Enhancing community awareness is crucial during cholera outbreaks resulting from untreated water consumption: a case-control study and environmental investigation, Mifi Health District, West Region-Cameroon, July 2022
1
1 Department for Disease, Epidemics and Pandemics Control, Ministry of Public Health, Yaounde, Cameroon
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2 Department of Microbiology and Parasitology, Faculty of Science, University of Buea, Buea, Cameroon
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3 Department of Public Health, University of Yaounde 1, Yaounde, Cameroon
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4 Cameroon Field Epidemiology Training Program, Ministry of Public Health, Yaounde, Cameroon
5
5 National Public Health Laboratory, Ministry of Public Health, Yaounde, Cameroon
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6 National Human African Trypanosomiasis Control Program, Ministry of Public Health, Yaounde, Cameroon
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
INTRODUCTION:
Diarrheal diseases are a leading cause of death in children under 5 years in Cameroon(1). Climate change, driving increased flooding and droughts, threatens the progress made in reducing diarrheal disease burden over the past decades(2). Cholera outbreaks have been increasing in Cameroon since 2018(3). In 2022, five cholera cases were confirmed in the Mifi health district, marking the first recorded cholera outbreak for the past ten years in West-Region. A water source was suspected to be contaminated. A multidisciplinary team was deployed to identify the risk factors and investigate water contamination.
METHODS:
We conducted a matched 1:2 case-control study (age and sex). Cases were persons having acute watery diarrhea confirmed by stool culture or an epidemiological link to a laboratory-confirmed case between May and July 2022. Controls were persons who did not have diarrhea and were enrolled in the same neighborhood. We described cases by time, place and sociodemographic characteristics (age, sex, state of dehydration, incidence rate, case fatality rate [CFR]). Water was assessed with WHO water source inspection form and microbiological analysis. We calculated adjusted odds ratios (aORs) to identify risk factors.
RESULTS:
Eighty-two cases were reported, but we identified a total of 172 cases through active case finding from 75% (15/20) health areas [median age: 32 years (IQR: 14-50)]. The incidence rate was 39 cases/100000 inhabitants, and the CFR was 2.33% (4/172). Fifteen cases (9%) experienced severe dehydration. Untreated water consumption (aOR=13.1; 95% CI: 2.3-75.1) and handwashing without soap (aOR=4.7; 95% CI: 1.6-13.7) were risk factors. Twenty-six percent (8/31) of the water sources tested were classified as very high risk according to WHO criteria. Vibrio cholerae was not isolated from the water samples.
CONCLUSIONS:
Sensitizing communities on safe hygiene practices and enhancing environmental surveillance of cholera among national guidelines for surveillance could improve cholera control.
Diarrheal diseases are a leading cause of death in children under 5 years in Cameroon(1). Climate change, driving increased flooding and droughts, threatens the progress made in reducing diarrheal disease burden over the past decades(2). Cholera outbreaks have been increasing in Cameroon since 2018(3). In 2022, five cholera cases were confirmed in the Mifi health district, marking the first recorded cholera outbreak for the past ten years in West-Region. A water source was suspected to be contaminated. A multidisciplinary team was deployed to identify the risk factors and investigate water contamination.
METHODS:
We conducted a matched 1:2 case-control study (age and sex). Cases were persons having acute watery diarrhea confirmed by stool culture or an epidemiological link to a laboratory-confirmed case between May and July 2022. Controls were persons who did not have diarrhea and were enrolled in the same neighborhood. We described cases by time, place and sociodemographic characteristics (age, sex, state of dehydration, incidence rate, case fatality rate [CFR]). Water was assessed with WHO water source inspection form and microbiological analysis. We calculated adjusted odds ratios (aORs) to identify risk factors.
RESULTS:
Eighty-two cases were reported, but we identified a total of 172 cases through active case finding from 75% (15/20) health areas [median age: 32 years (IQR: 14-50)]. The incidence rate was 39 cases/100000 inhabitants, and the CFR was 2.33% (4/172). Fifteen cases (9%) experienced severe dehydration. Untreated water consumption (aOR=13.1; 95% CI: 2.3-75.1) and handwashing without soap (aOR=4.7; 95% CI: 1.6-13.7) were risk factors. Twenty-six percent (8/31) of the water sources tested were classified as very high risk according to WHO criteria. Vibrio cholerae was not isolated from the water samples.
CONCLUSIONS:
Sensitizing communities on safe hygiene practices and enhancing environmental surveillance of cholera among national guidelines for surveillance could improve cholera control.
| eISSN: | 2654-1459 |
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