Cholera Incidence and Mortality in Sub-Saharan African Sites during Multi-country Surveillance.

Autor: Sauvageot D; Agence de Medecine Preventive, Paris, France., Njanpop-Lafourcade BM; Agence de Medecine Preventive, Paris, France., Akilimali L; Ministère de la santé, Kinshasa, Republique Democratique du Congo., Anne JC; Institut Pasteur, Abidjan, Cote d'Ivoire., Bidjada P; Institut National d'Hygiene, Lome, Togo., Bompangue D; Universite de Kinshasa, Kinshasa, Republique Democratique du Congo., Bwire G; Ministry of Health, Kampala, Uganda., Coulibaly D; Institut National d'hygiene Publique, Abidjan, Ivory Coast., Dengo-Baloi L; Instituto Nacional de Saude, Maputo, Mozambique., Dosso M; Institut Pasteur, Abidjan, Cote d'Ivoire., Orach CG; Makerere School of Public Health, Kampala, Uganda., Inguane D; Instituto Nacional de Saude, Maputo, Mozambique., Kagirita A; Central Public Health Laboratory, Ministry of Health, Kampala, Uganda., Kacou-N'Douba A; Institut Pasteur, Abidjan, Cote d'Ivoire., Keita S; Ministere de la sante publique et de l'hygiene publique, Conakry, Guinea., Kere Banla A; Institut National d'Hygiene, Lome, Togo., Kouame YJ; Institut National d'hygiene Publique, Abidjan, Ivory Coast., Landoh DE; Ministere de la sante, Lome, Togo., Langa JP; Instituto Nacional de Saude, Maputo, Mozambique., Makumbi I; Ministry of Health, Kampala, Uganda., Miwanda B; Institut National de Recherche Biomedicale, Kinshasa, Republique Democratique du Congo., Malimbo M; Ministry of Health, Kampala, Uganda., Mutombo G; Ministere de la santé, Division Provinciale de la santé, Goma, Republique Democratique du Congo., Mutombo A; Ministère de la santé, Kinshasa, Republique Democratique du Congo., NGuetta EN; Institut National d'hygiene Publique, Abidjan, Ivory Coast., Saliou M; Institut National de Sante Publique, Conakry, Guinea., Sarr V; Ministere de la sante publique et de l'hygiene publique, Conakry, Guinea., Senga RK; Ami-labo, Goma, Republique Democratique du Congo., Sory F; Ministere de la sante publique et de l'hygiene publique, Conakry, Guinea., Sema C; Instituto Nacional de Saude, Maputo, Mozambique., Tante OV; Ministere de la sante, Lome, Togo., Gessner BD; Agence de Medecine Preventive, Paris, France., Mengel MA; Agence de Medecine Preventive, Paris, France.
Jazyk: angličtina
Zdroj: PLoS neglected tropical diseases [PLoS Negl Trop Dis] 2016 May 17; Vol. 10 (5), pp. e0004679. Date of Electronic Publication: 2016 May 17 (Print Publication: 2016).
DOI: 10.1371/journal.pntd.0004679
Abstrakt: Background: Cholera burden in Africa remains unknown, often because of weak national surveillance systems. We analyzed data from the African Cholera Surveillance Network (www.africhol.org).
Methods/ Principal Findings: During June 2011-December 2013, we conducted enhanced surveillance in seven zones and four outbreak sites in Togo, the Democratic Republic of Congo (DRC), Guinea, Uganda, Mozambique and Cote d'Ivoire. All health facilities treating cholera cases were included. Cholera incidences were calculated using culture-confirmed cholera cases and culture-confirmed cholera cases corrected for lack of culture testing usually due to overwhelmed health systems and imperfect test sensitivity. Of 13,377 reported suspected cases, 34% occurred in Conakry, Guinea, 47% in Goma, DRC, and 19% in the remaining sites. From 0-40% of suspected cases were aged under five years and from 0.3-86% had rice water stools. Within surveillance zones, 0-37% of suspected cases had confirmed cholera compared to 27-38% during outbreaks. Annual confirmed incidence per 10,000 population was <0.5 in surveillance zones, except Goma where it was 4.6. Goma and Conakry had corrected incidences of 20.2 and 5.8 respectively, while the other zones a median of 0.3. During outbreaks, corrected incidence varied from 2.6 to 13.0. Case fatality ratios ranged from 0-10% (median, 1%) by country.
Conclusions/significance: Across different African epidemiological contexts, substantial variation occurred in cholera incidence, age distribution, clinical presentation, culture confirmation, and testing frequency. These results can help guide preventive activities, including vaccine use.
Databáze: MEDLINE
Externí odkaz: