1123. Individual and Household Risk Factors for Symptomatic Cholera Infection: A Systematic Review and Meta-Analysis
Session: Poster Abstract Session: Enteric Infections
Friday, October 5, 2018
Room: S Poster Hall
Posters
  • IDSA poster 1-PDF.pdf (1.0 MB)
  • Background:

    Cholera has caused seven global pandemics, including the current one which has been ongoing since 1961. A systematic review of risk factors for symptomatic cholera infection has not been previously published.

    Methods:

    In accordance with PRISMA guidelines, we performed a systematic review and meta-analysis of individual and household risk factors for symptomatic cholera infection.

    Results:

    We identified 110 studies eligible for inclusion in qualitative synthesis. Factors associated with symptomatic cholera that were eligible for meta-analysis included education less than secondary level (summary OR 2.64, 95% CI 1.41-4.92, I2 = 8%), unimproved water source (summary OR 4.78, 95% CI 3.02-7.57, I2 = 49%), open container water storage (summary OR 2.51, 95% CI 1.57-4.01, I2 = 33%), consumption of food outside the home (summary OR 5.02, 95% CI 2.34-10.76, I2 = 61%), household contact with cholera (summary OR 3.99, 95% CI 2.03-7.87, I2 = 89%), water treatment (summary OR 0.22, 95% CI 0.13-0.36, I2 = 37%), and handwashing (summary OR 0.17, 95% CI 0.10-0.30, I2 = 37%). Other notable associations with symptomatic infection included income/wealth, blood group, gastric acidity, infant breastfeeding status, and HIV infection.

    Conclusion:

    We identified potential risk factors for symptomatic cholera infection including environmental characteristics, socioeconomic factors, and intrinsic patient factors. Ultimately, a combination of interventional approaches targeting various groups with risk-adapted intensities may prove to be the optimal strategy for cholera control.

    Aaron Richterman, MD, Medicine, Brigham & Women's Hospital, Boston, MA, Duarxy Rodcnel Sainvilien, MD, Hôpital Universitaire de Mirebalais, Mirebalais, Haiti, Lauren Eberly, MD, Brigham & Women's Hospital, Boston, MA and Louise C. Ivers, MD, MPH, Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA

    Disclosures:

    A. Richterman, None

    D. R. Sainvilien, None

    L. Eberly, None

    L. C. Ivers, None

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