title: [Epidemiologic and medico-clinical aspects of the cholera outbreak in the Littoral department of Benin in 2008].
abstract: OBJECTIVE
  The purpose of this study was to determine epidemiological and medico-clinical features of the cholera outbreak that occurred in the Littoral department of Benin in 2008.
  
  
  METHODS
  This cross-sectional descriptive analytic study was based on review of a total of 404 patient files. Study data included patient identity, clinical and therapeutic features and treatment outcome. Ten randomly selected patients participated in a focus group discussion. Decision-makers in charge of managing the outbreak and medical personnel that provided care were thoroughly debriefed and 10 affected areas were visited. Data were analyzed using EPI INFO 3.3.2 and EXCEL 2007.
  
  
  RESULTS
  The outbreak started in Cotonou on 26 July 2008 and lasted for 21 weeks. Mean patient age was 23.72 +/- 14.80 years. Attack rates per district ranged from 15.86 to 172.98 per 100.000. Attack rates in Agbodjèdo, Hlacomey and Enagnon districts were significantly higher (p<10(-4)) than in other districts. The case fatality rate was 0.24 per 100. Crowded living conditions along the banks of the Cotonou lagoon along with poor sanitation and inadequate drinking water supply explain the endemicity of cholera in Cotonou. Vibrio cholerae O:1 was detected in 19 out of 36 stool samples. All strains were sensitive to ciprofloxacine but resistant to cotrimoxazole. Diarrhea was a consistent feature in all patients, along with vomiting in 88.11% and severe dehydration in 39.35%. Treatment involved oral rehydration, parenteral rehydration and antibiotherapy in 99.50%, 85% and 97.77% patients respectively. Antibiotherapy consisted of doxycycline for adult cases and amoxicilline for pregnant women and children. The duration of stay at the treatment center was significantly longer for patients with severe dehydration (p<10(-4)).
  
  
  CONCLUSIONS
  Enhancing basic sanitation and access to drinking water and intensifying information campaigns on the need for healthy living behavior especially in districts located near the banks of Cotonou lagoon are needed to improve cholera prevention in the Littoral department in Benin.
authors.affiliation: Bureau de la Représentation de l'Organisation Mondiale de la Santé au Bénin Cotonou, Bénin. gbarya@bj.afro.who.int
authors.forename: A R
authors.initials: AR
authors.lastname: Gbary
authors.forename: J P
authors.initials: JP
authors.lastname: Dossou
authors.forename: R A
authors.initials: RA
authors.lastname: Sossou
authors.forename: V
authors.initials: V
authors.lastname: Mongbo
authors.forename: A
authors.initials: A
authors.lastname: Massougbodji
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001493:Bathing Beaches / Q000706:statistics & numerical data; D001541:Benin / Q000453:epidemiology; D002648:Child; D002771:Cholera / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology* / Q000401:mortality / Q000628:therapy*; D003430:Cross-Sectional Studies; D003681:Dehydration / Q000382:microbiology; D003967:Diarrhea / Q000382:microbiology; D004196:Disease Outbreaks; D004318:Doxycycline / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D005440:Fluid Therapy; D017144:Focus Groups; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality / Q000628:therapy; D012499:Sanitation; D016896:Treatment Outcome; D014734:Vibrio cholerae / Q000302:isolation & purification; D014839:Vomiting / Q000382:microbiology; D014881:Water Supply
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D004318:Doxycycline