Highly targeted spatiotemporal interventions against cholera epidemics, 2000–19: a scoping review. Issue 3 (March 2021)

• Record Type: Journal Article
• Authors: Ratnayake, Ruwan; Finger, Flavio; Azman, Andrew S; Lantagne, Daniele; Funk, Sebastian; Edmunds, W John; Checchi, Francesco
• Is Part Of: Lancet infectious diseases. Volume 21:Issue 3(2021)
• Page Start: e37
• Page End: e48
• Publication Date: 2021-03
• Subjects: Communicable diseases -- Periodicals; Infection -- Periodicals; Communicable Diseases -- Periodicals; Infection -- Periodicals; Maladies infectieuses -- Périodiques; Infection -- Périodiques; Communicable diseases; Infection; Periodicals; 616.905
• DOI: 10.1016/S1473-3099(20)30479-5
• Languages: English
• ISSNs: 1473-3099

Abstract

Summary: Globally, cholera epidemics continue to challenge disease control. Although mass campaigns covering large populations are commonly used to control cholera, spatial targeting of case households and their radius is emerging as a potentially efficient strategy. We did a Scoping Review to investigate the effectiveness of interventions delivered through case-area targeted intervention, its optimal spatiotemporal scale, and its effectiveness in reducing transmission. 53 articles were retrieved. We found that antibiotic chemoprophylaxis, point-of-use water treatment, and hygiene promotion can rapidly reduce household transmission, and single-dose vaccination can extend the duration of protection within the radius of households. Evidence supports a high-risk spatiotemporal zone of 100 m around case households, for 7 days. Two evaluations separately showed reductions in household transmission when targeting case households, and in size and duration of case clusters when targeting radii. Although case-area targeted intervention shows promise for outbreak control, it is critically dependent on early detection capacity and requires prospective evaluation of intervention packages.