title: Cholera risk factors, Papua New Guinea, 2010.
abstract: BACKGROUND
  Cholera is newly emergent in Papua New Guinea but may soon become endemic. Identifying the risk factors for cholera provides evidence for targeted prevention and control measures.
  
  
  METHODS
  We conducted a hospital-based case-control study to identify cholera risk factors. Using stool culture as the standard, we evaluated a cholera point of care test in the field.
  
  
  RESULTS
  176 participants were recruited: 54 cases and 122 controls. Independent risk factors for cholera were: being over 20 years of age (aOR 2.5; 95%CI 1.1, 5.4), defecating in the open air (or river) (aOR 4.5; 95% CI 1.4, 14.4) and knowing someone who travelled to a cholera affected area (aOR 4.1; 95%CI 1.6, 10.7); while the availability of soap for handwashing at home was protective (aOR 0.41; 95%CI 0.19, 0.87). Those reporting access to a piped water distribution system in the home were twice as likely to report the availability of soap for handwashing. The sensitivity and specificity of the rapid test were 72% (95% CI 47-90) and 71% (95%CI 44-90%).
  
  
  CONCLUSIONS
  Improving population access to the piped water distribution system and sanitation will likely reduce transmission by enabling enhanced hygiene and limiting the contamination of water sources. The One step V. cholerae O1/O139 Antigen Test is of limited utility for clinical decision making in a hospital setting with access to traditional laboratory methods. Settlement dwellers and mobile populations of all age groups should be targeted for interventions in Papua New Guinea.
authors.affiliation: World Health Organization, Port Moresby, Papua New Guinea. arosewell@yahoo.com
authors.forename: Alexander
authors.initials: A
authors.lastname: Rosewell
authors.forename: Benita
authors.initials: B
authors.lastname: Addy
authors.forename: Lucas
authors.initials: L
authors.lastname: Komnapi
authors.forename: Freda
authors.initials: F
authors.lastname: Makanda
authors.forename: Berry
authors.initials: B
authors.lastname: Ropa
authors.forename: Enoch
authors.initials: E
authors.lastname: Posanai
authors.forename: Samir
authors.initials: S
authors.lastname: Dutta
authors.forename: Glen
authors.initials: G
authors.lastname: Mola
authors.forename: W Y Nicola
authors.initials: WY
authors.lastname: Man
authors.forename: Anthony
authors.initials: A
authors.lastname: Zwi
authors.forename: C Raina
authors.initials: CR
authors.lastname: MacIntyre
mesh_terms: D016022:Case-Control Studies; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology*; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D010219:Papua New Guinea / Q000453:epidemiology; D019095:Point-of-Care Systems; D011446:Prospective Studies; D012307:Risk Factors; D014734:Vibrio cholerae / Q000302:isolation & purification