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Epidemiol Health. 2019;41:e2019015. doi: 10.4178/epih.e2019015. Epub 2019 Apr 21.

Risk factors associated with the recent cholera outbreak in Yemen: a case-control study.

Author information

1
The Modern Social Association, Aden, Yemen.
2
Heidelberg Institute of Global Health, Heidelberg University School of Medicine, Heidelberg, Germany.
3
Institute of Medical Biometry and Informatics, Heidelberg University School of Medicine, Heidelberg, Germany.
4
Health and Education Association for Development (SAWT), Aden, Yemen.
5
Community Medicine Department, Faculty of Medicine, University of Aden, Aden, Yemen.
6
Institute of Public Health, Jagiellonian University Medical College, Krakow, Poland.

Abstract

OBJECTIVES:

The cholera outbreak in Yemen has become the largest in the recent history of cholera records, having reached more than 1.4 million cases since it started in late 2016. This study aimed to identify risk factors for cholera in this outbreak.

METHODS:

A case-control study was conducted in Aden in 2018 to investigate risk factors for cholera in this still-ongoing outbreak. In total, 59 cholera cases and 118 community controls were studied.

RESULTS:

The following risk factors were associated with being a cholera case in the bivariate analysis: a history of travelling and having had visitors from outside Aden Province; eating outside the house; not washing fruit, vegetables, and khat (a local herbal stimulant) before consumption; using common-source water; and not using chlorine or soap in the household. In the multivariate analysis, not washing khat and the use of common-source water remained significant risk factors for being a cholera case.

CONCLUSIONS:

Behavioural factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen. In order to reduce the risk of cholera, hygiene practices for washing khat and vegetables and the use and accessibility of safe drinking water should be promoted at the community level.

KEYWORDS:

Case-control studies; Cholera; Conflict; Khat; Risk factors; Yemen

PMID:
31010279
PMCID:
PMC6533552
DOI:
10.4178/epih.e2019015
[Indexed for MEDLINE]
Free PMC Article

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