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

Autor: Veronique Sarr, Raphael Kakongo Senga, Cynthia Sema, Guy Mutombo, Godfrey Bwire, Pawou Bidjada, Dorteia Inguane, Dadja Essoya Landoh, Delphine Sauvageot, Ouyi Valentin Tante, Liliana Candida Dengo-Baloi, Jean Claude Anne, Annie Mutombo, Daouda Coulibaly, José Paulo Langa, Christopher Garimoi Orach, Abiba Kere Banla, Berthe Marie Njanpop-Lafourcade, Mamadou Saliou, Yao Jean Pierre Kouame, Sakoba Keita, Muggaga Malimbo, Atek Kagirita, Martin A. Mengel, Issa Makumbi, Emilienne Niamke NGuetta, Adele Kacou-N'Douba, Bradford D. Gessner, Berthe Miwanda, Fode Sory, Mireille Dosso, Laurent Akilimali, Didier Bompangue
Přispěvatelé: Agence de Médecine Préventive, Service de Microbiologie [Kinshasa, République Démocratique du Congo], Faculté de Médecine [Kinshasa, République Démocratique du Congo], Université Libre de Kinshasa (ULK)-Université Libre de Kinshasa (ULK), Laboratoire Chrono-environnement - CNRS - UBFC (UMR 6249) (LCE), Centre National de la Recherche Scientifique (CNRS)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté [COMUE] (UBFC)-Université Bourgogne Franche-Comté [COMUE] (UBFC), Institut Pasteur de Côte d'Ivoire, Réseau International des Instituts Pasteur (RIIP), UFR des Sciences Médicales, Département de Microbiologie, Réseau International des Instituts Pasteur (RIIP)-Réseau International des Instituts Pasteur (RIIP)-CHU de Cocody-Abidjan, Division Prévention et Lutte contre la Maladie, Ministère de la Santé et de l’Hygiène Publique, UNICEF, country office of Togo, Institut National de Recherche Biomédicale [Kinshasa] (INRB), Health Ministry, Government of the Democratic Republic of Congo
Jazyk: angličtina
Rok vydání: 2016
Předmět:
Bacterial Diseases
Epidemiology
Marine and Aquatic Sciences
Geographical Locations
0302 clinical medicine
Cholera
Environmental protection
Medicine and Health Sciences
Uganda
030212 general & internal medicine
Child
Mozambique
ComputingMilieux_MISCELLANEOUS
Disease surveillance
Incidence
Incidence (epidemiology)
lcsh:Public aspects of medicine
Middle Aged
3. Good health
Infectious Diseases
Geography
Togo
Child
Preschool

[SDE]Environmental Sciences
Research Article
Neglected Tropical Diseases
Freshwater Environments
Adult
medicine.medical_specialty
Côte d'Ivoire
Sub saharan
lcsh:Arctic medicine. Tropical medicine
Adolescent
lcsh:RC955-962
030231 tropical medicine
Cote d ivoire
Disease Surveillance
03 medical and health sciences
Environmental health
medicine
Humans
Africa South of the Sahara
Ecology and Environmental Sciences
Public Health
Environmental and Occupational Health

Aquatic Environments
Infant
lcsh:RA1-1270
Bodies of Water
Tropical Diseases
medicine.disease
Lakes
People and Places
Africa
Earth Sciences
Guinea
Multi country
Zdroj: PLoS Neglected Tropical Diseases, Vol 10, Iss 5, p e0004679 (2016)
PLoS Neglected Tropical Diseases
PLoS Neglected Tropical Diseases, Public Library of Science, 2016, 10 (5), pp.e0004679. ⟨10.1371/journal.pntd.0004679⟩
ISSN: 1935-2735
1935-2727
Popis: 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
Author Summary Cholera burden in Africa remains unknown, often because of weak national surveillance systems. Reporting is non-exhaustive for various reasons, such as individual and community fears of stigmatization and economic loss. Furthermore, only 3% to 5% of all cases are laboratory confirmed. A variety of case definitions are used across countries, which could lead to cholera over or under-reporting. Our study presents the first data from prospective multi-country cholera surveillance in Africa, and the only such data based on culture confirmation and that includes a description of clinical presentation. We show how confirmed cholera cases varied over time by setting, and identified three epidemiological patterns that can guide decision-making processes. We documented that reliance on suspected cases–as is usually done in national surveillance–rather than confirmed cases can over-estimate substantially cholera incidence. Finally, our surveillance strategy of using case-based reporting and a standard comprehensive case reporting form provided more information on at-risk populations and geographical hot spots than is currently available in the literature; this is turn should facilitate development of efficient preventive strategies.
Databáze: OpenAIRE