Epidemiology, diagnostics and factors associated with mortality during a cholera epidemic in Nigeria, October 2020-October 2021: a retrospective analysis of national surveillance data.

Autor:	Elimian K; Nigeria Centre for Disease Control, Abuja, Nigeria kelly.elimian@ki.se.; Department of Global Public Health, Karolinska Institute, Stockholm, Sweden., Yennan S; Nigeria Centre for Disease Control, Abuja, Nigeria., Musah A; Department of Risk and Disaster Reduction, University College London, London, UK., Cheshi ID; Nigeria Centre for Disease Control, Abuja, Nigeria., King C; Department of Global Public Health, Karolinska Institute, Stockholm, Sweden., Dunkwu L; Tony Blair Institute for Global Change, London, UK., Mohammed AL; Nigeria Centre for Disease Control, Abuja, Nigeria., Ekeng E; Nigeria Centre for Disease Control, Abuja, Nigeria., Akande OW; Department of Epidemiology and Community Health, University of Ilorin Teaching Hospital, Ilorin, Nigeria., Ayres S; Department of Global Public Health, Karolinska Institute, Stockholm, Sweden., Gandi B; Bauchi State Ministry of Health, Bauchi, Nigeria., Pembi E; Adamawa State Ministry of Health, Yola, Nigeria., Saleh F; Nigeria Centre for Disease Control, Abuja, Nigeria., Omar AN; Nigeria Centre for Disease Control, Abuja, Nigeria., Crawford E; Nigeria Centre for Disease Control, Abuja, Nigeria., Olopha OO; Nigeria Centre for Disease Control, Abuja, Nigeria., Nnaji R; Nigeria Centre for Disease Control, Abuja, Nigeria., Muhammad B; Kano State Ministry of Health, Kano, Nigeria., Luka-Lawal R; Nigeria Centre for Disease Control, Abuja, Nigeria., Ihueze AC; Georgetown University, Abuja, Nigeria., Olatunji D; Nigeria Centre for Disease Control, Abuja, Nigeria., Ojukwu C; Nigeria Centre for Disease Control, Abuja, Nigeria., Akinpelu AM; Nigeria Centre for Disease Control, Abuja, Nigeria., Adaga E; Nigeria Centre for Disease Control, Abuja, Nigeria., Abubakar Y; Zamfara State Ministry of Health, Zamfara State, Nigeria., Nwadiuto I; Rivers State Ministry of Health, Port Harcourt, Nigeria., Ngishe S; Public Health, Ministry of Health, Benue State, Makurdi, Nigeria., Alowooye AB; Ekitit State Ministry of Health and Human Services, Ado-Ekiti, Nigeria., Nwogwugwu PC; Abia State Ministry of Health, Umuanhia, Nigeria., Kamaldeen K; Kwara State Ministry of Health, Ilorin, Nigeria., Abah HN; Nigeria Centre for Disease Control, Abuja, Nigeria., Chukwuebuka EH; Imo State Ministry of Health, Owerri, Nigeria., Yusuff HA; Ogun State Ministry of Health, Abeokuta, Nigeria., Mamadu I; World Health Organization Country Office for Nigeria, Abuja, Nigeria., Mohammed AA; Ministry of Health, Sokoto State, Sokoto, Nigeria., Peter S; Nigeria Centre for Disease Control, Abuja, Nigeria., Abbah OC; Nigeria Centre for Disease Control, Abuja, Nigeria., Oladotun PM; Nigeria Centre for Disease Control, Abuja, Nigeria., Oifoh S; Nigeria Centre for Disease Control, Abuja, Nigeria., Olugbile M; World Bank Nigeria Office, Abuja, Nigeria., Agogo E; Resolve to Saves Lives, Abuja, Nigeria., Ndodo N; Nigeria Centre for Disease Control, Abuja, Nigeria., Babatunde O; Nigeria Centre for Disease Control, Abuja, Nigeria., Mba N; Nigeria Centre for Disease Control, Abuja, Nigeria., Oladejo J; Nigeria Centre for Disease Control, Abuja, Nigeria., Ilori E; Nigeria Centre for Disease Control, Abuja, Nigeria., Alfvén T; Department of Global Public Health, Karolinska Institute, Stockholm, Sweden., Myles P; Clinical Practice Research Datalink, London, UK., Ochu CL; Nigeria Centre for Disease Control, Abuja, Nigeria., Ihekweazu C; Nigeria Centre for Disease Control, Abuja, Nigeria., Adetifa I; Nigeria Centre for Disease Control, Abuja, Nigeria.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2022 Sep 19; Vol. 12 (9), pp. e063703. Date of Electronic Publication: 2022 Sep 19.
DOI:	10.1136/bmjopen-2022-063703
Abstrakt:	Objectives: Nigeria reported an upsurge in cholera cases in October 2020, which then transitioned into a large, disseminated epidemic for most of 2021. This study aimed to describe the epidemiology, diagnostic performance of rapid diagnostic test (RDT) kits and the factors associated with mortality during the epidemic. Design: A retrospective analysis of national surveillance data. Setting: 33 of 37 states (including the Federal Capital Territory) in Nigeria. Participants: Persons who met cholera case definition (a person of any age with acute watery diarrhoea, with or without vomiting) between October 2020 and October 2021 within the Nigeria Centre for Disease Control surveillance data. Outcome Measures: Attack rate (AR; per 100 000 persons), case fatality rate (CFR; %) and accuracy of RDT performance compared with culture using area under the receiver operating characteristic curve (AUROC). Additionally, individual factors associated with cholera deaths and hospitalisation were presented as adjusted OR with 95% CIs. Results: Overall, 93 598 cholera cases and 3298 deaths (CFR: 3.5%) were reported across 33 of 37 states in Nigeria within the study period. The proportions of cholera cases were higher in men aged 5-14 years and women aged 25-44 years. The overall AR was 46.5 per 100 000 persons. The North-West region recorded the highest AR with 102 per 100 000. Older age, male gender, residency in the North-Central region and severe dehydration significantly increased the odds of cholera deaths. The cholera RDT had excellent diagnostic accuracy (AUROC=0.91; 95% CI 0.87 to 0.96). Conclusions: Cholera remains a serious public health threat in Nigeria with a high mortality rate. Thus, we recommend making RDT kits more widely accessible for improved surveillance and prompt case management across the country. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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