TY - JOUR
T1 - Risk factors for household transmission of vibrio cholerae in Dhaka, Bangladesh (CHoBI7 Trial)
AU - Burrowes, Vanessa
AU - Perin, Jamie
AU - Monira, Shirajum
AU - Sack, David A.
AU - Rashid, Mahamud Ur
AU - Mahamud, Toslim
AU - Rahman, Zillur
AU - Mustafiz, Munshi
AU - Bhuyian, Sazzadul I.
AU - Begum, Farzana
AU - Zohura, Fatema
AU - Biswas, Shwapon
AU - Parvin, Tahmina
AU - Hasan, Tasdik
AU - Zhang, Xiaotong
AU - Sack, Bradley R.
AU - Saif-Ur-Rahman, K. M.
AU - Alam, Munirul
AU - George, Christine Marie
N1 - Publisher Copyright:
Copyright © 2017 by The American Society of Tropical Medicine and Hygiene.
PY - 2017
Y1 - 2017
N2 - 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.
AB - 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.
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U2 - 10.4269/ajtmh.16-0871
DO - 10.4269/ajtmh.16-0871
M3 - Article
C2 - 28719281
AN - SCOPUS:85020416790
SN - 0002-9637
VL - 96
SP - 1382
EP - 1387
JO - American Journal of Tropical Medicine and Hygiene
JF - American Journal of Tropical Medicine and Hygiene
IS - 6
ER -