title: Risk factors associated with cholera in Harare City, Zimbabwe, 2008.
abstract: OBJECTIVE
  Two suspected cholera cases at Beatrice Road Infectious Diseases Hospital were reported to Harare City Health Department on 14 October 2008 setting in motion investigation and control measures. We determined the extent of the epidemic and risk factors for contracting cholera.
  
  
  METHODS
  An unmatched 1:1 case-control study was conducted.
  
  
  METHODS
  Any resident of Harare City, 2 years and above, with acute watery diarrhoea, with or without vomiting from 30 October 2008 to 01 December 2008.
  
  
  METHODS
  Any resident of Harare City, 2 years and above, neighbour to a case, who did not contract cholera during the same period.
  
  
  RESULTS
  From 14 October 2008 to 21 January 2009, 11203 cases were reported with a case fatality rate (CFR) of 3.98%. We interviewed 140 cases and 140 controls. Median age was 28 years (Q1 = 20; Q3 = 37.5) and 28.5 years (Q1 = 23; Q3 = 38) for cases and controls respectively. Having a diarrhoea contact at home [AOR = 12.02; 95% CI (5.46 - 26.44)], having attained less than secondary education [AOR = 4.40; 95% CI (2.28 - 8.48)]; eating cold food [AOR = 4.24; 95% CI (1.53 - 11.70)] were independent risk factors while drinking tap water [AOR = 0.05; 95% CI (0.03 - 0.11)], washing hands after using toilet [AOR = 0.19; 95% CI (0.09 - 0.39)]; eating hot food always [AOR= 0.29; 95% CI (0.17 - 0.49)] were independently protective factors.
  
  
  CONCLUSIONS
  The high CFR may be due to poor case management and staff shortage in treatment camps. Th e cholera outbreak in Harare resulted from poor personal and hygiene practices that occur when water supplies are cut. Lack of water, low knowledge on cholera prevention measures and delays in community health education campaigns contributed to the protracted outbreak. Having a diarrhoea contact at home increases chances of household members acquiring infection. Provision of safe drinking water, community health education, recruitment of staff and training of health workers on cholera case management must be prioritized.
authors: University of Zimbabwe, Department of Community Medicine, P.O. Box A 178. Avondale, Harare, Zimbabwe. koneasta@hotmail.com
authors: A
authors: A
authors: Kone-Coulibaly
authors: M
authors: M
authors: Tshimanga
authors: G
authors: G
authors: Shambira
authors: N T
authors: NT
authors: Gombe
authors: A
authors: A
authors: Chadambuka
authors: P
authors: P
authors: Chonzi
authors: S
authors: S
authors: Mungofa
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002771:Cholera / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D005260:Female; D005511:Food Handling; D006235:Hand Disinfection; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D006920:Hygiene; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D014881:Water Supply; D055815:Young Adult; D015030:Zimbabwe / Q000453:epidemiology