Risk factors for household transmission of vibrio cholerae in Dhaka, Bangladesh (CHoBI7 Trial)

Vanessa Burrowes, Jamie Perin, Shirajum Monira, David A. Sack, Mahamud Ur Rashid, Toslim Mahamud, Zillur Rahman, Munshi Mustafiz, Sazzadul I. Bhuyian, Farzana Begum, Fatema Zohura, Shwapon Biswas, Tahmina Parvin, Tasdik Hasan, Xiaotong Zhang, Bradley R. Sack, K. M. Saif-Ur-Rahman, Munirul Alam, Christine Marie George

Research output: Contribution to journalArticlepeer-review

Abstract

Household contacts of cholera patients are at a 100 times higher risk of a Vibrio cholerae infection than the general population. To examine risk factors for V. cholerae infections and investigate intervention strategies among this population, we followed household contacts of cholera patients for the 1-week high-risk period after the index patient obtained care. This study was nested within a randomized controlled trial of the Cholera-Hospital- Based-Intervention-for-7-days (CHoBI7), a handwashing with soap and water treatment intervention in Dhaka, Bangladesh. Rectal swab results were available from 320 household contacts of cholera patients at five time points over a 1-week period. Fecal and water samples were analyzed for V. cholerae by bacterial culture. All analyses were stratified by study arm. Within the intervention arm, stored household drinking water with a median free chlorine concentration below 0.5 mg/L was associated with a three times higher odds of a cholera infection (odds ratio [OR]: 3.0; 95% confidence interval [CI]: 1.32, 6.63). In the control arm, having V. cholerae in stored water was associated with a significantly higher odds of a symptomatic cholera infection (OR: 8.66; 95% CI: 2.11, 35.48). No association was found between observed handwashing with soap at food and stool-related events and V. cholerae infections. Stored household drinking water with detectable V.cholerae and chlorine concentrations below the World Health Organization guideline were found to be important risk factors for cholera infection among household contacts of cholera patients. These findings emphasize the need for water treatment interventions targeting this high risk population.

Original languageEnglish (US)
Pages (from-to)1382-1387
Number of pages6
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume96
Issue number6
DOIs
StatePublished - 2017

ASJC Scopus subject areas

  • Parasitology
  • Virology
  • Infectious Diseases

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