Descriptive and Clinical Epidemiology of Cholera in Al-Hudaydah, Yemen

Abstract

Background: Yemen where a new cholera outbreak started in 2016 and continued to spread till 2020, becoming the largest documented cholera epidemic of modern times. Al-Hudaydah at western part of Yemen was the most affected governorates in Yemen by cholera outbreak that considered about 15% of all cases in Yemen. The aim of this study is to fill the gap in the knowledge about the clinical epidemiology of cholera outbreak in Al-Hudaydah in Yemen in 2018. Methods: This is a retrospective analysis of secondary surveillance data spanning between January 1st and December 31, 2018 from Al-Hudaydah governorate at western part of Yemen. Results: A total of 13819 patients with acute watery diarrhea were reported in three diarrhea treatment centers in Al-Hudaydah governorate in 2018. The median age is 13 years, about one third of the patients are under 5 years of age (34.4%). The peak of the epidemic was occurred in the epi weeks 40 to 50 corresponding to the period from half of September to half of December 2018. most of them had some dehydration (66.6%) About 24.1% had no dehydration while only 9.3% of patients had severe dehydration. Only 1618 Rapid diagnostic tests (RDT) were positive for cholera (24%) while vibrio cholera was isolated from 97.6% of 1438 stool specimens from RDTs positive patients. Only 18% of cholera patients were admitted to in-patient department of the DTCs. It was reported very low death rate (0.1%). The treatment regimen used for patient care are vary from ORS only (45%) to ORS and IV fluid (36.2%) or sometimes accompanied fluid therapy with antibiotic. Conclusions: There is no doubt the AWD occurred in Yemen is cholera; Even CFR may be underestimated, good performance of DTCs reduce the case fatality rate from cholera among severely dehydrated patients to less than 1%

Keywords:  Cholera, Al-Hudaydah, Yemen.

DOI: 10.7176/JHMN/80-04

Publication date:September 30^th 2020