Treatment of severe cholera: a review of strategies to reduce stool output and volumes of rehydration fluid

Healthcare Seeking Behavior and Disease Perception Toward Cholera and Acute Diarrhea Among Populations Living in Cholera High-Priority Hotspots in Shashemene, Ethiopia

BACKGROUND

Healthcare seeking behavior (HSB) and community perception on cholera can influence its management. We conducted a cross-sectional survey to generate evidence on cholera associated HSB and disease perception in populations living in cholera hotspots in Ethiopia.

METHODS

A total of 870 randomly selected households (HHs) in Shashemene Town (ST) and Shashemene Woreda (SW) participated in our survey in January 2022.

RESULTS

Predominant HHs (91.0%; 792/870) responded "primary health center" as the nearest healthcare facility (HCF). Around 57.4% (247/430) of ST HHs traveled <30 minutes to the nearest HCF. In SW, 60.2% (265/440) of HHs travelled over 30 minutes and 25.9% (114/440) over 4 km. Two-thirds of all HHs paid

CONCLUSIONS

Variations in cholera prevention practices between rural and urban residents were shown. Addressing differences in HSB per age groups is needed for community engagement for early case detection and case management; critical in reducing cholera deaths and transmission.

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Key Words

• Ethiopia
• access to healthcare
• cholera
• disease perception
• healthcare seeking behavior

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MESH Headings

• Humans
• Cholera/epidemiology
• Ethiopia/epidemiology
• Cross-Sectional Studies
• Adult
• Female
• Male
• Patient Acceptance of Health Care/statistics & numerical data
• Diarrhea/epidemiology
• Adolescent
• Young Adult
• Middle Aged
• Health Knowledge, Attitudes, Practice
• Child
• Child, Preschool
• Infant
• Surveys and Questionnaires

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Grants

• Korea Support Committee
• CHMTD05083-010 International Vaccine Institute
• CHMTD05083-020 LG Electronics
• CHMTD05083-030 Community Chest of Korea

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Affiliation(s)

Tomas Getahun Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
Dejene Hailu Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea School of Public Health, Hawassa University, Hawassa, Ethiopia
Ondari D Mogeni Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea
Edlawit Mesfin Getachew Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
Biruk Yeshitela Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
Yeonji Jeon Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea
Abel Gedefaw Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
Samuyel Ayele Abebe Statistics and Data Management Department, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
Ermiyas Hundito Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
David Mukasa Biostatistics and Data Management (BDM) Department, International Vaccine Institute, Seoul, Republic of Korea
Geun Hyeog Jang Biostatistics and Data Management (BDM) Department, International Vaccine Institute, Seoul, Republic of Korea
Gi Deok Pak Biostatistics and Data Management (BDM) Department, International Vaccine Institute, Seoul, Republic of Korea
Deok Ryun Kim Biostatistics and Data Management (BDM) Department, International Vaccine Institute, Seoul, Republic of Korea
Yeshambel Worku Demlie Public Health Emergency Management, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
Mukemil Hussen Public Health Emergency Management, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
Mekonnen Teferi Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia
Se Eun Park Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea Department of Global Health and Disease Control, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea

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Phage for treatment of Vibrio cholerae infection

Bacteriophages (or "phages") are ubiquitous and the amplest biological entities on our planet. It is a natural enemy of bacteria. Cholera is one of the most known diseases to cause multiple pandemics around the world, killing millions of people. The pathogen of cholera is Vibrio species. Up until the emergence of multidrug resistance, preventive therapeutics like antibiotics were the most effective means of battling bacteria. Globally, one of the most significant challenges in treating microbial infections is the development of drug-resistant strains. Based on their antibacterial properties and unique characteristics, phages are being comprehensively evaluated taxonomically. Moreover, phage-based vaccination is evolving as one of the most encouraging preventive approaches. Due to this, its related research got remarkable recognition. However, due to the rapid emergence of bacterial resistance to antibiotics, the use of phages (phage therapy) could be a major motive for research because the most promising solution lies in bacteriophages. This chapter briefly highlights the promising use of bacteriophages to combat Vibrio-related infectious diseases.

Combating Cholera

Cholera infections caused by the gamma-proteobacterium Vibrio cholerae have ravaged human populations for centuries, and cholera pandemics have afflicted every corner of the globe. Fortunately, interventions such as oral rehydration therapy, antibiotics/antimicrobials, and vaccines have saved countless people afflicted with cholera, and new interventions such as probiotics and phage therapy are being developed as promising approaches to treat even more cholera infections. Although current therapies are mostly effective and can reduce disease transmission, cholera outbreaks remain deadly, as was seen during recent outbreaks in Haiti, Ethiopia, and Yemen. This is due to significant underlying political and socioeconomic complications, including shortages of vaccines and clean food and water and a lack of health surveillance. In this review, we highlight the strengths and weaknesses of current cholera therapies, discuss emerging technologies, and argue that a multi-pronged, flexible approach is needed to continue to reduce the worldwide burden of cholera.

Adult Immunization - Need of the Hour

Immunization is the process of making individuals immune. Childhood immunization is a common process for various aliments, but adult immunization in the Indian scenario is obscure. Officially, India has been declared polio-free, which is an achievement despite cultural, political, economic, geographic, and so many other factors. The changing demographics of adult, geriatric population and growing cost of health-care maintenance are a concern in developing countries like India. Thus, promoting healthy lifestyle needs prevention, early detection, and management of various diseases and disorders. Certainly, prevention in adults is yet to be tapped completely, so that goal of 100% prevention can be achieved. Various fraternities of medical association have come up with guidelines for adult immunization schedules in India. The present paper reviews infectious diseases such as anthrax, chikungunya, cholera, dengue, influenza, and malaria in this section of the review. We humbly request all health-care professionals and educators to educate the mass for adult immunization. So that, cost involved for treatment and workforce for the management of diseases can be better utilized in some other needed areas.