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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
immunology and microbiology
High mortality in a cholera outbreak in Western Kenya after post-election violence in 2008
American Journal of Tropical Medicine and Hygiene, Volume 81, No. 6, Year 2009
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Description
In 2008, a cholera outbreak with unusually high mortality occurred in western Kenya during civil unrest after disputed presidential elections.Through active case finding, we found a 200% increase in fatal cases and a 37% increase in surviving cases over passively reported cases; the case-fatality ratio increased from 5.5% to 11.4%. In conditional logistic regression of a matched case-control study of fatal versus non-fatal cholera infection, home antibiotic treatment (odds ratio [OR] 0.049; 95% CI: < 0.001-0.43), hospitalization (OR, 0.066; 95% CI, 0.001-0.54), treatment in government-operated health facilities (OR, 0.15; 95% CI, 0.015-0.73), and receiving education about cholera by health workers (OR, 0.19; 95% CI, 0.018-0.96) were protective against death. Among 13 hospitalized fatal cases, chart review showed inadequate intravenous and oral hydration and substantial staff and supply shortages at the time of admission. Cholera mortality was under-reported and very high, in part because of factors exacerbated by widespread post-election violence. © 2009 by The American Society of Tropical Medicine and Hygiene.
Authors & Co-Authors
Shikanga, O. Tipo
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Mutonga, David M.
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Abade, Mohammed
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Amwayi, Samuel Anyangu
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Ope, Maurice O.
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Limo, Hillary
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Mintz, Eric Daniel
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Quick, Robert E.
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Breiman, Robert F.
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
United States, Atlanta
Centers for Disease Control and Prevention
Feikin, Daniel R.
Kenya, Kisumu
Centers for Disease Control and Prevention, Kenya
Statistics
Citations: 73
Authors: 10
Affiliations: 2
Identifiers
Doi:
10.4269/ajtmh.2009.09-0400
ISSN:
00029637
Research Areas
Health System And Policy
Infectious Diseases
Study Design
Case-Control Study
Study Locations
Kenya