Scientific article
OA Policy
English

Prioritizing interventions for cholera control in Kenya, 2015-2020

Published inPLoS neglected tropical diseases, vol. 17, no. 5, e0010928
Publication date2023-05
First online date2023-05-17
Abstract

Kenya has experienced cholera outbreaks since 1971, with the most recent wave beginning in late 2014. Between 2015-2020, 32 of 47 counties reported 30,431 suspected cholera cases. The Global Task Force for Cholera Control (GTFCC) developed a Global Roadmap for Ending Cholera by 2030, which emphasizes the need to target multi-sectoral interventions in priority cholera burden hotspots. This study utilizes the GTFCC's hotspot method to identify hotspots in Kenya at the county and sub-county administrative levels from 2015 through 2020. 32 of 47 (68.1%) counties reported cholera cases during this time while only 149 of 301 (49.5%) sub-counties reported cholera cases. The analysis identifies hotspots based on the mean annual incidence (MAI) over the past five-year period and cholera's persistence in the area. Applying a MAI threshold of 90th percentile and the median persistence at both the county and sub-county levels, we identified 13 high risk sub-counties from 8 counties, including the 3 high risk counties of Garissa, Tana River and Wajir. This demonstrates that several sub-counties are high level hotspots while their counties are not. In addition, when cases reported by county versus sub-county hotspot risk are compared, 1.4 million people overlapped in the areas identified as both high-risk county and high-risk sub-county. However, assuming that finer scale data is more accurate, 1.6 million high risk sub-county people would have been misclassified as medium risk with a county-level analysis. Furthermore, an additional 1.6 million people would have been classified as living in high-risk in a county-level analysis when at the sub-county level, they were medium, low or no-risk sub-counties. This results in 3.2 million people being misclassified when county level analysis is utilized rather than a more-focused sub-county level analysis. This analysis highlights the need for more localized risk analyses to target cholera intervention and prevention efforts towards the populations most vulnerable.

Keywords
  • Humans
  • Cholera / epidemiology
  • Cholera / prevention & control
  • Kenya / epidemiology
  • Disease Outbreaks / prevention & control
  • Disease Hotspot
Affiliation entities Not a UNIGE publication
Funding
  • NIAID NIH HHS [R01 AI123422]
  • National Institute of Allergy and Infectious Diseases [5R01AI123422]
  • Bill and Melinda Gates Foundation [OPP1148763]
  • Bill and Melinda Gates Foundation [INV-002667]
Citation (ISO format)
BORU, Waqo et al. Prioritizing interventions for cholera control in Kenya, 2015-2020. In: PLoS neglected tropical diseases, 2023, vol. 17, n° 5, p. e0010928. doi: 10.1371/journal.pntd.0010928
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Identifiers
Journal ISSN1935-2727
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