Early use of oral cholera vaccines as a prime control measure during outbreaks: Necessary but not sufficient.

INTRODUCTION: Despite being a preventable and treatable disease, cholera remains a public health problem in Sudan. The objective of the outbreak investigation was to identify associated risk factors that would help institute appropriate control measures. MATERIAL AND METHODS: A case control study design was chosen to identify the risk factors for cholera in Gadarif State. RESULTS: Multi-variate analysis of identified two risk factors and three preventive factors for cholera in Gadarif City. RISK FACTORS: Buying foods or drinks from street vendors (OR = 71.36), 95 % CI: 16.58-307.14), living in an urban setting (Gadarif City) (OR = 5.38), 95 % CI: 2.10-13.81); and the preventive factors were: Washing hands with water after defecation but without soap (OR = 0.16), 95 % CI: 0.04-0.63) or with soap (OR = 0.01), 95 % CI: 0.00-0.03), washing hands before eating (OR = 0.15), 95 % CI: 0.05-0.51) and taking Oral Cholera Vaccine (OCV) (OR = 0.19, 95 % CI: 0.08-0.44). The effectiveness of OCV (VE) was (Unadjusted VE: 80 %, 95 % CI: 69 %-87 %) or (Adjusted VE = 81.0 %, 95 % CI: 56.0 %-92.0 %). DISCUSSION: Cholera outbreaks, especially in the setting of a complex humanitarian crises, can spread rapidly, resulting in many deaths, and quickly become a public health crisis. Implementation of a community-wide vaccination campaign using OCV as early as possible during the outbreak while implementing other control measures to target hotspots and at-risk populations would expedite halting outbreaks of cholera and save lives.

Migrant workers with COVID-19: a major challenge for Gulf Cooperation Council (GCC) countries to curb the spread of infection.

The six Gulf Cooperation Council (GCC) countries (Saudi Arabia, the United Arab Emirates, Bahrain, Kuwait, Oman and Qatar) host the majority of the estimated 23 million international migrants working in the Arab states. As the COVID-19 pandemic continues to evolve across the GCC states, the health authorities have reported a considerable number of non-national confirmed COVID-19 cases in the region. In Gulf countries, where more than half of the population are foreigners, migrant workers are more likely to contract and spread the disease due to numerous contributing factors. In this regard, unhygienic and overcrowded living conditions, barriers in accessing national or private health services, challenges in accessing accurate health information related to COVID-19, and lack of facemasks and hand hygiene facilities in their housing camps are the major factors that we identified and discuss in this paper. Moreover, we formulated specific recommendations for relevant authorities to overcome the challenges related to migrant workers during this pandemic situation. Because the migrant workers with COVID-19 infection could subsequently lead to more widespread community transmission, protecting this vulnerable group means reducing the risk of transmission for the entire population. It is essential to include migrant workers in all aspects of the response to COVID-19, such as prevention, detection, access to treatment, and containment measures.