Cholera outbreak investigation among children in Nishter Town District Lahore, Pakistan - May- June 2022: a retrospective cohort study
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CDC, Rawalpindi Cantt., Pakistan
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A231
In April 2022, National IHR Focal Point of Pakistan reported laboratory confirmed outbreak of Cholera. District Lahore reported highest number of Cholera cases from May – August 2022 in Province Punjab thus been epicenter of Cholera. WHO Global Task Force on Cholera Control focuses on containing Cholera outbreaks. In this regard joint field investigation team was formed of FELTP fellows, Communicable Disease & Epidemic Control Department and WHO to assess magnitude of outbreak, evaluate associated risk factors and recommend Prevention control measures. Retrospective Cohort study was designed on AWD/suspected Cholera cases enrolled from Children hospital. Cholera suspected case was defined as any child up to 12 years of age presenting with acute watery diarrhea of three or more loose watery (non-bloody) stools and severe dehydration within 24-hour period resident of Nishter town from 15th May -30th June2022 .Pre tested Questionnaire was adopted for Epidemiological Analysis .Environmental drinking Water and stool samples were sent to Public Health Lab for microbiological analysis .Descriptive analysis, attack rates and Risk factors were evaluated by applying logistic regression at CI=95% and p-value<0.05. Out of 288 AWD cases, Vibrio Cholera was isolated in 30 cases (Attack rate 10.4%). The mean age was 3.8 years (Range: 1 -12 years) included 163 (56.5%) male .Data Analysis showed Clustering of Cholera cases in age group 0-2 years( AR= 48%).Among five water sources used by residents , filtration plant water (AR=22%)(RR;4.6 95%CI=2.0-8.2 ) Municipal water (AR=16.6%)(RR;1.7; 95%CI=0.5-4.9 ) and Underground water (AR=4%)(RR;0.18; 95%CI=0.08-0.42 ) had highest water specific attack rates .On Logistic regression AOR 6.77 (CI=2.7-16.7) for filtration plant water was found significantly associated with cholera .Microbiological Examination of Filtration plant water reported E-coli and Coliform growth. Conclusions: This was point source outbreak due to Filtration plant mixed with sewage water. Multisectoral approach and Community awareness on WASH is suggested.
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