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A national cholera epidemic with high case fatality rates--Kenya 2009.

Research paper by Anagha A Loharikar, Elizabeth E Briere, Maurice M Ope, Daniel D Langat, Ian I Njeru, Lucy L Gathigi, Lyndah L Makayotto, Abdirizak M AM Ismail, Martin M Thuranira, Ahmed A Abade, Samuel S Amwayi, Jared J Omolo, Joe J Oundo, Kevin M KM De Cock, Robert F RF Breiman, et al.

Indexed on: 23 Oct '13Published on: 23 Oct '13Published in: The Journal of infectious diseases



Abstract

Cholera remains endemic in sub-Saharan Africa. We characterized the 2009 cholera outbreaks in Kenya and evaluated the response.We analyzed surveillance data and estimated case fatality rates (CFRs). Households in 2 districts, East Pokot (224 cases; CFR = 11.7%) and Turkana South (1493 cases; CFR = 1.0%), were surveyed. We randomly selected 15 villages and 8 households per village in each district. Healthcare workers at 27 health facilities (HFs) were surveyed in both districts.In 2009, cholera outbreaks caused a reported 11 425 cases and 264 deaths in Kenya. Data were available from 44 districts for 6893 (60%) cases. District CFRs ranged from 0% to 14.3%. Surveyed household respondents (n = 240) were aware of cholera (97.5%) and oral rehydration solution (ORS) (87.9%). Cholera deaths were reported more frequently from East Pokot (n = 120) than Turkana South (n = 120) households (20.7% vs. 12.3%). The average travel time to a HF was 31 hours in East Pokot compared with 2 hours in Turkana South. Fewer respondents in East Pokot (9.8%) than in Turkana South (33.9%) stated that ORS was available in their village. ORS or intravenous fluid shortages occurred in 20 (76.9%) surveyed HFs.High CFRs in Kenya are related to healthcare access disparities, including availability of rehydration supplies.