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Epidemic cholera in urban Zambia: hand soap and dried fish as protective factors

Published online by Cambridge University Press:  20 April 2006

A. E. DUBOIS ,
M. SINKALA ,
P. KALLURI ,
M. MAKASA-CHIKOYA  and
R. E. QUICK
A. E. DUBOIS
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA Epidemic Intelligence Service, Epidemiology Program Office, Office of Workforce and Career Development, Centers for Disease Control and Prevention, Atlanta, GA, USA
M. SINKALA
Affiliation:
Lusaka District Health Management Team, Lusaka, Zambia
P. KALLURI
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
M. MAKASA-CHIKOYA
Affiliation:
Lusaka District Health Management Team, Lusaka, Zambia
R. E. QUICK
Affiliation:
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Abstract

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Between 28 November 2003 and 23 February 2004, 4343 cases and 154 deaths from cholera (case-fatality rate 3·5%) were reported in Lusaka, Zambia. A case-control study was conducted in February 2004 to assess potential transmission routes and prevention strategies. Consumption of raw vegetables was significantly associated with cholera [adjusted odds ratio (aOR) 4·7, 95% confidence interval (CI) 1·7–13, P=0·003). Consumption of a local sardine-like fish was protective (aOR 0·3, 95% CI 0·1–0·7, P=0·008). Hand soap was present in 90% of control homes and 58% of case homes. Observed hand soap was a strongly protective factor (aOR 0·1, 95% CI 0·04–0·4, P=0·001). No water source or treatment practice was significantly associated with cholera. This study documents the importance of foodborne transmission of cholera, illustrates the protective role of hand washing in an epidemic setting, and identifies a novel possible protective factor, a local fish, which warrants further research.

Type
Short Report
Information
Epidemiology & Infection , Volume 134 , Issue 6 , December 2006 , pp. 1226 - 1230
Copyright
2006 Cambridge University Press