Prevalence and antimicrobial susceptibility pattern of Vibrio cholerae isolates from cholera outbreak sites in Ethiopia

Abstract

Background: Cholera is an acute infectious disease caused by ingestion of Vibrio cholerae (V. cholerae) with contaminated food or water. 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 atOromia 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. Culture, biochemical and serological tests were performed to identify and characterize V. cholerae. In addition, antibiotic susceptibility test 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. choleraeisolates were O1 serogroups 90.4% (n=113) and Ogawa serotypes 86.4% (n=108). Majority of the isolates were susceptible to ciprofloxacillin 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, drank river water were about three times more at risk for V. cholerae infection (AOR: 2.8, 95%CI: 1.08- 7.08). Conclusion: The prevalence of V. cholerae from fecal samples was high. The predominant serogroups and serotypes were O1 and Ogawa, respectively. Majority of the isolates were susceptible to most of the antibiotics tested. 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.

Key Considerations: Social, Structural and Community Dynamics of Cholera Transmission and Mortality in Ethiopia

“…Safe, piped water sources Communities and individuals without access to safe, piped water sources often rely on contaminated surface water or unsafe open wells for water to drink and wash. 43,44 Using these unreliable water sources increases people's exposure to cholera-causing bacteria and other pathogens in faecal matter. Around half of Ethiopia's population lacks access to safe drinking water, and 85% of schools lack a safe water supply.…”

“…However, political insecurity, rising reports of criminal activity and internal population displacement present major challenges for disease surveillance and intervention. 44,52 Refugees, asylum seekers and IDPs are at elevated risk of exposure to cholera. Ethiopia is the third largest host for refugees in Africa.…”