Cholera in Ecuador: Current relevance of past lessons learnt

Malavade, SS; Narvaez, A; Mitra, Anindya; Ochoa, Theresa J.; Naik, Eknath; Sharma, Monica; Galwankar, Sagar; Breglia,; Izurieta, Ricardo

doi:10.4103/0974-777x.81699

Cited by 6 publications

(4 citation statements)

References 5 publications

(6 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…There is ample evidence of the importance of water quality from the Mexican 1991 epidemic [ 24 ]. Contaminated water sources and the resultant water quality were found to be the most common causes for cholera in separate studies in Peru, Mexico and Ecuador [ 25 , 26 ]. However, the government of Cameroon has been building more potable water points to salvage this situation.…”

Section: Discussionmentioning

confidence: 99%

Assessing the risk factors of cholera epidemic in the Buea Health District of Cameroon

et al. 2015

View full text Add to dashboard Cite

BackgroundCholera is an acute diarrheal disease caused by the bacterium, Vibrio cholerae. A cholera epidemic occurred in Cameroon in 2010. After a cholera-free period at the end of 2010, new cases started appearing in early 2011. The disease affected 23,152 people and killed 843, with the South West Region registering 336 cases and 13 deaths. Hence, we assessed the risk factors of cholera epidemic in the Buea Health District to provide evidence-based cholera guidelines.MethodsWe conducted an unmatched case–control study. Cases were identified from health facility records and controls were neighbours of the cases in the same community. We interviewed 135 participants on socio-economic, household hygiene, food and water exposures practices using a semi-structured questionnaire. Data was analyzed using STATA. Fisher exact test and logistic regression were computed. P < 0.05 was considered to be statistically significant.ResultsThe 135 participants included 34 (25.2 %) cholera cases and 101 (74.8 %) controls. More females [78 (57.8 %)] participated in the study. Ages ranged from 1 year 3 months to 72 years; with a mean of 29.86 (±14.51) years. The cholera attack rate was 0.03 % with no fatality. Most participants [129 (99.2 %)] had heard of cholera. Poor hygienic practices [77 (59.2 %)] and contaminated water sources [54 (41.5 %)] were the main reported transmission routes of cholera. Good hygienic practices [108 (83.1 %)] were the main preventive methods of cholera in both cases [23 (76.6 %)] and controls [85 (85.0 %)]. Logistic regression analysis showed age below 21 years (OR = 1.72, 95 % CI: 0.73–4.06, p = 0.251), eating outside the home (OR = 1.06, CI: 0.46–2.43, p = 1.00) and poor food preservation method (OR = 9.20, CI: 3.67–23.08, p < 0.0001) were independent risk factors of cholera. Also, irregular water supply (OR = 0.66, 95 % CI: 0.30–1.43, p = 0.320), poor kitchen facility (OR = 0.60, CI: 0.16–2.23, p = 0.560), lack of home toilet (OR = 0.69, CI: 0.25–1.86, p = 0.490), and education below tertiary (OR = 0.87, 95 % CI: 0.36–2.11, p = 0.818) were independent protective factors for the occurrence of cholera.ConclusionThere was a good knowledge of cholera among participants. Poor food preservation method was a significant independent risk factor of cholera. Improvement in hygiene and sanitation conditions and water infrastructural development is crucial to combating the epidemic.

show abstract

Section: Discussionmentioning

confidence: 99%

Assessing the risk factors of cholera epidemic in the Buea Health District of Cameroon

et al. 2015

View full text Add to dashboard Cite

show abstract

“…Soon after the Peru outbreak, cholera was reported in Ecuador in February 1991, 6 weeks after the initial outbreak, and quickly spread across the country [55]. An outbreak was soon reported in Colombia and Brazil, and subsequently reached Bolivia and all other South American countries by 1992 [51].…”

Section: The Peruvian Epidemicmentioning

confidence: 99%

Cholera dynamics: lessons from an epidemic

Balasubramanian

Murcia

Ogbunugafor

et al. 2021

Journal of Medical Microbiology

View full text Add to dashboard Cite

Cholera is a severe diarrhoeal disease that spreads rapidly and affects millions of people each year, resulting in tens of thousands of deaths. The disease is caused by Vibrio cholerae O1 and is characterized by watery diarrhoea that can be lethal if not properly treated. Cholera had not been reported in South America from the late 1800s until 1991, when it was introduced in Peru, wreaking havoc in one of the biggest epidemics reported to date. Within a year, the disease had spread to most of the Latin American region, resulting in millions of cases and thousands of deaths in all affected countries. Despite its aggressive entry, cholera virtually disappeared from the continent after 1999. The progression of the entire epidemic was well documented, making it an ideal model to understand cholera dynamics. In this review, we highlight how the synergy of socioeconomic, political and ecological factors led to the emergence, rapid spread and eventual disappearance of cholera in Latin America. We discuss how measures implemented during the cholera epidemic drastically changed its course and continental dynamics. Finally, we synthesize our findings and highlight potential lessons that can be learned for efficient and standardized cholera management programmes during future outbreaks in non-endemic areas.

show abstract

“…El Oro and Guayas provinces, located in southern coastal Ecuador, collectively represented one of two disease epicenters in the country. Recent studies indicate a high risk of a second epidemic in Ecuador due to the presence of important risk factors including the growth of vulnerable urban populations, decreased investment in cholera surveillance and prevention programs, increased flood risk associated with climate change, and a street food culture that includes eating raw shellfish (ceviche) [ 23 ]. In addition, Guayaquil (Guayas Province), the largest city in Ecuador, has been identified as the third most vulnerable city in the world to future flood risk [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Spatiotemporal Variation in Environmental Vibrio cholerae in an Estuary in Southern Coastal Ecuador

Ryan

Stewart-Ibarra

Ordóñez-Enireb

et al. 2018

IJERPH

View full text Add to dashboard Cite

Cholera emergence is strongly linked to local environmental and ecological context. The 1991–2004 pandemic emerged in Perú and spread north into Ecuador’s El Oro province, making this a key site for potential re-emergence. Machala, El Oro, is a port city of 250,000 inhabitants, near the Peruvian border. Many livelihoods depend on the estuarine system, from fishing for subsistence and trade, to domestic water use. In 2014, we conducted biweekly sampling for 10 months in five estuarine locations, across a gradient of human use, and ranging from inland to ocean. We measured water-specific environmental variables implicated in cholera growth and persistence: pH, temperature, salinity, and algal concentration, and evaluated samples in five months for pathogenic and non-pathogenic Vibrio cholerae, by polymerase chain reaction (PCR). We found environmental persistence of pandemic strains O1 and O139, but no evidence for toxigenic strains. Vibrio cholerae presence was coupled to algal and salinity concentration, and sites exhibited considerable seasonal and spatial heterogeneity. This study indicates that environmental conditions in Machala are optimal for cholera re-emergence, with risk peaking during September, and higher risk near urban periphery low-income communities. This highlights a need for surveillance of this coupled cholera–estuarine system to anticipate potential future cholera outbreaks.

show abstract

Cholera in Ecuador: Current relevance of past lessons learnt

Cited by 6 publications

References 5 publications

Assessing the risk factors of cholera epidemic in the Buea Health District of Cameroon

Assessing the risk factors of cholera epidemic in the Buea Health District of Cameroon

Cholera dynamics: lessons from an epidemic

Spatiotemporal Variation in Environmental Vibrio cholerae in an Estuary in Southern Coastal Ecuador

Contact Info

Product

Resources

About