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Retrospective Analysis of Cholera/Acute Watery Diarrhea Outbreaks in Ethiopia From 2001 To 2023: Incidence, Case Fatality Rate, and Seasonal and Multiyear Epidemic Patterns.
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- Author(s): Demlie, Yeshambel Worku; Gedefaw, Abel; Jeon, Yeonji; Hailu, Dejene; Getahun, Tomas; Mogeni, Ondari D; Mukasa, David; Jang, Geun Hyeog; Pak, Gi Deok; Kim, Deok Ryun; Getachew, Edlawit Mesfin; Yeshitela, Biruk; Abebe, Samuyel Ayele; Edosa, Moti; Wossen, Mesfin; Teferi, Mekonnen; Park, Se Eun
- Source:
Clinical Infectious Diseases; 2024 Supplement, Vol. 78, pS8-S19, 12p- Subject Terms:
PREVENTION of cholera; DIARRHEA prevention; DIARRHEA; PEARSON correlation (Statistics); PUBLIC health surveillance; COMMUNITY health services; SEASONS; HUMAN services programs; DEATH; RESEARCH funding; CHOLERA; LOGISTIC regression analysis; MEDICAL case management; RETROSPECTIVE studies; DESCRIPTIVE statistics; CHI-squared test; PUBLIC health administration; EPIDEMICS; MEDICAL records; ACQUISITION of data; CONFIDENCE intervals; MEDICAL needs assessment; DEHYDRATION; EMERGENCY management - Source:
- Additional Information
- Subject Terms:
- Subject Terms:
- Abstract: Background The Ethiopian government has developed the multisectoral cholera elimination plan (NCP) with an aim of reducing cholera incidence and case fatality rate (CFR). To better understand and monitor the progress of this plan, a comprehensive review of national cholera epidemiology is needed. Methods Reported data on cholera/acute watery diarrhea (AWD) cases in the past 20 years were extracted from the Ethiopian Public Health Institute and World Health Organization databases. Descriptive statistics, Pearson χ2, and logistic regression analyses were conducted. Results From January 2001 to November 2023, a total of 215 205 cholera/AWD cases, 2355 deaths with a cumulative CFR of 1.10% (95% confidence interval [CI], 1.092–1.095), and a mean annual incidence rate of 8.9/100 000 (95% CI, 6.5–11.3) were reported. Two major upsurges of cholera epidemics were found in the last two decades with mean attack rate (AR) of 20.57/100 000 in 2006–2010 and 14.83/100 000 in 2016–2020. Another resurgence of outbreaks occured in 2021–2023 (mean AR, 8.63/100 000). In 2015–2023, 54.0% (53 990/99 945) of cases were aged 15–44 years. National cholera CFR (3.13% [95% CI: 2.1–4.5]) was the highest in 2022. The 2015–2023 cumulative cholera CFR was different across regions: Benishangul Gumuz (6.07%), Gambela (1.89%), Sidama (1.42%), Southern Nation, Nationalities, and Peoples' (1.34%), Oromia (1.10%), and Amhara (1.09%). Cholera/AWD patients in older adults (≥45 years), severe dehydration, peak rainy season (June–August), and outpatients were associated with higher risk of death. Conclusions Cholera has been a public health problem in Ethiopia with case fatalities still above the global target. Case management needs to be improved particularly in outpatients and older populations. Outbreak preparedness should be rolled out well in advance of the typical rainy seasons. Significant investments are essential to advance the cholera surveillance system at healthcare setting and community level. Underlying factors of cholera deaths per areas should be further investigated to guide appropriate interventions to meet the NCP target by 2028. [ABSTRACT FROM AUTHOR]
- Abstract: Copyright of Clinical Infectious Diseases is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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