Stanley Juin, Edwige Michel, Wilfredo R Matias, Evenel Thermidor, Molly F Franke, Michelle V Evans, Hetsner Denis, Yodeline Guillaume, Roberta Bouilly, Wisnel Mathurin, Katilla Pierre, Valusnor Compere, Kenold Rendel, Hebrelienne Amelus, Lesly Andrecy, Gerard A Joseph, Jacques Boncy, Donald Lafontant, Louise C Ivers
{"title":"Water Insecurity, Sociopolitical Instability, and Resurgence of Cholera in Haiti, 2022: An Outbreak Investigation.","authors":"Stanley Juin, Edwige Michel, Wilfredo R Matias, Evenel Thermidor, Molly F Franke, Michelle V Evans, Hetsner Denis, Yodeline Guillaume, Roberta Bouilly, Wisnel Mathurin, Katilla Pierre, Valusnor Compere, Kenold Rendel, Hebrelienne Amelus, Lesly Andrecy, Gerard A Joseph, Jacques Boncy, Donald Lafontant, Louise C Ivers","doi":"10.4269/ajtmh.24-0755","DOIUrl":null,"url":null,"abstract":"<p><p>We investigated a resurgence of cholera in Haiti in 2022, occurring after 3 years without cases. We analyzed data from the National Cholera Surveillance System for the first reported cases in 2022 and interviewed field epidemiology teams. We used logistic regression to identify risk factors associated with confirmed cholera. Few suspected cases reported ever receiving oral cholera vaccine (14%) or previous hospitalization for cholera (7%). Recently changing water sources were associated with culture-confirmed cholera (odds ratio 5.55, 95% CI 2.13-15.12). Spatial analysis of cholera cases revealed significant clustering (P = 0.001) and low prevalence (11%, 15 of 136) of residual chlorine in private water points in the affected area. Qualitative analysis suggested a link between cholera resurgence and an acute lack of access to safe water because of gang violence. Ongoing response to cholera in Haiti is crucial, alongside sustained investment in long-term solutions like improved water and sanitation infrastructure and addressing socioeconomic issues.</p>","PeriodicalId":7752,"journal":{"name":"American Journal of Tropical Medicine and Hygiene","volume":" ","pages":""},"PeriodicalIF":1.9000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American Journal of Tropical Medicine and Hygiene","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.4269/ajtmh.24-0755","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH","Score":null,"Total":0}
引用次数: 0
Abstract
We investigated a resurgence of cholera in Haiti in 2022, occurring after 3 years without cases. We analyzed data from the National Cholera Surveillance System for the first reported cases in 2022 and interviewed field epidemiology teams. We used logistic regression to identify risk factors associated with confirmed cholera. Few suspected cases reported ever receiving oral cholera vaccine (14%) or previous hospitalization for cholera (7%). Recently changing water sources were associated with culture-confirmed cholera (odds ratio 5.55, 95% CI 2.13-15.12). Spatial analysis of cholera cases revealed significant clustering (P = 0.001) and low prevalence (11%, 15 of 136) of residual chlorine in private water points in the affected area. Qualitative analysis suggested a link between cholera resurgence and an acute lack of access to safe water because of gang violence. Ongoing response to cholera in Haiti is crucial, alongside sustained investment in long-term solutions like improved water and sanitation infrastructure and addressing socioeconomic issues.
期刊介绍:
The American Journal of Tropical Medicine and Hygiene, established in 1921, is published monthly by the American Society of Tropical Medicine and Hygiene. It is among the top-ranked tropical medicine journals in the world publishing original scientific articles and the latest science covering new research with an emphasis on population, clinical and laboratory science and the application of technology in the fields of tropical medicine, parasitology, immunology, infectious diseases, epidemiology, basic and molecular biology, virology and international medicine.
The Journal publishes unsolicited peer-reviewed manuscripts, review articles, short reports, images in Clinical Tropical Medicine, case studies, reports on the efficacy of new drugs and methods of treatment, prevention and control methodologies,new testing methods and equipment, book reports and Letters to the Editor. Topics range from applied epidemiology in such relevant areas as AIDS to the molecular biology of vaccine development.
The Journal is of interest to epidemiologists, parasitologists, virologists, clinicians, entomologists and public health officials who are concerned with health issues of the tropics, developing nations and emerging infectious diseases. Major granting institutions including philanthropic and governmental institutions active in the public health field, and medical and scientific libraries throughout the world purchase the Journal.
Two or more supplements to the Journal on topics of special interest are published annually. These supplements represent comprehensive and multidisciplinary discussions of issues of concern to tropical disease specialists and health issues of developing countries