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Epidemic cholera in rural El Salvador: risk factors in a region covered by a cholera prevention campaign

Published online by Cambridge University Press:  15 May 2009

R. E. Quick
Affiliation:
Division of Field Epidemiology, Epidemiology Program Office
B. L. Thompson
Affiliation:
Division of Field Epidemiology, Epidemiology Program Office
A. Zuniga
Affiliation:
Ministry of Public Health and Social Assistance
G. Dominguez
Affiliation:
Ministry of Public Health and Social Assistance
E. L. De Brizuela
Affiliation:
Ministry of Public Health and Social Assistance
O. De Palma
Affiliation:
Ministry of Public Health and Social Assistance
S. Almeida
Affiliation:
Ministry of Public Health and Social Assistance
A. Valencia
Affiliation:
Pan American Health Organization, San Salvador, El Salvador
A. A. Ries
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333
N. H. Bean
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333
P. A. Blake
Affiliation:
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333
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In response to the Latin American cholera epidemic, El Salvador began a prevention programme in April 1991. The first case was confirmed in August, and 700 cases were reported within 3 months. A matched case-control study was conducted in rural La Libertad Department in November 1991. Illness was associated with eating cold cooked or raw seafood (odds ratio [OR] = 7·0; 95% confidence limits [CL] = 1·4, 35·0) and with drinking water outside the home (OR = 8·8; 95% CL = 1·7, 44·6). Assertion of knowledge about how to prevent cholera (OR = 0·2; 95% CL = 0·1, 0·8) and eating rice (OR = 0·2; 95% CL = 0·1, 0·8) were protective. More controls than patients regularly used soap (OR = 0·3; 95% CL = 0·1, 1·0). This study demonstrated three important points for cholera prevention: (1) seafood should be eaten cooked and hot; (2) populations at risk should be taught to treat household drinking water and to avoid drinking water outside the home unless it is known to be treated; and (3) education about hygiene can be an important tool in preventing cholera.

Type
Research Article
Copyright
Copyright © Cambridge University Press 1995

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