Association Between Earthquake Events and Cholera Outbreaks: A Cross-country 15-year Longitudinal Analysis. Issue 6 (29th October 2013)

• Record Type: Journal Article
• Authors: Sumner, Steven A.; Turner, Elizabeth L.; Thielman, Nathan M.
• Is Part Of: Prehospital and disaster medicine. Volume 28:Issue 6(2013)
• Page Start: 567
• Page End: 572
• Publication Date: 2013-10-29
• Subjects: Emergency medical services -- Periodicals; Emergency medicine -- Periodicals; Disaster medicine -- Periodicals; 616.025
• DOI: 10.1017/S1049023X13008984
• Languages: English
• ISSNs: 1049-023X

Abstract

<abstract abstract-type="normal"> <title>Abstract</title> <sec id="abs1" sec-type="intro"> <title>Introduction</title> <p>Large earthquakes can cause population displacement, critical sanitation infrastructure damage, and increased threats to water resources, potentially predisposing populations to waterborne disease epidemics such as cholera.</p> </sec> <sec id="abs2" sec-type="general"> <title>Problem</title> <p>The risk of cholera outbreaks after earthquake disasters remains uncertain. A cross-country analysis of World Health Organization (WHO) cholera data that would contribute to this discussion has yet to be published.</p> </sec> <sec id="abs3" sec-type="methods"> <title>Methods</title> <p>A cross-country longitudinal analysis was conducted among 63 low- and middle-income countries from 1995-2009. The association between earthquake disasters of various effect sizes and a relative spike in cholera rates for a given country was assessed utilizing fixed-effects logistic regression and adjusting for gross domestic product per capita, water and sanitation level, flooding events, percent urbanization, and under-five child mortality. Also, the association between large earthquakes and cholera rate increases of various degrees was assessed.</p> </sec> <sec id="abs4" sec-type="results"> <title>Results</title> <p>Forty-eight of the 63 countries had at least one year with reported cholera infections during the 15-year study period. Thirty-six of these 48 countries had at least one earthquake disaster. In adjusted analyses, country-years with ≥10, 000 persons affected by an earthquake had 2.26 times increased odds (95 CI, 0.89-5.72, <italic>P</italic> = .08) of having a greater than average cholera rate that year compared to country-years having <10, 000 individuals affected by an earthquake. The association between large earthquake disasters and cholera infections appeared to weaken as higher levels of cholera rate increases were tested.</p> </sec> <sec id="abs5" sec-type="conclusion"> <title>Conclusion</title> <p>A trend of increased risk of greater than average cholera rates when more people were affected by an earthquake in a country-year was noted. However these findings did not reach statistical significance at traditional levels and may be due to chance. Frequent large-scale cholera outbreaks after earthquake disasters appeared to be relatively uncommon.</p> <p> <mixed-citation id="ref" publication-type="journal"> <string-name> <given-names>S</given-names> <x content-type="archive" xml:space="preserve"> </x> <surname>Sumner</surname> </string-name>, <string-name><given-names>E</given-names><x content-type="archive" xml:space="preserve"> </x><surname>Turner</surname></string-name>, <string-name><given-names>N</given-names><x content-type="archive" xml:space="preserve"> </x><surname>Thielman</surname></string-name>. <article-title>Association between earthquake events and cholera outbreaks: a cross-country 15-year longitudinal analysis</article-title>. <source>Prehosp Disaster Med</source>. <year>2013</year>;<volume>28</volume>(<issue>6</issue>):<fpage>1</fpage>-<lpage>6</lpage></mixed-citation>.</p> </sec> </abstract>