

Data & Media loading...

  • Received : 16 Apr 2016
  • Accepted : 07 Sep 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error