Epidemiol Health.  2019;41:e2019015. 10.4178/epih.e2019015.

Risk factors associated with the recent cholera outbreak in Yemen: a case-control study

• Dureab F
• Jahn A
• Krisam J
• Dureab A
• Zain O
• Al-Awlaqi
• Müller O

• KMID: 2469418
• DOI: http://doi.org/10.4178/epih.e2019015

Abstract

OBJECTIVES
The cholera outbreak in Yemen has become the largest in the recent history of cholera records, having reached more than 1.4 million cases since it started in late 2016. This study aimed to identify risk factors for cholera in this outbreak.
METHODS
A case-control study was conducted in Aden in 2018 to investigate risk factors for cholera in this still-ongoing outbreak. In total, 59 cholera cases and 118 community controls were studied.
RESULTS
The following risk factors were associated with being a cholera case in the bivariate analysis: a history of travelling and having had visitors from outside Aden Province; eating outside the house; not washing fruit, vegetables, and khat (a local herbal stimulant) before consumption; using common-source water; and not using chlorine or soap in the household. In the multivariate analysis, not washing khat and the use of common-source water remained significant risk factors for being a cholera case.
CONCLUSIONS
Behavioural factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen. In order to reduce the risk of cholera, hygiene practices for washing khat and vegetables and the use and accessibility of safe drinking water should be promoted at the community level.

Keyword

Cholera; Case-control studies; Risk factors; Conflict; Khat; Yemen

MeSH Terms

Case-Control Studies*
Catha
Chlorine
Cholera*
Drinking Water
Eating
Family Characteristics
Fruit
Hygiene
Multivariate Analysis
Risk Factors*
Soaps
Vegetables
Water
Yemen*
Chlorine
Drinking Water
Soaps
Water