Recent Cholera Publications on PubMed

Associations Between Eight Earth Observation-Derived Climate Variables and Enteropathogen Infection: An Independent Participant Data Meta-Analysis of Surveillance Studies With Broad Spectrum Nucleic Acid Diagnostics

January 13, 2022

Geohealth. 2022 Jan 1;6(1):e2021GH000452. doi: 10.1029/2021GH000452. eCollection 2022 Jan.


Diarrheal disease, still a major cause of childhood illness, is caused by numerous, diverse infectious microorganisms, which are differentially sensitive to environmental conditions. Enteropathogen-specific impacts of climate remain underexplored. Results from 15 studies that diagnosed enteropathogens in 64,788 stool samples from 20,760 children in 19 countries were combined. Infection status for 10 common enteropathogens-adenovirus, astrovirus, norovirus, rotavirus, sapovirus, Campylobacter, ETEC, Shigella, Cryptosporidium and Giardia-was matched by date with hydrometeorological variables from a global Earth observation dataset-precipitation and runoff volume, humidity, soil moisture, solar radiation, air pressure, temperature, and wind speed. Models were fitted for each pathogen, accounting for lags, nonlinearity, confounders, and threshold effects. Different variables showed complex, non-linear associations with infection risk varying in magnitude and direction depending on pathogen species. Rotavirus infection decreased markedly following increasing 7-day average temperatures-a relative risk of 0.76 (95% confidence interval: 0.69-0.85) above 28°C-while ETEC risk increased by almost half, 1.43 (1.36-1.50), in the 20-35°C range. Risk for all pathogens was highest following soil moistures in the upper range. Humidity was associated with increases in bacterial infections and decreases in most viral infections. Several virus species' risk increased following lower-than-average rainfall, while rotavirus and ETEC increased with heavier runoff. Temperature, soil moisture, and humidity are particularly influential parameters across all enteropathogens, likely impacting pathogen survival outside the host. Precipitation and runoff have divergent associations with different enteric viruses. These effects may engender shifts in the relative burden of diarrhea-causing agents as the global climate changes.

PMID:35024531 | PMC:PMC8729196 | DOI:10.1029/2021GH000452

Signatures of Cholera Outbreak during the Yemeni Civil War, 2016-2019

January 11, 2022

Int J Environ Res Public Health. 2021 Dec 30;19(1):378. doi: 10.3390/ijerph19010378.


The Global Task Force on Cholera Control (GTFCC) created a strategy for early outbreak detection, hotspot identification, and resource mobilization coordination in response to the Yemeni cholera epidemic. This strategy requires a systematic approach for defining and classifying outbreak signatures, or the profile of an epidemic curve and its features. We used publicly available data to quantify outbreak features of the ongoing cholera epidemic in Yemen and clustered governorates using an adaptive time series methodology. We characterized outbreak signatures and identified clusters using a weekly time series of cholera rates in 20 Yemeni governorates and nationally from 4 September 2016 through 29 December 2019 as reported by the World Health Organization (WHO). We quantified critical points and periods using Kolmogorov-Zurbenko adaptive filter methodology. We assigned governorates into six clusters sharing similar outbreak signatures, according to similarities in critical points, critical periods, and the magnitude of peak rates. We identified four national outbreak waves beginning on 12 September 2016, 6 March 2017, 28 May 2018, and 28 January 2019. Among six identified clusters, we classified a core regional hotspot in Sana'a, Sana'a City, and Al-Hudaydah-the expected origin of the national outbreak. The five additional clusters differed in Wave 2 and Wave 3 peak frequency, timing, magnitude, and geographic location. As of 29 December 2019, no governorates had returned to pre-Wave 1 levels. The detected similarity in outbreak signatures suggests potentially shared environmental and human-made drivers of infection; the heterogeneity in outbreak signatures implies the potential traveling waves outwards from the core regional hotspot that could be governed by factors that deserve further investigation.

PMID:35010649 | DOI:10.3390/ijerph19010378

Cholera outbreak caused by drinking unprotected well water contaminated with faeces from an open storm water drainage: Kampala City, Uganda, January 2019

December 28, 2021

BMC Infect Dis. 2021 Dec 27;21(1):1281. doi: 10.1186/s12879-021-07011-9.


BACKGROUND: Kampala city slums, with one million dwellers living in poor sanitary conditions, frequently experience cholera outbreaks. On 6 January 2019, Rubaga Division notified the Uganda Ministry of Health of a suspected cholera outbreak in Sembule village. We investigated to identify the source and mode of transmission, and recommended evidence-based interventions.

METHODS: We defined a suspected case as onset of profuse, painless, acute watery diarrhoea in a Kampala City resident (≥ 2 years) from 28 December 2018 to 11 February 2019. A confirmed case was a suspected case with Vibrio cholerae identified from the patient's stool specimen by culture. We found cases by record review and active community case-finding. We conducted a case-control study in Sembule village, the epi-center of this outbreak, to compare exposures between confirmed case-persons and asymptomatic controls, individually matched by age group. We overlaid rainfall data with the epidemic curve to identify temporal patterns between rain and illnesses. We conducted an environmental assessment, interviewed village local council members, and tested water samples from randomly-selected households and water sources using culture and PCR to identify V. cholerae.

RESULTS: We identified 50 suspected case-patients, with three deaths (case-fatality rate: 6.0%). Of 45 case-patients with stool samples tested, 22 were confirmed positive for V. cholerae O1, serotype Ogawa. All age groups were affected; persons aged 5-14 years had the highest attack rate (AR) (8.2/100,000). The epidemic curve showed several point-source outbreaks; cases repeatedly spiked immediately following rainfall. Sembule village had a token-operated water tap, which had broken down 1 month before the outbreak, forcing residents to obtain water from one of three wells (Wells A, B, C) or a public tap. Environmental assessment showed that residents emptied their feces into a drainage channel connected to Well C. Drinking water from Well C was associated with illness (ORM-H = 21, 95% CI 4.6-93). Drinking water from a public tap (ORM-H = 0.07, 95% CI 0.014-0.304) was protective. Water from a container in one of eight households sampled tested positive for V. cholerae; water from Well C had coliform counts ˃ 900/100 ml.

CONCLUSIONS: Drinking contaminated water from an unprotected well was associated with this cholera outbreak. We recommended emergency chlorination of drinking water, fixing the broken token tap, and closure of Well C.

PMID:34961483 | DOI:10.1186/s12879-021-07011-9

Knowledge into the Practice against COVID-19: A Cross-Sectional Study from Ghana

December 24, 2021

Int J Environ Res Public Health. 2021 Dec 7;18(24):12902. doi: 10.3390/ijerph182412902.


The COVID-19 pandemic has affected populations globally, including Ghana. Knowledge of the COVID-19 disease, and the application of preventive public health interventions are pivotal to its control. Besides a lockdown, measures taken against the spread of the virus include the wearing of face masks, social distancing, regular hand washing with soap and, more recently, vaccination against the virus. In order to establish a possible link between the knowledge of the disease and compliance with preventive measures, including vaccination, a cross-sectional study employing an interview-structured questionnaire was conducted in six regions of Ghana (n = 1560). An adequate level of knowledge of COVID-19 (69.9%) was reported. The linear multiple regression analysis further explicated the differences in the knowledge of COVID-19 among the respondents by their knowledge of cholera and influenza (adjusted R-Square = 0.643). Despite this profound knowledge of the illness, two thirds of the respondents were unwilling to follow basic preventive measures and only 35.3% were willing to be vaccinated. Amazingly, neither knowledge of COVID-19 nor the socio-demographic characteristics had any meaningful influence on the practice of preventive measures. Personal attitude leading to efficient public compliance with preventive measures, therefore, is a critical issue demanding special attention and effective interventions by the government and locals with authority to curb the spread of the pandemic which surpasses the traditional channels of public health communication. This includes a roll-out of persuasion, possibly including public figures and influencers, and in any case, a balanced and open discussion addressing the acceptance of the COVID-19 vaccine in order to avoid new variants and comparable problems currently facing many countries of Western Europe. Indeed, a profound hesitancy against vaccination may turn African countries such as Ghana for many years into hotspots of new viral variants.

PMID:34948512 | PMC:PMC8702109 | DOI:10.3390/ijerph182412902

The spread of cholera in western Democratic Republic of the Congo is not unidirectional from East-West: a spatiotemporal analysis, 1973-2018

December 20, 2021

BMC Infect Dis. 2021 Dec 19;21(1):1261. doi: 10.1186/s12879-021-06986-9.


BACKGROUND: Cholera outbreaks in western Democratic Republic of the Congo (DRC) are thought to be primarily the result of westward spread of cases from the Great Lakes Region. However, other patterns of spatial spread in this part of the country should not be excluded. The aim of this study was to explore alternative routes of spatial spread in western DRC.

METHODS: A literature review was conducted to reconstruct major outbreak expansions of cholera in western DRC since its introduction in 1973. We also collected data on cholera cases reported at the health zone (HZ) scale by the national surveillance system during 2000-2018. Based on data from routine disease surveillance, we identified two subperiods (week 45, 2012-week 42, 2013 and week 40, 2017-week 52, 2018) for which the retrospective space-time permutation scan statistic was implemented to detect spatiotemporal clusters of cholera cases and then to infer the spread patterns in western DRC other than that described in the literature.

RESULTS: Beyond westward and cross-border spread in the West Congo Basin from the Great Lakes Region, other dynamics of cholera epidemic propagation were observed from neighboring countries, such as Angola, to non-endemic provinces of southwestern DRC. Space-time clustering analyses sequentially detected clusters of cholera cases from southwestern DRC to the northern provinces, demonstrating a downstream-to-upstream spread along the Congo River.

CONCLUSIONS: The spread of cholera in western DRC is not one-sided. There are other patterns of spatial spread, including a propagation from downstream to upstream areas along the Congo River, to be considered as preferential trajectories of cholera in western DRC.

PMID:34923959 | DOI:10.1186/s12879-021-06986-9

Cholera rapid diagnostic tests recycled for PCR confirmation

December 17, 2021

Lancet Glob Health. 2022 Jan;10(1):e35-e36. doi: 10.1016/S2214-109X(21)00465-4.


PMID:34919850 | DOI:10.1016/S2214-109X(21)00465-4

Corrigendum to: Phylogenetic Analysis Revealed the Dissemination of Closely Related Epidemic Vibrio cholerae O1 Isolates in Laos, Thailand, and Vietnam

December 13, 2021

Open Forum Infect Dis. 2021 Dec 9;8(12):ofab355. doi: 10.1093/ofid/ofab355. eCollection 2021 Dec.


[This corrects the article DOI: 10.1093/ofid/ofaa492.].

PMID:34901298 | PMC:PMC8661072 | DOI:10.1093/ofid/ofab355

Molecular characterization of Vibrio cholerae O1 strains circulating in Assam: a north eastern state of India

December 13, 2021

Iran J Microbiol. 2021 Oct;13(5):583-591. doi: 10.18502/ijm.v13i5.7420.


BACKGROUND AND OBJECTIVES: Information on the genetic epidemiology of cholera in Assam, a northeastern state of India is lacking despite cholera being a major public health problem. The study aimed to determine the virulence genes and genes encoding antibiotic resistance in Vibrio cholerae isolates and to determine the prevalent genotypes based on the presence or absence of the virulence genes and ctxB genotype.

MATERIALS AND METHODS: Twenty-five V. cholerae strains were subjected to conventional biotyping and serotyping followed by multiplex PCR to detect ctxA, ctxB, zot, ace, O1rfb, tcpA, ompU, ompW, rtxC, hly and toxR and antibiotic resistance genes. Cholera toxin B (ctxB) gene was amplified followed by sequencing.

RESULTS: All the V. cholerae O1 isolates were El Tor Ogawa and showed the presence of the core toxin region representing the genome of the filamentous bacteriophage CTXø. The complete cassette of virulence genes was seen in 48% of the isolates which was the predominant genotype. All the isolates possessed amino acid sequences identical to the El Tor ctxB subunit of genotype 3. sulII gene was detected in 68% of the isolates, dfrA1 in 88%, strB in 48% and SXT gene was detected in 36% of the isolates.

CONCLUSION: Toxigenic V. cholerae O1 El Tor Ogawa strains of ctxB genotype 3 carrying a large pool of virulence genes are prevailing in Assam. Presence of a transmissible genetic element SXT in 36% of the strains is of major concern as it indicates the emergence of multiple drug resistance among the V. cholerae isolates.

PMID:34900155 | PMC:PMC8629826 | DOI:10.18502/ijm.v13i5.7420

Emergence of a novel SARS-CoV-2 Pango lineage B.1.1.526 in West Bengal, India

December 13, 2021

J Infect Public Health. 2021 Dec 4;15(1):42-50. doi: 10.1016/j.jiph.2021.11.020. Online ahead of print.


BACKGROUND: Since its inception in late 2019, SARS-CoV-2 has been evolving continuously by procuring mutations, leading to emergence of numerous variants, causing second wave of pandemic in many countries including India in 2021. To control this pandemic continuous mutational surveillance and genomic epidemiology of circulating strains is very important to unveil the emergence of the novel variants and also monitor the evolution of existing variants.

METHODS: SARS-CoV-2 sequences were retrieved from GISAID database. Sequence alignment was performed with MAFT version 7. Phylogenetic tree was constructed by using MEGA (version X) and UShER.

RESULTS: In this study, we reported the emergence of a novel variant of SARS-CoV-2, named B.1.1.526, in India. This novel variant encompasses 129 SARS-CoV-2 strains which are characterized by the presence of 11 coexisting mutations including D614G, P681H, and V1230L in S glycoprotein. Out of these 129 sequences, 27 sequences also harbored E484K mutation in S glycoprotein. Phylogenetic analysis revealed strains of this novel variant emerged from the GR clade and formed a new cluster. Geographical distribution showed, out of 129 sequences, 126 were found in seven different states of India. Rest 3 sequences were observed in USA. Temporal analysis revealed this novel variant was first collected from Kolkata district of West Bengal, India.

CONCLUSIONS: The D614G, P618H and E484K mutations have previously been reported to favor increased transmissibility, enhanced infectivity, and immune invasion, respectively. The transmembrane domain (TM) of S2 subunit anchors S glycoprotein to the virus envelope. The V1230L mutation, present within the TM domain of S glycoprotein, might strengthen the interaction of S glycoprotein with the viral envelope and increase S glycoprotein deposition to the virion, resulting in more infectious virion. Therefore, the new variant having D614G, P618H, V1230L, and E484K may have higher infectivity, transmissibility, and immune invasion characteristics, and thus need to be monitored closely.

PMID:34896696 | DOI:10.1016/j.jiph.2021.11.020

Seroprevalence of IgG antibodies against SARS-CoV-2 among the general population and healthcare workers in India, June-July 2021: A population-based cross-sectional study

December 10, 2021

PLoS Med. 2021 Dec 10;18(12):e1003877. doi: 10.1371/journal.pmed.1003877. Online ahead of print.


BACKGROUND: India began COVID-19 vaccination in January 2021, initially targeting healthcare and frontline workers. The vaccination strategy was expanded in a phased manner and currently covers all individuals aged 18 years and above. India experienced a severe second wave of COVID-19 during March-June 2021. We conducted a fourth nationwide serosurvey to estimate prevalence of SARS-CoV-2 antibodies in the general population aged ≥6 years and healthcare workers (HCWs).

METHODS AND FINDINGS: We did a cross-sectional study between 14 June and 6 July 2021 in the same 70 districts across 20 states and 1 union territory where 3 previous rounds of serosurveys were conducted. From each district, 10 clusters (villages in rural areas and wards in urban areas) were selected by the probability proportional to population size method. From each district, a minimum of 400 individuals aged ≥6 years from the general population (40 individuals from each cluster) and 100 HCWs from the district public health facilities were included. The serum samples were tested for the presence of IgG antibodies against S1-RBD and nucleocapsid protein of SARS-CoV-2 using chemiluminescence immunoassay. We estimated the weighted and test-adjusted seroprevalence of IgG antibodies against SARS-CoV-2, along with 95% CIs, based on the presence of antibodies to S1-RBD and/or nucleocapsid protein. Of the 28,975 individuals who participated in the survey, 2,892 (10%) were aged 6-9 years, 5,798 (20%) were aged 10-17 years, and 20,285 (70%) were aged ≥18 years; 15,160 (52.3%) participants were female, and 21,794 (75.2%) resided in rural areas. The weighted and test-adjusted prevalence of IgG antibodies against S1-RBD and/or nucleocapsid protein among the general population aged ≥6 years was 67.6% (95% CI 66.4% to 68.7%). Seroprevalence increased with age (p < 0.001) and was not different in rural and urban areas (p = 0.822). Compared to unvaccinated adults (62.3%, 95% CI 60.9% to 63.7%), seroprevalence was significantly higher among individuals who had received 1 vaccine dose (81.0%, 95% CI 79.6% to 82.3%, p < 0.001) and 2 vaccine doses (89.8%, 95% CI 88.4% to 91.1%, p < 0.001). The seroprevalence of IgG antibodies among 7,252 HCWs was 85.2% (95% CI 83.5% to 86.7%). Important limitations of the study include the survey design, which was aimed to estimate seroprevalence at the national level and not at a sub-national level, and the non-participation of 19% of eligible individuals in the survey.

CONCLUSIONS: Nearly two-thirds of individuals aged ≥6 years from the general population and 85% of HCWs had antibodies against SARS-CoV-2 by June-July 2021 in India. As one-third of the population is still seronegative, it is necessary to accelerate the coverage of COVID-19 vaccination among adults and continue adherence to non-pharmaceutical interventions.

PMID:34890407 | DOI:10.1371/journal.pmed.1003877

Variants of ctxB alleles of Vibrio cholerae O1 caused sequential cholera outbreaks in the tribal areas of Odisha, India

December 7, 2021

J Water Health. 2021 Dec;19(6):1021-1029. doi: 10.2166/wh.2021.126.


Cholera localized outbreaks/epidemics accounting for high morbidity and mortality have been reported in different years both from the coastal and tribal districts of Odisha. In the present study, the emergence and spread of two sequential cholera outbreaks reported in July to October 2012 from Rayagada and Kalahandi districts of Odisha was investigated. Environmental water samples from different sources and rectal swabs from diarrhoea patients were analysed for identification, antibiogram profiles and molecular studies using DMAMA-PCR assays. The pulsed field gel electrophoresis (PFGE) was done on some selected Vibrio cholerae O1 strains isolated from these cholera outbreak areas. Results showed 42% of rectal swabs and 2.3% of water samples collected from both the districts were positive for Vibrio cholerae O1 Ogawa biotype El Tor carrying both ctxB1 and ctxB7 genotypes. The common resistance profile of V. cholerae O1 strains was ampicillin, nalidixic acid, furazolidone and co-trimoxazole. The PFGE analysis on selected V. cholerae O1 strains of ctxB1 and ctxB7 genotypes showed three pulsotypes with 96% similarity matrix exhibiting the relationship with their respective water sources. Hence, continuous surveillance is highly essential to monitor the antibiogram profile and changing pattern of ctxB genotypes of V. cholerae O1 in this region.

PMID:34874908 | DOI:10.2166/wh.2021.126

Knowledge on and preventive practices of cholera in Al-Mahweet - Yemen, 2018: a cross-sectional study

December 7, 2021

J Water Health. 2021 Dec;19(6):1002-1013. doi: 10.2166/wh.2021.139.


Yemen has experienced one of the world's worst cholera outbreaks in the recent history of cholera records. This study aims to identify knowledge and practices among people of Al-Mahweet governorate toward cholera infection, which can play a critical role in reducing cholera morbidity and shaping the public health response. A cross-sectional study was conducted in an area of high cholera prevalence in 2018 using structured questionnaires. Most community respondents were able to correctly identify the symptoms and risk factors of cholera. While 65% of the respondents in this study knew that proper disposal of human waste is an essential measure of cholera prevention, only 11% of the respondents knew that proper washing of fruits and vegetables lowers the risk of cholera infection. About 62.5% of households did not treat water for safe drinking. Water was scarce in about 30% of households and near-home defecation was observed in about 23%. In conclusion, this study reveals several gaps in different aspects of hygienic and preventive practices including water treatment, waste disposal, and defecation practices. Cholera response should contain comprehensive health promotion interventions to improve the public's knowledge and enhance healthy practices. Stakeholders should support communities with sustainable water and sanitation systems.

PMID:34874906 | DOI:10.2166/wh.2021.139

Origin and Dissemination of Altered El Tor Vibrio cholerae O1 Causing Cholera in Odisha, India: Two and Half Decade's View

December 6, 2021

Front Microbiol. 2021 Nov 18;12:757986. doi: 10.3389/fmicb.2021.757986. eCollection 2021.


The origin, spread and molecular epidemiology of altered El Tor Vibrio cholerae O1 strains isolated from cholera outbreaks/surveillance studies between 1995 and 2019 from different district of Odisha were analyzed. The stock cultures of V. cholerae O1 strains from 1995 to 2019 were analyzed through molecular analysis using different PCR assays and pulse field gel electrophoresis (PFGE) analysis. The spread map (month, year and place) was constructed to locate the dissemination of altered El Tor variants of V. cholerae O1 in this region. A total of 13 cholera outbreaks were caused by V. cholerae O1 Ogawa biotype El Tor carrying ctxB1 and ctxB7 genotypes. The ctxB1 alleles of V. cholerae O1 mostly confined to the coastal areas, whereas the ctxB7 genotypes, though originating in the coastal region of Odisha, concentrated more in the tribal areas. The positive correlation between virulence-associated genes (VAGs) was found through Pearson's correlation model, indicative of a stronger association between the VAGs. The clonal relationship through PFGE between ctxB1 and ctxB7 genotypes of V. cholerae O1 strains exhibited 80% similarity indicating single- or multi-clonal evolution. It is evident from this study that the spread of multidrug-resistant V. cholerae O1-altered El Tor was dominant over the prototype El Tor strains in this region. The origin of altered El Tor variants of V. cholerae O1 occurred in the East Coast of Odisha established that the origin of cholera happened in the Gangetic belts of Bay of Bengal where all new variants of V. cholerae O1 might have originated from the Asian countries.

PMID:34867883 | PMC:PMC8637270 | DOI:10.3389/fmicb.2021.757986

Prevalence of syphilis infection and associated sociodemographic factors among antenatal-care attendees in Meghalaya, India: Revisiting HIV Sentinel Surveillance data

December 2, 2021

Int J STD AIDS. 2021 Dec 1:9564624211054940. doi: 10.1177/09564624211054940. Online ahead of print.


BACKGROUND: Despite relatively simple prevention and treatment, syphilis remains a major social and public health concern worldwide, particularly in developing nations.

OBJECTIVE: To estimate the prevalence and to determine the sociodemographic factors associated with syphilis infection among antenatal-care (ANC) attendees in Meghalaya, India.

MATERIALS AND METHOD: A facility-based cross-sectional study was conducted utilizing National HIV Sentinel Surveillance of Meghalaya, January-March 2017. Pregnant women aged 15-49 years (n = 3015) were recruited consecutively, interviewed, and tested for syphilis by Venereal Disease Research Laboratory test in eight selected ANC sites representing all districts of Meghalaya.

RESULTS: Prevalence of syphilis was found to be 1.03 % (95% CI = 0.67-1.39) (31/3015). Prevalence was maximum among illiterates with gradual lowering of adjusted odds ratio (AOR) with improvement of education. Women whose husbands had no income were associated with higher risk (AOR = 4.97, 95% CI = 1.11-22.20) of syphilis. Significant risk (OR = 2.42, 95% CI = 1.02-5.74) was also observed with Jaintia Hills residents as compared to Garo Hills.

CONCLUSIONS: As high prevalence of gestational syphilis was identified in Meghalaya along with important sociodemographic predictors, evidence to policy translation is required at state and national level to scale up prevention, screening, and management of syphilis.

PMID:34852699 | DOI:10.1177/09564624211054940

Mathematical modeling of the influence of cultural practices on cholera infections in Cameroon

November 24, 2021

Math Biosci Eng. 2021 Sep 27;18(6):8374-8391. doi: 10.3934/mbe.2021415.


The Far North Region of Cameroon, a high risk cholera endemic region, has been experiencing serious and recurrent cholera outbreaks in recent years. Cholera outbreaks in this region are associated with cultural practices (traditional and religious beliefs). In this paper, we introduce a mathematical model of the influence of cultural practices on the dynamics of cholera in the Far North Region. Our model is an SEIR type model with a pathogen class and multiple susceptible classes based on traditional and religious beliefs. Using daily reported cholera cases from three health districts (Kaélé, Kar Hay and Moutourwa) in the Far North Region from June 25, 2019 to August 16, 2019, we estimate parameter values of our model and use Akaike information criterion (AIC) to demonstrate that our model gives a good fit for our data on cholera cases. We use sensitivity analysis to study the impact of each model parameter on the threshold parameter (control reproduction number), Rc, and the number of model predicted cholera cases. Finally, we investigate the effect of cultural practices on the number of cholera cases in the region.

PMID:34814304 | DOI:10.3934/mbe.2021415

Molecular characterization of Vibrio cholerae O1 isolates obtained from outbreaks in the Philippines, 2015-2016

November 24, 2021

J Med Microbiol. 2021 Nov;70(11). doi: 10.1099/jmm.0.001443.


Introduction. The Philippines, comprising three island groups, namely, Luzon, Visayas and Mindanao, experienced an increase in cholera outbreaks in 2016. Previous studies have shown that Vibrio cholerae isolates obtained from the Philippines are novel hybrid El Tor strains that have evolved in the country and are clearly distinct from those found in Mozambique and Cameroon.Gap statement. The characterization of the strains isolated from outbreaks has been limited to phenotypic characteristics, such as biochemical and serological characteristics, in most previous studies.Aim. We performed multilocus variable-number tandem repeat (VNTR) analysis (MLVA) for V. cholerae isolates obtained from 2015 to 2016 to further characterize and understand the emergence and dissemination of the strains in the Philippines.Methodology. A total of 139 V. cholerae O1 Ogawa biotype El Tor isolates were obtained from the Philippines during diarrhoeal outbreaks in 18 provinces between 2015 and 2016. VNTR data were analysed to classify the MLVA profiles where the large-chromosome types (LCTs) were applied for grouping.Results. We identified 50 MLVA types among 139 isolates originating from 18 provinces, and 14 LCTs. The distribution of the LCTs was variable, and a few were located in specific areas or even in specific provinces. Based on eBURST analysis, 99 isolates with 7 LCTs and 32 MLVA types belonged to 1 group, suggesting that they were related to each other. LCT A was predominant (n=67) and was isolated from Luzon and Visayas. LCT A had 14 MLVA types; however, it mostly emerged during a single quarter of a year. Eight clusters were identified, each of which involved specific MLVA type(s). The largest cluster involved 23 isolates showing 3 MLVA types, 21 of which were MLVA type A-14 isolated from Negros Occidental during quarter 4 of 2016. Comparative analysis showed that almost all isolates from the Philippines were distinct from those in other countries.Conclusions. The genotypic relationship of the V. cholerae isolates obtained during outbreaks in the Philippines was studied, and their emergence and dissemination were elucidated. MLVA revealed the short-term dynamics of V. cholerae genotypes in the Philippines.

PMID:34817317 | DOI:10.1099/jmm.0.001443

Exploring relationships between drought and epidemic cholera in Africa using generalised linear models

November 23, 2021

BMC Infect Dis. 2021 Nov 22;21(1):1177. doi: 10.1186/s12879-021-06856-4.


BACKGROUND: Temperature and precipitation are known to affect Vibrio cholerae outbreaks. Despite this, the impact of drought on outbreaks has been largely understudied. Africa is both drought and cholera prone and more research is needed in Africa to understand cholera dynamics in relation to drought.

METHODS: Here, we analyse a range of environmental and socioeconomic covariates and fit generalised linear models to publicly available national data, to test for associations with several indices of drought and make cholera outbreak projections to 2070 under three scenarios of global change, reflecting varying trajectories of CO2 emissions, socio-economic development, and population growth.

RESULTS: The best-fit model implies that drought is a significant risk factor for African cholera outbreaks, alongside positive effects of population, temperature and poverty and a negative effect of freshwater withdrawal. The projections show that following stringent emissions pathways and expanding sustainable development may reduce cholera outbreak occurrence in Africa, although these changes were spatially heterogeneous.

CONCLUSIONS: Despite an effect of drought in explaining recent cholera outbreaks, future projections highlighted the potential for sustainable development gains to offset drought-related impacts on cholera risk. Future work should build on this research investigating the impacts of drought on cholera on a finer spatial scale and potential non-linear relationships, especially in high-burden countries which saw little cholera change in the scenario analysis.

PMID:34809609 | DOI:10.1186/s12879-021-06856-4

Cholera: Still a Major Public Health Issue in Sub-Saharan Africa

November 22, 2021

J Health Care Poor Underserved. 2021;32(4):1734-1741. doi: 10.1353/hpu.2021.0162.


Cholera continues to be a public health issue in sub-Saharan Africa, specifically the African Great Lakes region. Cases of cholera and deaths from cholera are increasing yearly. Studies have identified lakes and war/conflict as the risk factors for cholera in the African Great Lakes region. Other studies suggest that surveillance, handwashing, sanitation, oral cholera vaccine, education, and access to care are effective preventive measures against cholera in sub-Saharan Africa. But sub-Saharan Africa is not meeting the 2030 Sustainable Development Goal of ensuring availability and sustainable management of water and sanitation for all. This commentary calls for research and implementation of interventions, specifically tailored for the culturally, ethnically, and linguistically diverse populations in sub-Saharan Africa, also taking into account the historical context of each population.

PMID:34803039 | DOI:10.1353/hpu.2021.0162

Antimicrobial effect of Moringa oleifera seed powder against Vibrio cholerae isolated from the rearing water of shrimp (Penaeus vannamei) postlarvae

November 22, 2021

Lett Appl Microbiol. 2021 Nov 22. doi: 10.1111/lam.13604. Online ahead of print.


Shrimp farming has experienced rising costs as a result of disease outbreaks associated with Vibrio spp. Suitable strategies for disease prevention and control are therefore urgently needed. This study aimed to evaluate the antimicrobial effect of Moringa oleifera seed powder against Vibrio cholerae in the rearing water of Pacific white shrimp (Penaeus vannamei) postlarvae. In vitro assays included the determination of minimum inhibitory concentration (MIC) of M. oleifera seed powder against V. cholerae, whereas in vivo assays included the effect of M. oleifera seed powder on bacterial load and water quality parameters in the rearing tanks, as well as its effect on shrimp postlarvae survival. M. oleifera seed powder inhibited the growth of V. cholerae with MIC values of 62.5 µg/mL. Moreover, seawater pH of treated tanks (8.66) was significantly lower (p<0.01) than pH of the control tanks (9.02), whereas the visibility of treated tanks (37.08 cm) was significantly higher (p<0.01) as compared to control tanks (35.37 cm). Likewise, V. cholerae load was significantly reduced (p<0.01) from 4.7×104 to 3.1×103 CFU/mL in tanks treated with M. oleifera seed powder. Altogether, this study demonstrates the antimicrobial activity of M. oleifera against V. cholerae in shrimp culture.

PMID:34806784 | DOI:10.1111/lam.13604

Survey of water supply and assessment of groundwater quality in the suburban communes of Selembao and Kimbanseke, Kinshasa in Democratic Republic of the Congo

November 18, 2021

Sustain Water Resour Manag. 2022;8(1):3. doi: 10.1007/s40899-021-00592-y. Epub 2021 Nov 10.


In many suburban municipalities of developing countries, the household drinking water comes mainly from groundwater including, wells, streams and springs. These sources are vulnerable because poor hygienic conditions and sanitation prevail causing persistence and recurrent waterborne diseases. In this research, a survey study on water resource use and an epidemiological survey of waterborne diseases were conducted among users of water points and medical institutions in suburban communes of Selembao and Kimbanseke (Kinshasa, the Democratic Republic of the Congo). In addition, physicochemical (temperature, pH, O2, electrical conductivity, and soluble ions: Na+, K+, PO4 3-, SO4 2-, NO3 -, NO2 -) and bacteriological (FIB: faecal indicator bacteria) analyses of water from 21 wells and springs were performed according to the seasonal variations. FIB included Escherichia coli (E. coli), Enterococcus and Total Coliforms. The survey results indicate that more than 75% of the patients admitted to local medical institutions between 2016 and 2019 are affected by waterborne diseases, including typhoid fever, amoebic dysentery, diarrhoea, gastroenteritis disorders and cholera. Except for NO3 - in some sites, the water physicochemical parameter values are within WHO permissible limits for drinking/domestic water quality. On the contrary, the results revealed high FIB levels in water from unmanaged wells and springs during rainy and dry seasons. The microbiological pollution was significantly higher in the rainy season compared to the dry season. Interestingly, no FIB contamination was observed in water samples from managed/developed wells. The results from this study will guide local government decisions on improving water quality to prevent recurrent waterborne diseases.

PMID:34790861 | PMC:PMC8580925 | DOI:10.1007/s40899-021-00592-y