Investigation of cholera outbreak and its determinants in Shaggar city, Oromia, Ethiopia, 2024: a case-control study

Abstract

Introduction: Cholera, a severe acute diarrheal disease, with an epidemic-prone transmission patterns and serious public health emergencies that have a major impact on health and the economic in Ethiopia. A cholera outbreak was reported on 30 May 2023 in Shaggar City and declared the cholera outbreak after confirmed cases. In the city, the source and risk factors were unknown. The aim of this study was to verify and identify the determinants of the cholera outbreak and guide intervention measures in the sub-city of Shaggar City, Oromia, Ethiopia. Method An unmatched case-control study was carried out to assess the determinants of cholera outbreaks in the sub-city of the shaggar, Oromia with 1:1 case to control ratio. A total of 180 (60 cases and 120 controls) participants were included in the study. We interviewed study participants and collected data on demographic and cholera risk factors using a structured questionnaire. Data were entered into Epi-info 7.2.1.0 and analyzed with SPSS version 26. We used COR with p.value < 0.25 in bivariable analysis to identify candidate variables for multivariable regression analysis. In multivariable logistic regression, 95% CI with AOR were used to measure strength of association between outcome and independent variables and p.value < 0.05 was used to declare statistical significance. Results The median age of the cases and controls was 31 and 32 years respectively. 36 (60%) of the cases and 59 (49%) of the controls were men. The overall attack rate was 0.12 per 1000 population. According to multivariate analysis, people live in a household with overcrowding and poor sanitation(AOR: 0.03, 95% CI: (0.001–0.86), Eating outside of the home from different food and drink establishments AOR: 0.29, 95% CI: (0.08–1.02), Poor status of the latrine in the home [AOR: 6.76, 95% CI: (1.50-30.44)], Drinking water from a borehole [A OR:20.7,95%CI:(1.97-218.05] and deep well watercourse was a more likely risk in cases compared to controls, drinking water treatment and boiling (AOR:0.02, 95% CI:(0.003–0.210) were protective factors for the diseases. Conclusion Drinking unsafe water and household sanitation problem appears to be the major risk factors in the recent cholera outbreak in the sub-city. Health education, chlorination of drinking water, and strengthening surveillance were implemented. To reduce the risk of future outbreaks of cholera; environmental hygiene practices and the use and accessibility of safe drinking water should be promoted at the community level.