Prioritizing interventions for cholera control in Kenya, 2015-2020.
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 emphasize...
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ftdoajarticles:oai:doaj.org/article:4434cd1dd33b4a6b98590bf3f5b49213 2023-07-02T03:31:36+02:00 Prioritizing interventions for cholera control in Kenya, 2015-2020. Waqo Boru Shaoming Xiao Patrick Amoth David Kareko Daniel Langat Ian Were Mohammad Ali David A Sack Elizabeth C Lee Amanda K Debes 2023-05-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0010928 https://doaj.org/article/4434cd1dd33b4a6b98590bf3f5b49213 EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0010928 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010928 https://doaj.org/article/4434cd1dd33b4a6b98590bf3f5b49213 PLoS Neglected Tropical Diseases, Vol 17, Iss 5, p e0010928 (2023) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2023 ftdoajarticles https://doi.org/10.1371/journal.pntd.0010928 2023-06-11T00:37:56Z 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. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Tana River ENVELOPE(28.395,28.395,70.503,70.503) PLOS Neglected Tropical Diseases 17 5 e0010928 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
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ftdoajarticles |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Waqo Boru Shaoming Xiao Patrick Amoth David Kareko Daniel Langat Ian Were Mohammad Ali David A Sack Elizabeth C Lee Amanda K Debes Prioritizing interventions for cholera control in Kenya, 2015-2020. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
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. |
format |
Article in Journal/Newspaper |
author |
Waqo Boru Shaoming Xiao Patrick Amoth David Kareko Daniel Langat Ian Were Mohammad Ali David A Sack Elizabeth C Lee Amanda K Debes |
author_facet |
Waqo Boru Shaoming Xiao Patrick Amoth David Kareko Daniel Langat Ian Were Mohammad Ali David A Sack Elizabeth C Lee Amanda K Debes |
author_sort |
Waqo Boru |
title |
Prioritizing interventions for cholera control in Kenya, 2015-2020. |
title_short |
Prioritizing interventions for cholera control in Kenya, 2015-2020. |
title_full |
Prioritizing interventions for cholera control in Kenya, 2015-2020. |
title_fullStr |
Prioritizing interventions for cholera control in Kenya, 2015-2020. |
title_full_unstemmed |
Prioritizing interventions for cholera control in Kenya, 2015-2020. |
title_sort |
prioritizing interventions for cholera control in kenya, 2015-2020. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2023 |
url |
https://doi.org/10.1371/journal.pntd.0010928 https://doaj.org/article/4434cd1dd33b4a6b98590bf3f5b49213 |
long_lat |
ENVELOPE(28.395,28.395,70.503,70.503) |
geographic |
Arctic Tana River |
geographic_facet |
Arctic Tana River |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 17, Iss 5, p e0010928 (2023) |
op_relation |
https://doi.org/10.1371/journal.pntd.0010928 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0010928 https://doaj.org/article/4434cd1dd33b4a6b98590bf3f5b49213 |
op_doi |
https://doi.org/10.1371/journal.pntd.0010928 |
container_title |
PLOS Neglected Tropical Diseases |
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17 |
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5 |
container_start_page |
e0010928 |
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