PDF(Pubmed)
Abstract：
BACKGROUND: Cholera outbreaks are a recurrent issue in Tanzania, with Ilemela and Nkasi districts being particulary affected. The objective of this study was to conduct a socio-ecological system (SES) analysis of cholera outbreaks in these districts, identifying potential factors and assessing the preparedness for cholera prevention and control.
METHODS: A cross-sectional study was carried out in Ilemela and Nkasi districts of Mwanza and Rukwa regions, respectively in Tanzania between September and October 2021. A SES framework analysis was applied to identify potential factors associated with cholera outbreaks and assess the readiness of the districts to cholera prevention and control.
RESULTS: Ilemela is characterised by urban and peri-urban ecosystems while Nkasi is mainly rural. Cholera was reported to disproportionately affect people living along the shores of Lake Victoria in Ilemela and Lake Tanganyika in Nkasi, particularly fishermen and women involved infish trading. The main potential factors identified for cholera outbreaks included defecation in the shallow ends and along the edges of lakes, open defecation, bathing/swimming in contaminated waters and improper waste disposal. The preparedness of both districts for cholera prevention and response was found to be inadequate due to limited laboratory capacity, insufficient human resources, and budget constraints.
CONCLUSIONS: People of Ilemela and Nkasi districts remain at significant risk of recurrent cholera outbreaks and the capacity of the districts to detect the disease is limited. Urgent preventive measures, such as conducting considerable community awareness campaigns on personal hygiene and environmental sanitation are needed to alleviate the disease burden and reduce future cholera outbreaks.
METHODS: A cross-sectional study was carried out in Ilemela and Nkasi districts of Mwanza and Rukwa regions, respectively in Tanzania between September and October 2021. A SES framework analysis was applied to identify potential factors associated with cholera outbreaks and assess the readiness of the districts to cholera prevention and control.
RESULTS: Ilemela is characterised by urban and peri-urban ecosystems while Nkasi is mainly rural. Cholera was reported to disproportionately affect people living along the shores of Lake Victoria in Ilemela and Lake Tanganyika in Nkasi, particularly fishermen and women involved infish trading. The main potential factors identified for cholera outbreaks included defecation in the shallow ends and along the edges of lakes, open defecation, bathing/swimming in contaminated waters and improper waste disposal. The preparedness of both districts for cholera prevention and response was found to be inadequate due to limited laboratory capacity, insufficient human resources, and budget constraints.
CONCLUSIONS: People of Ilemela and Nkasi districts remain at significant risk of recurrent cholera outbreaks and the capacity of the districts to detect the disease is limited. Urgent preventive measures, such as conducting considerable community awareness campaigns on personal hygiene and environmental sanitation are needed to alleviate the disease burden and reduce future cholera outbreaks.
摘要：
背景：霍乱疫情在坦桑尼亚是一个反复出现的问题，Ilemela和Nkasi地区受到特别影响。这项研究的目的是对这些地区的霍乱疫情进行社会生态系统(SES)分析,确定潜在因素并评估霍乱预防和控制的准备情况。
方法：在Mwanza和Rukwa地区的Ilemela和Nkasi地区进行了横断面研究，分别于2021年9月至10月在坦桑尼亚。SES框架分析用于确定与霍乱暴发相关的潜在因素，并评估各地区预防和控制霍乱的准备情况。
结果：Ilemela的特征是城市和城市周围的生态系统，而Nkasi主要是农村地区。据报道，霍乱不成比例地影响了伊勒梅拉的维多利亚湖和恩卡西的坦any尼喀湖沿岸的人们，特别是参与鱼类贸易的渔民和妇女。确定的霍乱暴发的主要潜在因素包括浅端和湖泊边缘的排便，开放式排便,在受污染的水域洗澡/游泳和不适当的废物处理。由于实验室能力有限，两个地区预防和应对霍乱的准备不足，人力资源不足,和预算限制。
结论：Ilemela和Nkasi地区的人群仍然面临着反复爆发霍乱的重大风险，并且这些地区检测该疾病的能力有限。紧急预防措施,例如，需要开展大量关于个人卫生和环境卫生的社区意识运动，以减轻疾病负担并减少未来的霍乱爆发。
方法：在Mwanza和Rukwa地区的Ilemela和Nkasi地区进行了横断面研究，分别于2021年9月至10月在坦桑尼亚。SES框架分析用于确定与霍乱暴发相关的潜在因素，并评估各地区预防和控制霍乱的准备情况。
结果：Ilemela的特征是城市和城市周围的生态系统，而Nkasi主要是农村地区。据报道，霍乱不成比例地影响了伊勒梅拉的维多利亚湖和恩卡西的坦any尼喀湖沿岸的人们，特别是参与鱼类贸易的渔民和妇女。确定的霍乱暴发的主要潜在因素包括浅端和湖泊边缘的排便，开放式排便,在受污染的水域洗澡/游泳和不适当的废物处理。由于实验室能力有限，两个地区预防和应对霍乱的准备不足，人力资源不足,和预算限制。
结论：Ilemela和Nkasi地区的人群仍然面临着反复爆发霍乱的重大风险，并且这些地区检测该疾病的能力有限。紧急预防措施,例如，需要开展大量关于个人卫生和环境卫生的社区意识运动，以减轻疾病负担并减少未来的霍乱爆发。
