Social and Environmental Determinants of Cholera in Hodeidah , Yemen : A Cross Sectional Study

الملخص

Background: Cholera remains an important public health problem for many countries continuing to cause major morbidity and mortality worldwide. It is most likely to be found and spread in places with inadequate water treatment and hygiene, and poor sanitation.

Objective: The study aimed to determine the social and environmental determinants of cholera in Hodeidah, Yemen during January to August 2018. Methodology : A cross-sectional study was conducted in Hodeida governorate. All confirmed cholera patients were admitted in Authority of Public -ALThawara Public Hospital/ Cholera Treatment Center (CTC) during January to August 2018 were the study subjects. Data were collected by a questionnaire about socio-demographic characteristics, environment and social factors and about patients’ awareness towards cholera prevention and control. Data were analyzed and presented in tables and graphs in descriptive and inferential statistical methods. Results: Family contacts, poverty and illiteracy were main social characteristics of studied cholera patients. About 38% of patients reported contact with a family former cholera patient. About 52% have low income and 18.7% have no income at all, in additional, bout 25% of families borrow money to cover treatment which affects family financial capability. Illiteracy rate among adult cholera patients was about 24.7% and those who had only elementary education were 37%. Families of cholera patients in Hodeida are rarely to treating drinking water. Only 5.7% chlorinate water, but 2.3% were exposed to unsafe water. Hand washing was still not a regular practice, although 61% of patients wash their hands with water and soap. The transmission of the disease is probably increased more by exposure to contaminated food than to exposed water. The most preventive measure used by the patients are: Hand washing (59%), Eat covered/well cooked food (48%), washing vegetables and fruits (40.7%) and boiling /chlorination of the drinking water.  Conclusions: Four social and four environmental determinants were identified regarding cholera in Hodeida. The social factors are: family contact, poverty, illiteracy, crowding houses; while the environmental factors are: exposure to contaminated food, drinking unsafe water, lack of proper hand washing and poor coverage of the proper sanitation system. Person to person transmission may be the probable patterns of transmission rather than the common source.