Flags of the World · Statistics · International Relations · Travel · Religion Water-Borne Diseases: Cholera and Dysentery: Cholera: Scourge of the waters, which increase the risk of contracting cholera among area residents. . Areas without a safe water supply and good sanitation are at most risk for epidemic cholera. Cases of Cholera Reported in Canada Between and ; the risk of contaminating your water supply with other types of bacteria. Between and , the water supply system in Uvira will benefit from a €10 association between interruptions in water service and suspected cholera.
Outbreaks of cholera have been reported in areas with piped water systems that suffer from breaks in quality system and maintenance, including lack of chlorination, resulting in cross-contamination with the nearby sewage system 8 — Contamination of drinking-water due to disaster has been responsible for some of these incidents 2. Cholera affects both children and adults following ingestion of food or water contaminated with toxigenic bacterium Vibrio cholerae 12 — The enterotoxin of the bacillus causes copious painless watery diarrhoea which can lead to severe dehydration and death.
Two serogroups of Vibrio cholerae O1 and O are the commonest causes of outbreaks 12 They have a short incubation period ranging from two hours to five days, leading to explosive outbreaks Eighty percent of the cases can be successfully managed with oral rehydration formulation alone 14 Effective control measures rely on the prevention, preparedness, and early mitigation response Provision of safe water and sanitation is critical in reducing the impact of cholera and other waterborne diseases 14 It had the speed of kilometres per hour and caused widespread flooding and uprooting of trees and power-lines.
Subsequently, a week later, on 7 Januarya peripheral health facility reported clusters of cases with acute diarrhoea in two localities [population-size: An investigation team comprising local health authorities, experts from local referral hospitals, and a public health trainee from central health services investigated this cluster to confirm the outbreak; characterize the causal agent; describe the outbreak by time, place, and person; identify the sources; and formulate recommendations for the control of outbreak.
Further, we ascertained information regarding any recent population migration or changes in the surveillance system.The Great Stink - Full Documentary
We defined a case of diarrhoea according to the WHO guideline as the occurrence of more than three watery stools per day among the residents of affected localities between 6 and 18 January The investigation team conducted active door-to-door search for cases in the affected localities and also stimulated passive surveillance in health facilities in the costal district to identify new cases.
We collected personal history, including symptoms, from case-patients and established a line-listing. An epidemic curve was constructed to describe the development of the outbreak over time. We calculated the attack rate AR by age and gender, using population census available at the health centre as denominator.
The cases were plotted on a map to understand the spatial distribution.
To aid in generating hypotheses, we gathered information from case-patients, health workers, and local leaders, using an unstructured trawling questionnaire. On the basis of descriptive epidemiology and abovementioned interviews, we generated hypothesis about the possible sources of the outbreak.
Laboratory procedure We collected rectal swabs from patients admitted in government health facilities. We tested those by culture, antimicrobial sensitivity, and molecular characterization 18 The specimens were incubated in alkaline peptone water enrichment media for 6 hours.
Enriched cultures were inoculated in thiosulphate-citrate-bile salts-sucrose TCBS agar for Vibrio cholerae and in Salmonella and Shigella agar for other enteropathogens. Typical colonies were confirmed by standard biochemical and slide agglutination with V. Antimicrobial sensitivity was determined by the Kirby-Bauer disc diffusion method. Further, genomic DNA was extracted and subjected to molecular analysis.
Amplification of ctxA gene of V. PCR products were separated on 1. The nucleotide sequence of the ctxA gene was compared with the ctxA orthologous sequences of other Vibrio species obtained from GenBank database.
The ctxA gene sequences retrieved as above were subjected to multiple sequence alignment using ClustalW and in BioEdit software. Water samples taken from the affected area were tested for coliforms by membrane-filtration technique at the public health laboratory.
Environmental investigation The water supply pipelines and sanitation situation were reviewed. We checked water chlorination records and generator operations records at the pump-house providing head pressure to water-lines. Analytical epidemiology To test our hypothesis on potential sources of infection and other risk factors, we conducted a matched case-control study in the area with high attack rate.
Aurelie Jeandron is currently working on an impact evaluation of a large water supply improvement project in Uvira, in Eastern DRC. Uvira is located in South-Kivu province in Eastern DRC, at the border with Burundi, and has an estimated population ofinhabitants Access to safe drinking water is generally low with almost half of all households using surface water source that is rarely boiled or chlorinated at home.
Some are served by the existing the Regideso water supply system, which provides chlorinated water, but this limited network private and shared taps experiences frequent service interruptions.
Only a third of households are estimated to have an improved sanitation facility. Although it has long been argued that improving domestic water supply is critical in reducing faecal-oral transmission of enteric pathogens by making greater quantities of water available for hygienic practices, there have been no rigorous controlled intervention studies. Specifically with regard to cholera, it is unclear if and how improving water supply — i.
AFD and the Veolia Foundation contracted the London School of Hygiene and Tropical Medicine in to design and conduct an impact evaluation of the water supply improvement works on cholera, other diarrhoeal diseases and water-related practices.
A stepped wedge cluster randomised controlled trial SWcRCT will be carried out to measure the effect of the intervention on cholera centre admission and confirmed cholera cases www.
In parallel, a cohort study will be implemented to assess how water-related practices change following the intervention. Based on data collected daily since at the Uvira Cholera Treatment Centre CTC and at the water treatment plant, we first conducted a time-series regression between suspected cholera and daily amounts of tap water supplied across town and found a strong and consistent association between interruptions in water service and suspected cholera.
The CTC admits all patients presenting with severe acute diarrhoea.
However, in the absence of adequate local laboratory facilities, regular confirmation of cholera is not conducted, except occasionally at the beginning of suspected cholera outbreaks. Admission to, and treatment at, the CTC is free of charge for all patients.
In order to confirm or infirm cholera diagnosis amongst patients admitted to the CTC, we started a cholera confirmation study in Aprilwith rapid diagnostic tests. The impact evaluation will last until summer