Epidemiological link of a major cholera outbreak in Greater Accra region of Ghana, 2014

Abstract

BackgroundCholera remains an important public health challenge globally. Several pandemics have occurred in different parts of the world and have been epidemiologically linked by different researchers to illustrate how the cases were spread and how they were related to index cases. Even though the risk factors associated with the 2014 cholera outbreak were investigated extensively, the link between index cases and the source of infection was not investigated to help break the transmission process. This study sought to show how the index cases from various districts of the Greater Accra Region may have been linked.MethodsWe carried out a descriptive cross sectional study to investigate the epidemiological link of the 2014 cholera outbreak in the Greater Accra region of Ghana. An extensive review of all district records on cholera cases in the Greater Accra region was carried out. Index cases were identified with the help of line lists. Univariate analyses were expressed as frequency distributions, percentages, mean ± Standard Deviation, and rates (attack rates, case-fatality rates etc.) as appropriate. Maps were drawn using Arc GIS and Epi info software to describe the pattern of transmission.ResultsUp to 20,199 cholera cases were recorded. Sixty percent of the cases were between 20 and 40 years and about 58% (11,694) of the total cases were males. Almost 50% of the cases occurred in the Accra Metro district. Two-thirds of the index cases ate food prepared outside their home and had visited the Accra Metropolis.ConclusionsThe 2014 cholera outbreak can be described as a propagated source outbreak linked to the Accra Metropolis. The link between index cases and the source of infection, if investigated earlier could have helped break the transmission process. Such investigations also inform decision-making about the appropriate interventions to be instituted to prevent subsequent outbreaks.Electronic supplementary materialThe online version of this article (10.1186/s12889-017-4803-9) contains supplementary material, which is available to authorized users.

Influences of Land-Use Dynamics and Surface Water Systems Interactions on Water-Related Infectious Diseases—A Systematic Review

“…This was attributed to the upstream discharge of domestic and industrial effluents into the river. Similar results were found in Ghana, Senegal, Indonesia, and Iran [27,63,80,83].…”

“…A few studies (n = 6), which made explicit linkages between land-use change and surface water pollution, identified some common infectious water-related diseases ( Figure 6). Relatedly, water-borne diseases appeared in 22 studies in Africa and Asia [61][62][63]. Schistosomiasis (n = 16) was commonly examined as a result of its emergence and transmission through direct human interaction with water (body contact with polluted water and the infected intermediate snail host).…”

Electrochemical biosensors for pathogen detection

“…While biosensors for pathogen detection are critical to water and food safety in developed regions, biosensors are particularly important aspects of public healthcare in remote and under-developed regions due to relatively reduced infrastructure and resources for food and water quality analysis. For example, in 2014, a cholera outbreak linked to V. cholerae in Ghana, which has been associated with poor environmental water management and sanitation issues, infected over 20,000 individuals (Ohene-Adjei et al 2017). The selective detection of pathogens in food and water remains a global healthcare challenge.…”

Cholera dynamics: lessons from an epidemic

“…The latter two epidemics are still ongoing to date. Additionally, smaller outbreaks have also occurred in places such as Sierra Leone [14], Zimbabwe (2013), Mexico (2013), and South Sudan and Ghana [14][15][16][17][18]. While affecting many parts of the world during most of the 20th century, cholera had not entered Latin America in almost 100 years until the devastating Peruvian epidemic started in 1991 [19][20][21][22].…”