Spatial clustering of cholera cases in the Kathmandu Valley: implications for a ring vaccination strategy.
Int Health
; 13(2): 170-177, 2021 02 24.
Article
en En
| MEDLINE
| ID: mdl-32761173
ABSTRACT
BACKGROUND:
In mid-2016, a cholera outbreak occurred in Kathmandu Valley, Nepal. This retrospective study aims to determine if a reactive, ring vaccination strategy would have been useful in preventing cholera transmission during that outbreak.METHODS:
Data on cholera cases were collected as part of hospital-based surveillance in the Kathmandu Valley in 2016. Global Positioning System (GPS) coordinates were obtained during household visits. Geographic clusters of cases were visually determined and tested statistically for clustering. Cluster size was determined based on the distribution of cases around the index case.RESULTS:
GPS coordinates for 69 cases were analysed. Six geographic clusters were identified, all of which showed significant clustering of cases. Approximately 85% of cases within a cluster occurred more than 7 d after the index case. The median ring size was 1 km, with a population of 14 000 people.CONCLUSIONS:
Cholera cases were clustered in space and the majority of cases occurred over 1 week after the initial cases in the cluster, allowing for an opportunity to prevent transmission through the use of the vaccine soon after the initial case was identified. A ring vaccination strategy may be especially useful for large urban areas with recurrent seasonal outbreaks but where the specific locations for such outbreaks are not predictable.Palabras clave
Texto completo:
1
Bases de datos:
MEDLINE
Asunto principal:
Vacunas contra el Cólera
/
Cólera
Tipo de estudio:
Observational_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
Asia
Idioma:
En
Revista:
Int Health
Año:
2021
Tipo del documento:
Article
País de afiliación:
Estados Unidos