Skip to main content Accessibility help
×
Home

Incidence of severe diarrhoea due to Vibrio cholerae in the catchment area of six surveillance hospitals in Bangladesh

  • R. C. PAUL (a1), A. S. G. FARUQUE (a1), M. ALAM (a1), A. IQBAL (a1), K. ZAMAN (a1), N. ISLAM (a1), A. SOBHAN (a1), S. K. DAS (a1), M. A. MALEK (a1), F. QADRI (a1), A. CRAVIOTO (a1) (a2) and S.P. LUBY (a1) (a3)...

Summary

Cholera is an important public health problem in Bangladesh. Interventions to prevent cholera depend on their cost-effectiveness which in turn depends on cholera incidence. Hospital-based diarrhoeal disease surveillance has been ongoing in six Bangladeshi hospitals where a systematic proportion of patients admitted with diarrhoea were enrolled and tested for Vibrio cholerae. However, incidence calculation using only hospital data underestimates the real disease burden because many ill persons seek treatment elsewhere. We conducted a healthcare utilization survey in the catchment areas of surveillance hospitals to estimate the proportion of severe diarrhoeal cases that were admitted to surveillance hospitals and estimated the population-based incidence of severe diarrhoea due to V. cholerae by combining both hospital surveillance and catchment area survey data. The estimated incidence of severe diarrhoea due to cholera ranged from 0·3 to 4·9/1000 population in the catchment area of surveillance hospitals. In children aged <5 years, incidence ranged from 1·0 to 11·0/1000 children. Diarrhoeal deaths were most common in the Chhatak Hospital's catchment area (18·5/100 000 population). This study provides a credible estimate of the incidence of severe diarrhoea due to cholera in Bangladesh, which can be used to assess the cost-effectiveness of cholera prevention activities.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Incidence of severe diarrhoea due to Vibrio cholerae in the catchment area of six surveillance hospitals in Bangladesh
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Incidence of severe diarrhoea due to Vibrio cholerae in the catchment area of six surveillance hospitals in Bangladesh
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Incidence of severe diarrhoea due to Vibrio cholerae in the catchment area of six surveillance hospitals in Bangladesh
      Available formats
      ×

Copyright

Corresponding author

*Author for correspondence: Mr R. C. Paul, Assistant Scientist, Centre for Communicable Diseases, icddr,b, 68, Shahid Tajuddin Ahmed Sharani, Mohakhali, Dhaka-1212, Bangladesh. (Email: repon@icddrb.org)

References

Hide All
1. Snow, J. On the mode of communication of cholera, 1855. Salud publica de Mexico 1991; 33: 194201.
2. Sack, DA, et al. Cholera. Lancet 2004; 363: 223233.
3. Anon. Large epidemic of cholera-like disease in Bangladesh caused by Vibrio cholerae O139 synonym Bengal. Cholera Working Group, International Centre for Diarrhoeal Diseases Research, Bangladesh. Lancet 1993; 342: 387390.
4. Nair, GB, et al. Spread of Vibrio cholerae O139 Bengal in India. Journal of Infectious Diseases 1994; 169: 10291034.
5. World Health Organization. Cholera outbreak: assessing the outbreak response and improving preparedness: Global Task Force on Cholera Control, 2004.
6. Deen, JL, et al. The high burden of cholera in children: comparison of incidence from endemic areas in Asia and Africa. PLoS Neglected Tropical Diseases 2008; 2: e173.
7. WHO. Cholera vaccines. Weekly Epidemiological Record 2011; 76: 117124.
8. WHO. Cholera surveillance and number of cases . Geneva: WHO (http://www.who.int/topics/cholera/surveillance/en/index.html). Accessed 22 August 2012.
9. Kimball, AM, Wong, KY, Taneda, K. An evidence base for international health regulations: quantitative measurement of the impacts of epidemic disease on international trade. Revue Scientifique et Technique (International Office of Epizootics) 2005; 24: 825832.
10. Sack, RB, et al. A 4-year study of the epidemiology of Vibrio cholerae in four rural areas of Bangladesh. Journal of Infectious Diseases 2003; 187: 96101.
11. Barua, D. History of Cholera. New York: Plenum Medical Book, 1992.
12. Schwartz, BS, et al. Diarrheal epidemics in Dhaka, Bangladesh, during three consecutive floods: 1988, 1998, and 2004. American Journal of Tropical Medicine and Hygiene 2006; 74: 10671073.
13. Lopez, AL, et al. Cholera vaccines for the developing world. Human Vaccines 2008; 4: 165169.
14. Clemens, JD, et al. Field trial of oral cholera vaccines in Bangladesh: results of one year of follow-up. Journal of Infectious Diseases 1988; 158: 6069.
15. Sur, D, et al. Efficacy and safety of a modified killed-whole-cell oral cholera vaccine in India: an interim analysis of a cluster-randomised, double-blind, placebo-controlled trial. Lancet 2009; 374: 16941702.
16. Andrews, JR, Basu, S. Transmission dynamics and control of cholera in Haiti: an epidemic model. Lancet 2011; 377: 12481255.
17. Bertuzzo, E, et al. Prediction of the spatial evolution and effects of control measures for the unfolding Haiti cholera outbreak. Geophysical Research Letters 2011; 38 (L06403).
18. Mari, L, et al. Modelling cholera epidemics: the role of waterways, human mobility and sanitation. Journal of the Royal Society Interface 2012; 9: 376388.
19. Tuite, AR, et al. Cholera epidemic in Haiti, 2010: using a transmission model to explain spatial spread of disease and identify optimal control interventions. Annals of Internal Medicine 2011; 154: 593601.
20. Chaignat, CL, Monti, V. Use of oral cholera vaccine in complex emergencies: what next? Summary report of an expert meeting and recommendations of WHO. Journal of Health, Population, and Nutrition 2007; 25: 244261.
21. Clemens, JD, et al. Field trial of oral cholera vaccines in Bangladesh: results from three-year follow-up. Lancet 1990; 335: 270273.
22. Sur, D, et al. Efficacy of a low-cost, inactivated whole-cell oral cholera vaccine: results from 3 years of follow-up of a randomized, controlled trial. PLoS Neglected Tropical Diseases 2011; 5: e1289.
23. Anwar, I. Perceptions of quality of care for serious illness at different levels of facilities in a rural area of Bangladesh. Journal of Health, Population, and Nutrition 2009; 27: 396405.
24. Alam, M, et al. Seasonal cholera caused by Vibrio cholerae serogroups O1 and O139 in the coastal aquatic environment of Bangladesh. Applied and Environmental Microbiology 2006; 72: 40964104.
25. WHO. World Health Organization Guidelines for the laboratory diagnosis of cholera , Geneva: WHO Bacterial Disease Unit, 1974.
26. Daniel WW. Biostatistics: A Foundation for Analysis in the Health Sciences, 7th edn. New York: John Wiley & Sons, 1999.
27. Paul, RC, et al. A novel low-cost approach to estimate the incidence of Japanese encephalitis in the catchment area of three hospitals in Bangladesh. American Journal of Tropical Medicine and Hygiene 2011; 85: 379385.
28. Homaira, N, et al. Influenza-associated mortality in 2009 in four sentinel sites in Bangladesh. Bulletin of the World Health Organization 2012; 90: 272278.
29. Biggs, HM, et al. Estimating leptospirosis incidence using hospital-based surveillance and a population-based health care utilization survey in Tanzania. PLoS Neglected Tropical Diseases 2013; 7: e2589.
30. Bangladesh Population and Housing Census 2011 (http://www.bbs.gov.bd/Home.aspx). Accessed 21 August 2012.
31. Rogers, WH. Regression standard errors in clustered samples. Stata Technical Bulletin 1993; 13: 1923.
32. Akanda, AS, Jutla, AS, Islam, S. Dual peak cholera transmission in Bengal Delta: a hydroclimatological explanation. Geophysical Research Letters 2009; 36 (19).
33. Bertuzzo, E, et al. Hydroclimatology of dual-peak annual cholera incidence: insights from a spatially explicit model. Geophysical Research Letters 2012; 39 (5).
34. Islam, N, et al. Slums of urban Bangladesh: mapping and census . Dhaka: Centre for Urban Studies, 2005.
35. Sur, D, et al. The burden of cholera in the slums of Kolkata, India: data from a prospective, community based study. Archives of Disease in Childhood 2005; 90: 11751181.
36. Sur, D, et al. Correlates for diarrhoea and treatment uptake in an impoverished slum area of Kolkata, India. Journal of Health, Population, and Nutrition 2004; 22: 130138.
37. Ali, M, et al. The global burden of cholera. Bulletin of the World Health Organization 2012; 90: 209218A.
38. Das, SK, et al. Geographical diversity in seasonality of major diarrhoeal pathogens in Bangladesh observed between 2010 and 2012. Epidemiology and Infection 2014; 142: 25302541.
39. King, AA, et al. Inapparent infections and cholera dynamics. Nature 2008; 454: 877880.
40. Longini, IM Jr., et al. Epidemic and endemic cholera trends over a 33-year period in Bangladesh. Journal of Infectious Diseases 2002; 186: 246251.
41. Carrel, M, et al. Spatio-temporal clustering of cholera: the impact of flood control in Matlab, Bangladesh, 1983–2003. Health & Place 2009; 15: 741752.
42. Alam, M, et al. Diagnostic limitations to accurate diagnosis of cholera. Journal of Clinical Microbiology 2010; 48: 39183922.
43. Colwell, RR, et al. Viable but non-culturable Vibrio cholerae O1 revert to a cultivable state in the human intestine. World Journal of Microbiology & Biotechnology 1996; 12: 2831.
44. Faruque, SM, et al. Transmissibility of cholera: in vivo-formed biofilms and their relationship to infectivity and persistence in the environment. Proceedings of the National Academy of Sciences USA 2006; 103: 63506355.
45. Boncy, J, et al. Performance and utility of a rapid diagnostic test for cholera: notes from Haiti. Diagnostic Microbiology and Infectious Disease 2013; 76: 521523.
46. Ley, B, et al. Evaluation of a rapid dipstick (Crystal VC) for the diagnosis of cholera in Zanzibar and a comparison with previous studies. PLoS ONE 2012; 7: e36930.
47. Nato, F, et al. One-step immunochromatographic dipstick tests for rapid detection of Vibrio cholerae O1 and O139 in stool samples. Clinical and Diagnostic Laboratory Immunology 2003; 10: 476478.
48. Waldman, RJ, Mintz, ED, Papowitz, HE. The cure for cholera – improving access to safe water and sanitation. New England Journal of Medicine 2013; 368: 592594.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed