Epidemic cholera in Kakuma Refugee Camp, Kenya, 2009: the importance of sanitation and soap
Open accessAbstract
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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Poor WASH practices elevate the risk for waterborne diseases, including cholera.
“Among other burdens, poor WASH practices elevate the risk for waterborne diseases, including for example cholera, a bacterial infection and transmitted by contaminated water and poor sanitation and hygiene practices (Mahamud et al., 2011;Fletcher and Schonewille, 2015).”
From A Systematic Review of Water and Gender Interlinkages: Assessing the Intersection With Health (2020) · cites this paper as Mahamud et al., 2011
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- Authors
- Mahamud, A. S., Ahmed, J. A., Nyoka, R., Auko, E., Kahi, V., Ndirangu, J., Nguhi, M., Burton, J. W., Muhindo, B. Z., Breiman, R. F., & Eidex, R. B.
- Affiliations
- Kenya Medical Research Institute (KE)
- Centers for Disease Control and Prevention (US)
- International Rescue Committee (US)
- International Rescue Committee (ET)
- Office of the United Nations High Commissioner for Refugees (CH)
- Venue
- The Journal of Infection in Developing Countries
- Published
- 2011-11-30
- Volume
- 6
- Issue
- 03
- Pages
- 234-241
- ISSN
- 1972-2680 (ISSN-L)
- OpenAlex
- W2082171594
- Cited by
- 89
- References
- 24
- Citations by year
- 2026: 1 · 2025: 7 · 2024: 5 · 2023: 8 · 2022: 5 · 2021: 6 · 2020: 19 · 2019: 7 · 2018: 6 · 2017: 5 · 2016: 2 · 2015: 3 · 2014: 6 · 2013: 7 · 2012: 2
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- cc-by
- Locations
- The Journal of Infection in Developing Countries (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Topics
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Vibrio bacteria research studies
- Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
- Health Sciences › Nursing › Nutrition and Dietetics › Child Nutrition and Water Access
- Keywords
- cholera epidemic, Kakuma refugee camp, refugees, handwashing with soap, hand hygiene, water storage containers, sanitation, hygiene, cholera prevention, outbreak epidemiology
- MeSH terms
- Adolescent, Adult, Child, Child, Preschool, Cholera, Female, Hand Disinfection, Humans, Hygiene, Kenya, Male, Surveys and Questionnaires, Refugees, Sanitation, Soaps, Case-Control Studies, Vibrio cholerae O1, Young Adult, Epidemics
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