TY - JOUR
T1 - Epidemiology of Vibrio cholerae Infections in the Households of Cholera Patients in the Democratic Republic of the Congo
T2 - PICHA7 WASHmobile Prospective Cohort Study
AU - George, Christine Marie
AU - Sanvura, Presence
AU - Namunesha, Alves
AU - Bisimwa, Jean Claude
AU - Endres, Kelly
AU - Felicien, Willy
AU - Williams, Camille
AU - Trivedi, Shubhanshi
AU - Davis, Kilee L.
AU - Perin, Jamie
AU - Sack, David A.
AU - Bengehya, Justin
AU - Maheshe, Ghislain
AU - Cikomola, Cirhuza
AU - Bisimwa, Lucien
AU - Leung, Daniel T.
AU - Mwishingo, Alain
N1 - Publisher Copyright:
© 2025 The Author(s). Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For commercial re-use, please contact [email protected] for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site - for further information please contact [email protected].
PY - 2025/10/15
Y1 - 2025/10/15
N2 - Background The aim of this prospective cohort study is to build evidence on transmission dynamics and risk factors for Vibrio cholerae infections in cholera patient households. Methods Household contacts of cholera patients were observed for 1 month after the index cholera patient was admitted to a healthcare facility for stool, serum, and water collection in urban Bukavu in South Kivu, Democratic Republic of the Congo. A V. cholerae infection was defined as a V. cholerae bacterial culture positive result during the 1-month surveillance period and/or a 4-fold rise in a V. cholerae O1 serological antibody from baseline to the 1-month follow-up. Results Sixty-seven percent of cholera patient households (56/83) had ≥1 V. cholerae infected contact during the 1-month surveillance period. Twenty-seven percent of contacts (134 of 491) of cholera patients had a V. cholerae infection. Twelve percent (9 of 77) of cholera patient households had a stored water sample with V. cholerae by bacterial culture, and 7% (5 of 70) for water sources. Significant risk factors for symptomatic V. cholerae infections among contacts were stored food left uncovered (odds ratio (OR): 2.39, 95% confidence interval (CI): 1.13, 5.05) and younger age (children <5 years) (OR: 2.09, 95% CI: 1.12, 3.90), and a drinking water source with >1 colony forming unit Escherichia coli 100 mL (OR: 3.59, 95% CI: 1.46, 8.84) for V. cholerae infections. None of the contacts residing in households where the index patient consumed doxycycline in the past 48 hours had a V. cholerae infection compared with 28% of contacts (133 out of 470) where the index patient did not consume doxycycline (P =. 005). Conclusions The findings indicate a high risk of cholera among contacts of cholera patients in this urban cholera endemic setting, and the need for targeted water treatment and hygiene interventions to prevent household transmission of V. cholerae.
AB - Background The aim of this prospective cohort study is to build evidence on transmission dynamics and risk factors for Vibrio cholerae infections in cholera patient households. Methods Household contacts of cholera patients were observed for 1 month after the index cholera patient was admitted to a healthcare facility for stool, serum, and water collection in urban Bukavu in South Kivu, Democratic Republic of the Congo. A V. cholerae infection was defined as a V. cholerae bacterial culture positive result during the 1-month surveillance period and/or a 4-fold rise in a V. cholerae O1 serological antibody from baseline to the 1-month follow-up. Results Sixty-seven percent of cholera patient households (56/83) had ≥1 V. cholerae infected contact during the 1-month surveillance period. Twenty-seven percent of contacts (134 of 491) of cholera patients had a V. cholerae infection. Twelve percent (9 of 77) of cholera patient households had a stored water sample with V. cholerae by bacterial culture, and 7% (5 of 70) for water sources. Significant risk factors for symptomatic V. cholerae infections among contacts were stored food left uncovered (odds ratio (OR): 2.39, 95% confidence interval (CI): 1.13, 5.05) and younger age (children <5 years) (OR: 2.09, 95% CI: 1.12, 3.90), and a drinking water source with >1 colony forming unit Escherichia coli 100 mL (OR: 3.59, 95% CI: 1.46, 8.84) for V. cholerae infections. None of the contacts residing in households where the index patient consumed doxycycline in the past 48 hours had a V. cholerae infection compared with 28% of contacts (133 out of 470) where the index patient did not consume doxycycline (P =. 005). Conclusions The findings indicate a high risk of cholera among contacts of cholera patients in this urban cholera endemic setting, and the need for targeted water treatment and hygiene interventions to prevent household transmission of V. cholerae.
KW - Democratic Republic of the Congo
KW - Vibrio cholerae
KW - cholera
KW - household transmission
KW - serosurveillance
UR - https://www.scopus.com/pages/publications/105021200796
UR - https://www.scopus.com/pages/publications/105021200796#tab=citedBy
U2 - 10.1093/cid/ciaf418
DO - 10.1093/cid/ciaf418
M3 - Article
C2 - 41206551
AN - SCOPUS:105021200796
SN - 1058-4838
VL - 81
SP - 797
EP - 805
JO - Clinical Infectious Diseases
JF - Clinical Infectious Diseases
IS - 4
ER -