BACKGROUND: Cholera is an acute infectious disease caused by ingestion of contaminated food or water with Vibrio cholerae. Cholera remains a global threat to public health and an indicator of inequity and lack of social development. The aim of this study was to assess the prevalence and antimicrobial susceptibility pattern of V. cholerae from cholera outbreak sites in Ethiopia.
METHODS: Across-sectional study was conducted from May 2022 to October 2023 across different regions in Ethiopia: Oromia National Regional State, Amhara National Regional State and Addis Ababa City Administration. A total of 415 fecal samples were collected from the three regions. Two milliliter fecal samples were collected from each study participants. The collected samples were cultured on Blood Agar, MacConkey Agar and Thiosulfate Citrate Bile Salt Sucrose Agar. A series of biochemical tests Oxidase test, String test, Motility, Indole, Citrate, Gas production, H2S production, Urease test were used to identify V. cholerae species. Both polyvalent and monovalent antisera were used for agglutination tests to identify and differentiate V. cholerae serogroup and serotypes. In addition, Kirby-Bauer Disk diffusion antibiotic susceptibility test method was done. Data were registered in epi-enfo version 7 and analyzed by Statistical Package for Social Science version 25. Descriptive statistics were used to determine the prevalence of Vibrio cholerae. Logistic regression model was fitted and p-value < 0.05 was considered as statically significant.
RESULTS: The prevalence of V. cholerae in the fecal samples was 30.1%. Majority of the isolates were from Oromia National Regional State 43.2% (n = 54) followed by Amhara National Regional State 31.2% (n = 39) and Addis Ababa City Administration 25.6% (n = 32). Most of the V. cholerae isolates were O1 serogroups 90.4% (n = 113) and Ogawa serotypes 86.4% (n = 108). Majority of the isolates were susceptible to ciprofloxacin 100% (n = 125), tetracycline 72% (n = 90) and gentamycin 68% (n = 85). More than half of the isolates were resistant to trimethoprim-sulfamethoxazole 62.4% (n = 78) and ampicillin 56.8% (n = 71). In this study, participants unable to read and write were about four times more at risk for V. cholerae infection (AOR: 3.8, 95% CI: 1.07-13.33). In addition, consumption of river water were about three times more at risk for V. cholerae infection (AOR: 2.8, 95% CI: 1.08-7.08).
CONCLUSIONS: our study revealed a high prevalence of V. cholerae from fecal samples. The predominant serogroups and serotypes were O1 and Ogawa, respectively. Fortunately, the isolates showed susceptible to most tested antibiotics. Drinking water from river were the identified associated risk factor for V. cholerae infection. Protecting the community from drinking of river water and provision of safe and treated water could reduce cholera outbreaks in the study areas.

Dilip Mahalanabis, an esteemed Indian pediatrician, revolutionized global health through his pioneering work in combatting diarrheal diseases, particularly during the Bangladesh War of Independence in 1971. His development of oral rehydration therapy (ORT) provided a simple, cost-effective solution that significantly reduced mortality rates among cholera patients. Mahalanabis\' dedication to equitable healthcare, evidenced by his leadership roles in organizations such as the World Health Organization (WHO), underscores his legacy as a champion for vulnerable populations. ORT\'s widespread adoption has democratized treatment, empowering communities and drastically reducing mortality rates associated with diarrheal diseases.

UNASSIGNED: In Ethiopia, despite major improvements seen in health service delivery system, the country continues to be significantly affected by cholera outbreaks. Cholera remains a significant public health problem among the vulnerable populations living in many resource-limited settings with poor access to safe and clean water and hygiene practices. Recurring cholera outbreaks are an indication of deprived water and sanitation conditions as well as weak health systems, contributing to the transmission and spread of the cholera infection.
UNASSIGNED: To assess the cholera outbreak, its challenges, and the way forward on public health interventions to solve the knowledge and health service delivery gaps related to cholera control in Guraghe Zone, Ethiopia, 2023.
UNASSIGNED: Active surveillance of the cholera outbreak was conducted in all kebeles and town administrative of Guraghe zone from 7/8/2023 to 30/10/2023. A total of 224 cholera cases were detected during the active surveillance method. Data obtained from Guraghe zone offices were exported to SPSS version 25 for additional analysis. The case fatality rate, incidence of the cases, and other descriptive variables were presented and described using figures and tables.
UNASSIGNED: A total of 224 cholera cases were detected through an active surveillance system. In this study, the case fatality rate of cholera outbreak was 2.6%. To tackle the cholera outbreak, the Guraghe zone health office collaborated with other stakeholders to prepare four cholera treatment centers. The absence of OCV, inaccessible safe water, low latrine coverage, inappropriate utilization of latrines, and absence of cholera laboratory rapid diagnostics test in Guraghe Zone are barriers to tackling the outbreak.
UNASSIGNED: Ethiopia National Cholera Plan targeted eradicating cholera by 2030, 222 cholera outbreak occurred in Guraghe Zone, Ethiopia. To minimize and control cholera mortality rate oral cholera vaccinations should be employed in all areas of the region. Sustainable WASH measures should be guaranteed for the use of safe water and good hygiene practices. Early diagnosis and treatment should be initiated appropriately for those who are infected.

Global efforts to combat epidemic cholera outbreaks have witnessed tremendous feats over the decades. However, sporadic outbreaks in regions, particularly across African states, mask these advancements. This regressive trend is frequently fuelled by factors retarding efforts towards optimal environmental sanitation and personal hygiene, which include ingesting infected food, drinking contaminated waters, and engaging in unhealthy environmental practices such as indiscriminate waste and sewage disposal and poor toilet practices. The ongoing efforts to achieve the Global Taskforce on Cholera Control (GTFCC) targets of a 90% reduction in cases and deaths by 2030, even in the wake of continuous outbreaks across various African regions, as reported by the World Health Organization (WHO) face a significant threat. One such effort, among others, is the AFRICHOL project, an enhanced cholera surveillance consortium launched in Africa over a decade ago as part of the GTFCC at WHO to monitor and fast-track the GTFCC\'s 2030 targets. It is tasked with supporting the implementation of research-based strategies for combating cholera in Africa. The prequalified oral cholera vaccines - Dukoral, Shanchol, and Euvichol - and those with recombinant DNA technology have also emerged as remarkable strides. In the face of this progress, challenges persist. Climate change, including extreme weather events and the lack of safe water, sanitation, and hygiene facilities, acts as a multiplier, amplifying existing challenges and hindering progress. Porous borders with inefficient disease surveillance networks among member states also facilitate the inter-territorial spread of the disease. Despite ongoing challenges, global targets are achievable provided strong institutional infrastructure and additional evidence-based public health initiatives are promulgated and enacted. The Global Roadmap to Ending Cholera Outbreaks by 2030 is a resourceful tool for advancing this fight and eradicating cholera.

BACKGROUND: This study assesses the impact of Water, Sanitation, and Hygiene (WASH) interventions on cholera understanding and hygiene practices in La Gonâve Island, Haiti. It examines the changes after implementing interventions in seven villages across the Downtown, Mountain, and Seaside regions.
METHODS: A retrospective investigation surveyed 210 school students from each region using a validated questionnaire. It assessed knowledge, attitudes, practices (KAP), and environmental aspects related to cholera and hygiene. Data analysis involved descriptive statistics and chi-square tests.
RESULTS: The study highlights significant disparities in education levels, toilet ownership, and healthcare access. Challenges in finding public toilets (86.67%) and accessing water sources (67.78%) are consistent across regions, with Seaside facing financial constraints (85.00%) and water cost concerns (91.67%). Attitudes toward hygiene vary, with the Mountain region having the highest \'Never\' responses for handwashing (38.89%), and Downtown leading in water treatment practices (11.67%). There is a strong willingness to share health knowledge, particularly in Downtown (100.00%). Seaside (83.33%) and Downtown (73.33%) revealed a higher cholera awareness, while nearly half of Mountain students lacked knowledge (54.44%).
CONCLUSIONS: This study highlights significant disparities in WASH practices among La Gonâve\'s adolescents in Downtown, Mountain, and Seaside regions. Urgent interventions are crucial for improving sanitation, ensuring clean water access, and implementing targeted hygiene education, especially in the resource-constrained Mountain and Seaside areas. The findings underscore the vital roles of adolescents and schools in disseminating knowledge, with further research needed to explore intervention differences.

Aeromonas caviae is an increasingly recognized etiological agent of acute gastroenteritis. Here, we report five draft genomes of A. caviae isolated from suspected cholera cases during the 2022-2023 cholera outbreak in Malawi.

The developing world has been facing a significant health issue due to cholera as an endemic communicable disease. Lusaka was Zambia\'s worst affected province, with 5414 reported cases of cholera during the outbreak from late October 2017 to May 12, 2018. To explore the epidemiological characteristics associated with the outbreak, we fitted weekly reported cholera cases with a compartmental disease model that incorporates two transmission routes, namely environment-to-human and human-to-human. Estimates of the basic reproduction number show that both transmission modes contributed almost equally during the first wave. In contrast, the environment-to-human transmission appears to be mostly dominating factor for the second wave. Our study finds that a massive abundance of environmental vibrio\'s with a huge reduction in water sanitation efficacy triggered the secondary wave. To estimate the expected time to extinction (ETE) of cholera, we formulate the stochastic version of our model and find that cholera can last up to 6.5-7 years in Lusaka if any further outbreak occurs at a later time. Results indicate that a considerable amount of attention is to be paid to sanitation and vaccination programs in order to reduce the severity of the disease and to eradicate cholera from the community in Lusaka.

Cholera is a significant threat causing outbreaks/epidemics with high morbidity and mortality in coastal and tribal districts of Odisha. A sequential cholera outbreak reported from four places in Mayurbhanj district of Odisha during June to July 2009 was investigated.
Rectal swabs from diarrhea patients were analyzed for the identification, antibiogram profiles and detection of ctxB genotypes by double mismatch amplification mutation (DMAMA) polymerase chain reaction (PCR) assays and sequenced. The different virulent and drug resistant genes were detected by multiplex PCR assays. The clonality analysis on selected strains was done by pulse field gel electrophoresis (PFGE).
Bacteriological analysis of rectal swabs revealed the presence of V. cholerae O1 Ogawa biotype El Tor which were resistant to co-trimoxazole, chloramphenicol, streptomycin, ampicillin, nalidixic acid, erythromycin, furazolidone and polymyxin B. DMAMA-PCR assay revealed that the cholera outbreak in Mayurbhanj district was due to both ctxB1 and ctxB7 alleles of V. cholerae O1 El Tor strains. All the V. cholerae O1 strains were positive for all virulence genes. The multiplex PCR assay on V. cholerae O1 strains revealed the presence of antibiotic resistance genes like dfrA1 (100%), intSXT (100%), sulII (62.5%) and StrB (62.5%). PFGE results on V. cholerae O1 strains exhibited two different pulsotypes with 92% similarity.
This outbreak was a transition phase where both ctxB genotypes were prevalent after which the ctxB7 genotype gradually became dominant in Odisha. Therefore, close monitoring and continuous surveillance on diarrheal disorders is essential to prevent the future diarrheal outbreaks in this region.

METHODS: Cholera can aggravate or precipitate malnutrition, and children with severe acute malnutrition (SAM) have a higher incidence and longer duration of diarrhoea.
OBJECTIVE: To describe 1) characteristics of and treatment outcomes in children aged 2-4 years with cholera, 2) the case fatality rate (CFR) in all children treated, and 3) the associations between nutritional status, hydration status, treatment administered and hospital outcomes.
METHODS: An observational cohort study of children admitted to one cholera treatment centre in Maiduguri, Nigeria, with a focus on children aged 2-4 years. CFRs were examined by cross tabulation and mean length of stay (LOS) using analysis of variance.
RESULTS: SAM was identified in 24% of children aged 2-4 years. The CFR for children aged 2-4 years was 1.4%. As the sample size was small, we did not find any association between nutritional status and death due to cholera. The proportion of children discharged within 2 days was 79%, and the longest stay was 8 days. In general, health facility LOS increased with severity of malnutrition.
CONCLUSIONS: Our study found that nutritional status affected the LOS, but was unable to find an association between malnutrition and fatality among children aged 2-4 years.
UNASSIGNED: Le choléra peut aggraver ou précipiter la malnutrition et les enfants atteints de malnutrition aiguë grave (SAM) ont une incidence plus élevée et une durée plus longue de diarrhée.
UNASSIGNED: Décrire 1) les caractéristiques et les résultats du traitement d’enfants de 2–4 ans atteints de choléra, 2) le taux de mortalité de tous les enfants traités, et 3) les associations entre état nutritionnel, hydratation, traitement administré et évolution à l’hôpital.
UNASSIGNED: Cohorte d’observation d’enfants admis au centre de traitement du choléra de Maiduguri, Nigeria, avec un focus sur les enfants de 2–4 ans. Les taux de létalité ont été examinés par tabulation croisée et la durée moyenne de séjour par analyse de la variance.
UNASSIGNED: Une SAM a été identifiée chez 24% des enfants de 2–4 ans. Le taux de létalité des enfants de 2–4 ans était de 1,4%. La petite taille de la population n’a pas permis d’observer d’association entre état nutritionnel et décès dû au choléra. La proportion d’enfants sortis en 48h a été de 79% et la durée la plus longue de séjour de 8 jours. En général, la durée de séjour en structure de santé augmentait avec la gravité de la malnutrition.
CONCLUSIONS: Notre étude a constaté que l’état nutritionnel affectait la durée de séjour mais n’a pas permis de trouver une association entre malnutrition et létalité parmi les enfants de 2–4 ans.

BACKGROUND: Suspected cholera cases were reported to the city administration health bureau in Addis-Ababa, Ethiopia on June 5, 2016 and it was laboratory confirmed by culture on 7 June 2016. The outbreak was declared by the government on June 8, 2016. The aim of this study was to rapidly investigate the outbreak epidemiologically and guide response activities in the affected Sub cities of Addis Ababa city administration.
METHODS: An unmatched 1:2 case-control study was conducted in six selected sub-cities of the city administration. Different laboratory tests were also done from suspected possible risk factors identified to support the epidemiological findings. A case was a patient greater than 5 years old, who developed acute watery diarrhea with or without Vomiting. Control was an individual greater than 5 years\' old who stayed in the same township and did not suffer from cholera. A structured questionnaire was used to select cases and controls. Epi InfoTM statistical software was used to analyze the data. Results were presented in narratives, figures and tables.
RESULTS: The present study found that, the study participants who used street-vended water (Odds Ratio (OR)=10.4; 95% CI: 1.20-90.9), those who reported holy water sources use (OR=2.7, 95% CI: 1.45-5.04), eating raw meat (OR=7.75; 95% CI: 3.86-15.54) or roasted meat (OR=2.16; 95% CI: 1.19-3.93) and vegetable salad (OR=2.07; 95% CI: 1.14-3.76) were associated with contracting cholera infection. The likelihood of contracting cholera was significantly higher among those who ate food from street vendor sources (OR=5.32; 95% CI: 1.82-15.56) and those who practiced open defecation (OR=8.12; 95% CI (2.20-29.81). Having a latrine (OR=0.29; 95% CI: 0.12-0.69) and proper hand hygiene practice (OR=0.22; 95% CI: 0.14-0.38) were found to be protective against cholera infection.
CONCLUSIONS: Improving awareness of the community by intensifying social mobilization activities through community participation in proper hygienic practice, proper waste disposal and latrine facility construction and utilization. Provision of safe water for the community by strictly conducting end-point assessment of water points and conducting a KAP assessment among food handlers to explore their knowledge and practices regarding safe food/drink handling and water treatment as well as initiate appropriate PH actions based on the findings which will be necessary for prevention of similar cholera outbreaks in the future.