title: Incidence of severe diarrhoea due to Vibrio cholerae in the catchment area of six surveillance hospitals in Bangladesh.
abstract: Cholera is an important public health problem in Bangladesh. Interventions to prevent cholera depend on their cost-effectiveness which in turn depends on cholera incidence. Hospital-based diarrhoeal disease surveillance has been ongoing in six Bangladeshi hospitals where a systematic proportion of patients admitted with diarrhoea were enrolled and tested for Vibrio cholerae. However, incidence calculation using only hospital data underestimates the real disease burden because many ill persons seek treatment elsewhere. We conducted a healthcare utilization survey in the catchment areas of surveillance hospitals to estimate the proportion of severe diarrhoeal cases that were admitted to surveillance hospitals and estimated the population-based incidence of severe diarrhoea due to V. cholerae by combining both hospital surveillance and catchment area survey data. The estimated incidence of severe diarrhoea due to cholera ranged from 0.3 to 4.9/1000 population in the catchment area of surveillance hospitals. In children aged <5 years, incidence ranged from 1.0 to 11.0/1000 children. Diarrhoeal deaths were most common in the Chhatak Hospital's catchment area (18.5/100 000 population). This study provides a credible estimate of the incidence of severe diarrhoea due to cholera in Bangladesh, which can be used to assess the cost-effectiveness of cholera prevention activities.
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: R C
authors.initials: RC
authors.lastname: Paul
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: A S G
authors.initials: AS
authors.lastname: Faruque
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: M
authors.initials: M
authors.lastname: Alam
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: A
authors.initials: A
authors.lastname: Iqbal
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: K
authors.initials: K
authors.lastname: Zaman
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: N
authors.initials: N
authors.lastname: Islam
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: A
authors.initials: A
authors.lastname: Sobhan
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: S K
authors.initials: SK
authors.lastname: DAS
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: M A
authors.initials: MA
authors.lastname: Malek
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: F
authors.initials: F
authors.lastname: Qadri
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: A
authors.initials: A
authors.lastname: Cravioto
authors.affiliation: International Center for Diarrhoeal Disease Research,Bangladesh (icddr,b),Dhaka,Bangladesh.
authors.forename: S P
authors.initials: SP
authors.lastname: Luby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001459:Bangladesh / Q000453:epidemiology; D002391:Catchment Area, Health; D002648:Child; D002675:Child, Preschool; D002771:Cholera / Q000453:epidemiology* / Q000382:microbiology; D003967:Diarrhea / Q000453:epidemiology* / Q000382:microbiology; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006761:Hospitals; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D014734:Vibrio cholerae; D055815:Young Adult
keywords: Cholera; diarrhoea; incidence; vaccines; waterborne infections