Outbreak Investigation of Cholera in Kamaran Island, Hodeidah, Yemen: Ecological study

Abstract

Background: Yemen, in particular, face challenges with compromised sanitation conditions , while maintaining a clean physical environment is the responsibility of local communities, ensuring adequate sanitation remains a pressing concern. Objectives: The study aimed to describe the ecological characteristics of  cholera outbreak in Kamaran Island, Hodeidah, Yemen.  Methodology: The research included descriptive observation ecological study and pilot experimental study that were  carried out from July and August 2018 in Kamaran Island of Hodeidah, Yemen that is high war area and difficult to access. The study included 179 of suspected cases that were diagnosed clinically according to national and world health organization (WHO) guideline. 6/179 fecal samples of patients were diagnosed in laboratory. In addition, 7 of water samples were collected from the source and the coliform and cholera in water were isolated. On the other hand , the chlorine in water samples were detected . Results: The patients with diarrhea aged from 1 to 85 years (179 cases) were investigated. The males/ females ratio (%) was 44 % : 56 % (79/100). The attack rate (AR) was reported about 4.096 % and 1 case was dead with the case fatality rate (CFR) was 0.55 % (1 /179 cases).  In addition , 6 fecal samples of severe cases were positive with Vibrio cholerae (V. cholerae), based on rapid test and 1 fecal sample of death case was confirmed using gold standard microbiological method.  On the other hand, the fecal coliforms were confirmed in all water samples collected (7/7; 100 %) associated with zero chlorine detected. Also, the cholera was isolated  and confirmed in drinking water (1/7; 14.42 %). Conclusion: Our findings highlight the urgent need to improve water infrastructure, sanitation, and access to clean water, water chlorination and vaccination campaign in Kamaran Island, Hodeidah, Yemen, to control and prevention of cholera outbreaks. Also, strengthening health awareness, surveillance, resource availability, and international collaboration, along with regular response evaluations, is essential for improving public health and combating the epidemic.