Risk factors for cholera transmission in Haiti during inter-peak periods: insights to improve current control strategies from two case-control studies. Epidemiol Infect. 2014 Aug.
Grandesso F1, Allan M1, Jean-Simon PS2, Boncy J3, Blake A1, Pierre R4, Alberti KP1, Munger A2, Elder G5, Olson D5, Porten K1, Luquero FJ1.
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1Epicentre, Paris,France.
2Médecins sans Frontières, Paris,France.
3Laboratoire National de Santé Publique, Ministère de la Santé Publique et de la Population, Port-au-Prince,Haiti.
4Direction Sanitaire de l’Artibonite, Gonaives,Haiti.
5Médecins sans Frontières, New York,USA.
SUMMARY Two community-based density case-control studies were performed to assess risk factors for cholera transmission during inter-peak periods of the ongoing epidemic in two Haitian urban settings, Gonaives and Carrefour. The strongest associations were: close contact with cholera patients (sharing latrines, visiting cholera patients, helping someone with diarrhoea), eating food from street vendors and washing dishes with untreated water. Protective factors were: drinking chlorinated water, receiving prevention messages via television, church or training sessions, and high household socioeconomic level.
These findings suggest that, in addition to contaminated water, factors related to direct and indirect inter-human contact play an important role in cholera transmission during inter-peak periods. In order to reduce cholera transmission in Haiti intensive preventive measures such as hygiene promotion and awareness campaigns should be implemented during inter-peak lulls, when prevention activities are typically scaled back.
