Water Insecurity, Sociopolitical Instability, and Resurgence of Cholera in Haiti, 2022: An Outbreak Investigation.

IF 1.9 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
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
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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.

水不安全,社会政治不稳定,和霍乱在海地的死灰复燃,2022年:一项疫情调查。
我们调查了海地在3年无病例后于2022年再次出现的霍乱。我们分析了国家霍乱监测系统对2022年首次报告病例的数据,并采访了现场流行病学小组。我们使用逻辑回归来确定与确诊霍乱相关的危险因素。据报告,很少有疑似病例曾接受口服霍乱疫苗(14%)或曾因霍乱住院(7%)。最近水源的改变与培养证实的霍乱有关(优势比5.55,95%可信区间2.13-15.12)。霍乱病例的空间分析显示,疫区私人供水点的余氯呈显著聚集性(P = 0.001),流行率较低(11%,136人中有15人)。定性分析表明,霍乱卷土重来与帮派暴力造成的严重缺乏安全饮用水之间存在联系。持续应对海地霍乱至关重要,同时持续投资于改善水和卫生基础设施以及解决社会经济问题等长期解决方案。
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来源期刊
American Journal of Tropical Medicine and Hygiene
American Journal of Tropical Medicine and Hygiene 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.20
自引率
3.00%
发文量
508
审稿时长
3 months
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
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