Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap

Introduction: Cholera remains a major public health problem that causes substantial morbidity and mortality in displaced populations due to inadequate or unprotected water supplies, poor sanitation and hygiene, overcrowding, and limited resources. A cholera outbreak with 224 cases and four deaths o...

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Main Authors: Abdirahman Sheikh Mahamud, Jamal A Ahmed, Raymond Nyoka, Erick Auko, Vincet Kahi, James Ndirangu, Margaret Nguhi, John Wagacha Burton, Bosco Z Muhindo, Robert F Breiman, Rachel B. Eidex
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2011-11-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/1966
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author Abdirahman Sheikh Mahamud
Jamal A Ahmed
Raymond Nyoka
Erick Auko
Vincet Kahi
James Ndirangu
Margaret Nguhi
John Wagacha Burton
Bosco Z Muhindo
Robert F Breiman
Rachel B. Eidex
author_facet Abdirahman Sheikh Mahamud
Jamal A Ahmed
Raymond Nyoka
Erick Auko
Vincet Kahi
James Ndirangu
Margaret Nguhi
John Wagacha Burton
Bosco Z Muhindo
Robert F Breiman
Rachel B. Eidex
author_sort Abdirahman Sheikh Mahamud
collection DOAJ
description Introduction: Cholera remains a major public health problem that causes substantial morbidity and mortality in displaced populations due to inadequate or unprotected water supplies, poor sanitation and hygiene, overcrowding, and limited resources. A cholera outbreak with 224 cases and four deaths occurred in Kakuma Refugee Camp in Kenya from September to December 2009. Methodology: We conducted a case-control study to characterize the epidemiology of the outbreak. Cases were identified by reviewing the hospital registry for patients meeting the World Health Organization (WHO) case definition for cholera. For each case a matched control was selected. A questionnaire focusing on potential risk factors was administered to cases and controls. Results: From 18 September to 15 December 2009, a total of 224 cases were identified and were hospitalised at Kakuma IRC hospital.  Three refugees and one Kenyan national died of cholera. V. cholerae O1, serotype Inaba was isolated in 44 (42%) out of 104 stool specimens collected. A total of 93 cases and 93 matched controls were enrolled in the study. In a multivariate model, washing hands with soap was protective against cholera (adjusted odds ratio [AOR] =0.25[0.09-0.71]; p < 0.01), while presence of dirty water storage containers was a risk factor (AOR=4.39[1.12-17.14]; p=0.03). Conclusion:  Provision of soap, along with education on hand hygiene and cleaning water storage containers, may be an affordable intervention to prevent cholera.
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spelling doaj-art-0dfafafcab9b4c80974a2cd561b4496e2025-08-20T02:27:12ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802011-11-0160310.3855/jidc.1966Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soapAbdirahman Sheikh Mahamud0Jamal A Ahmed1Raymond Nyoka2Erick Auko3Vincet Kahi4James Ndirangu5Margaret Nguhi6John Wagacha Burton7Bosco Z Muhindo8Robert F Breiman9Rachel B. Eidex10Kenya Medical Research Institute/ Centers for Disease Control and Prevention, Nairobi, KenyaUS Centers for Disease Control and Prevention, Nairobi, KenyaUS Centers for Disease Control and Prevention, Nairobi, KenyaKenya Medical Research Institute/CDCInternational Rescue Committee, KenyanteInternational Rescue Committee, KenyanteInternational Rescue Committee, KenyaUnited Nations High Commissioner for RefugeesUnited Nations High Commissioner for RefugeesUS Centers for Disease Control and Prevention, KenyaUS Centers for Disease Control and Prevention, Kenya Introduction: Cholera remains a major public health problem that causes substantial morbidity and mortality in displaced populations due to inadequate or unprotected water supplies, poor sanitation and hygiene, overcrowding, and limited resources. A cholera outbreak with 224 cases and four deaths occurred in Kakuma Refugee Camp in Kenya from September to December 2009. Methodology: We conducted a case-control study to characterize the epidemiology of the outbreak. Cases were identified by reviewing the hospital registry for patients meeting the World Health Organization (WHO) case definition for cholera. For each case a matched control was selected. A questionnaire focusing on potential risk factors was administered to cases and controls. Results: From 18 September to 15 December 2009, a total of 224 cases were identified and were hospitalised at Kakuma IRC hospital.  Three refugees and one Kenyan national died of cholera. V. cholerae O1, serotype Inaba was isolated in 44 (42%) out of 104 stool specimens collected. A total of 93 cases and 93 matched controls were enrolled in the study. In a multivariate model, washing hands with soap was protective against cholera (adjusted odds ratio [AOR] =0.25[0.09-0.71]; p < 0.01), while presence of dirty water storage containers was a risk factor (AOR=4.39[1.12-17.14]; p=0.03). Conclusion:  Provision of soap, along with education on hand hygiene and cleaning water storage containers, may be an affordable intervention to prevent cholera. https://jidc.org/index.php/journal/article/view/1966CholerarefugeesoapsanitationKenya
spellingShingle Abdirahman Sheikh Mahamud
Jamal A Ahmed
Raymond Nyoka
Erick Auko
Vincet Kahi
James Ndirangu
Margaret Nguhi
John Wagacha Burton
Bosco Z Muhindo
Robert F Breiman
Rachel B. Eidex
Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap
Journal of Infection in Developing Countries
Cholera
refugee
soap
sanitation
Kenya
title Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap
title_full Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap
title_fullStr Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap
title_full_unstemmed Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap
title_short Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap
title_sort epidemic cholera in kakuma refugee camp kenya 2009 the importance of sanitation and soap
topic Cholera
refugee
soap
sanitation
Kenya
url https://jidc.org/index.php/journal/article/view/1966
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