Last data update: Jun 03, 2024. (Total: 46935 publications since 2009)
Records 1-3 (of 3 Records) |
Query Trace: N'Cho H S [original query] |
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Risk factors for epidemic cholera in Lusaka, Zambia-2017
Nanzaluka FH , Davis WW , Mutale L , Kapaya F , Sakubita P , Langa N , Gama A , N'Cho H S , Malambo W , Murphy J , Blackstock A , Mintz E , Riggs M , Mukonka V , Sinyange N , Yard E , Brunkard J . Am J Trop Med Hyg 2020 103 (2) 646-651 On October 6, 2017, the Zambia Ministry of Health declared a cholera outbreak in Lusaka. By December, 1,462 cases and 38 deaths had occurred (case fatality rate, 2.6%). We conducted a case-control study to identify risk factors and inform interventions. A case was any person with acute watery diarrhea (>/= 3 loose stools in 24 hours) admitted to a cholera treatment center in Lusaka from December 16 to 21, 2017. Controls were neighbors without diarrhea during the same time period. Up to two controls were matched to each case by age-group (1-4, 5-17, and >/= 18 years) and neighborhood. Surveyors interviewed cases and controls, tested free chlorine residual (FCR) in stored water, and observed the presence of soap in the home. Conditional logistic regression was used to generate matched odds ratios (mORs) based on subdistricts and age-groups with 95% CIs. We enrolled 82 cases and 132 controls. Stored water in 71% of case homes had an FCR > 0.2 mg/L. In multivariable analyses, those who drank borehole water (mOR = 2.4, CI: 1.1-5.6), had close contact with a cholera case (mOR = 6.2, CI: 2.5-15), and were male (mOR = 2.5, CI: 1.4-5.0) had higher odds of being a cholera case than their matched controls. The use of groundwater for drinking, contact with a cholera case, and male gender were associated with cholera. Based on these findings, we recommended health education about household water chlorination and hygiene in the home. Emergency responses included providing chlorinated water through emergency tanks and maintaining adequate FCR levels through close monitoring of water sources. |
Notes from the Field: Typhoid fever outbreak - Harare, Zimbabwe, October 2017-February 2018
N'Cho H S , Masunda KPE , Mukeredzi I , Manangazira P , Govore E , Duri C , Aubert RD , Martin H , Gonese E , Vere M , Tippett Barr BA , Balachandra S , Strysko J , Davis WW , Appiah GD , Mintz E . MMWR Morb Mortal Wkly Rep 2019 68 (2) 44-45 On October 16, 2017, the Harare City Health Department (HCHD) in Zimbabwe identified a suspected typhoid fever (typhoid) case in a resident of Harare’s Mbare suburb. Typhoid is a potentially fatal illness caused by Salmonella enterica serovar Typhi (Typhi). HCHD initiated an investigation and identified a cluster of 17 suspected typhoid cases, defined as the occurrence of fever and at least one of the following symptoms: headache, malaise, abdominal discomfort, vomiting, diarrhea, cough, or constipation. A confirmed case had Typhi isolated from blood, stool, or rectal swab culture (1). | | As of February 24, 2018 (the most recent publicly available data), 3,187 suspected and 191 confirmed cases were identified (Figure), with no reported deaths among confirmed cases. Among suspected cases, 1,696 (53%) patients were male, and median age was 17 years (range = 1 month–90 years). In addition to clusters in Mbare, clusters were detected in Harare’s western suburbs, including Kuwadzana, where high rates of ciprofloxacin-resistant Typhi were identified. |
Cholera epidemic - Lusaka, Zambia, October 2017-May 2018
Sinyange N , Brunkard JM , Kapata N , Mazaba ML , Musonda KG , Hamoonga R , Kapina M , Kapaya F , Mutale L , Kateule E , Nanzaluka F , Zulu J , Musyani CL , Winstead AV , Davis WW , N'Cho H S , Mulambya NL , Sakubita P , Chewe O , Nyimbili S , Onwuekwe EVC , Adrien N , Blackstock AJ , Brown TW , Derado G , Garrett N , Kim S , Hubbard S , Kahler AM , Malambo W , Mintz E , Murphy J , Narra R , Rao GG , Riggs MA , Weber N , Yard E , Zyambo KD , Bakyaita N , Monze N , Malama K , Mulwanda J , Mukonka VM . MMWR Morb Mortal Wkly Rep 2018 67 (19) 556-559 On October 6, 2017, an outbreak of cholera was declared in Zambia after laboratory confirmation of Vibrio cholerae O1, biotype El Tor, serotype Ogawa, from stool specimens from two patients with acute watery diarrhea. The two patients had gone to a clinic in Lusaka, the capital city, on October 4. Cholera cases increased rapidly, from several hundred cases in early December 2017 to approximately 2,000 by early January 2018 (Figure). In collaboration with partners, the Zambia Ministry of Health (MoH) launched a multifaceted public health response that included increased chlorination of the Lusaka municipal water supply, provision of emergency water supplies, water quality monitoring and testing, enhanced surveillance, epidemiologic investigations, a cholera vaccination campaign, aggressive case management and health care worker training, and laboratory testing of clinical samples. In late December 2017, a number of water-related preventive actions were initiated, including increasing chlorine levels throughout the city's water distribution system and placing emergency tanks of chlorinated water in the most affected neighborhoods; cholera cases declined sharply in January 2018. During January 10-February 14, 2018, approximately 2 million doses of oral cholera vaccine were administered to Lusaka residents aged >/=1 year. However, in mid-March, heavy flooding and widespread water shortages occurred, leading to a resurgence of cholera. As of May 12, 2018, the outbreak had affected seven of the 10 provinces in Zambia, with 5,905 suspected cases and a case fatality rate (CFR) of 1.9%. Among the suspected cases, 5,414 (91.7%), including 98 deaths (CFR = 1.8%), occurred in Lusaka residents. |
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