Cholera outbreak caused by drinking lakeshore water contaminated by feces washed down from a hill-side residential area: Kaiso Village, Uganda
David Were Oguttu1,&, Allen Eva Okullo1, Alex Riolexus Ario1
1Uganda Public Health Fellowship Program, Kampala, Uganda
David Were Oguttu, Uganda Public Health Fellowship Program, Kampala, Uganda
cholera is a bacterial diarrheal disease caused by Vibrio cholerae. On 15 October 2015, a cholera outbreak involving dozens of cases and 2 deaths was reported in Kaiso, a lakeshore fishing village. The district health department responded by setting up a treatment center and sensitizing the community. Despite initial response, the outbreak persisted, prompting a detailed epidemiological investigation to identify the source and mode of transmission and recommend evidence-based interventions to stop the epidemic.
we defined a suspected case as onset of acute watery diarrhoea in a Kaiso Village resident from 1st October 2015 onward; a confirmed case was a suspected case with Vibrio cholerae isolated from stool. We performed descriptive epidemiology to generate a hypothesis, and conducted a case-control study to compare exposure histories of 61 cases and 126 controls randomly selected among village residents (age ≥ 4 years in both groups). We conducted environmental assessment and obtained meteorological data from a local weather station.
123 suspected cases (2 deaths) were line-listed at the village’s cholera clinic. The initial 2 deceased cases had onset on 2nd and 10th October. Heavy rainfall occurred during 7–11th October, setting in a point-source outbreak which started on 12th and peaked
on 13th October. Three water collection points (WCP) A, B and C were associated with the outbreak. 9.8% (6/61) of case-persons and 31% (39/126) of control-persons
usually collected water from WCP A. In comparison, 21% (13/61) of case-persons and 37% (46/126) of control-persons usually collected water from WCP B (OR = 1.8, 95%CI: 0.64-5.3) and 69% (42/61) of case-persons and 33% (41/126) of control-persons
from WCP C (OR = 6.7; 95%CI = 2.5-17). 100% (61/61) of case-persons and 93% (117/126) of control-persons never treated/boiled drinking water (OR = ∞, 95%CIFisher = 1.0-∞). A gully channel from a hillside open defecation area
washed down feces to the lakeshore at WCP C.
this outbreak was caused by drinking lakeshore water contaminated by feces washed down a gully from the village. We recommended water boiling and treatment, fixing the broken piped-water system, and constructing latrines. The outbreak was stopped by implementing treatment and boiling of drinking water at household level.
The 1st Uganda National Field Epidemiology Conference (Kampala)
The one-day Field Epidemiology Conference took place on December 11th, 2015 at Golf Course Hotel, Kampala. At this conference, Fellows presented investigations and epidemiologic studies they conducted since they joined the Fellowship in January 2015. Through these investigations and studies, important public health problems facing the nation were unveiled and strategies to address them proposed. This conference presented opportunity for national and international experts to discuss and propose solutions. This was the first Field Epidemiology Conference in Uganda and was attended by important dignitaries from the key partner institutions including Ministry of Health, UN agencies, Embassies, University officials, representatives from districts as well as other national and international delegates.
Dates: 11 Dec 2015
Venue: Golf Course Hotel, Kampala
Organizers: Ministry of Health and Makerere University School of Public Health
Contact person: Dr. Alex Riolexus Ario (email@example.com)