Availability of safe drinking-water: the answer to cholera outbreak? Nabua, Camarines Sur, Philippines, 2012
	    		
		   		
		   			
		   		
	    	
    	 
    	10.5365/WPSAR.2015.6.1.005
   		
        
        	
        	
        	
        		- Author:
	        		
		        		
		        		
			        		De Guzman Alethea
			        		
			        		;
		        		
		        		
		        		
			        		de los Reyes Vikki Carr
			        		
			        		;
		        		
		        		
		        		
			        		Sucaldito Ma Nemia
			        		
			        		;
		        		
		        		
		        		
			        		Tayag Enrique
			        		
			        		
		        		
		        		
		        		
		        		
		        		
			        		
			        		
		        		
	        		
        		 
        	
        	
        	
        		- Publication Type:News
 
        	
        	
            
            
            	- From:
	            		
	            			Western Pacific Surveillance and Response
	            		
	            		 2015;6(3):12-16
	            	
            	
 
            
            
            	- CountryWHO-WPRO
 
            
            
            	- Language:English
 
            
            
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		        	Abstract:
			       	
			       		
				        
				        	Background:In May 2012, there were increasing diarrhoea cases and deaths reported from Nabua, Camarines Sur to the Philippines event-based surveillance system. An investigation was conducted to identify risk factors and determine transmission dynamics.Methods:A suspected case was defined as a resident of Nabua with at least three episodes of watery diarrhoea per day from 16 March to 22 June 2012. A confirmed case was defined as a suspected case positive for Vibrio cholerae. An environmental investigation was conducted and rectal swabs and water samples sent to the national reference laboratory for bacterial isolation. A 1:2 case-control study matching for age and sex was conducted. Data were analysed using Epi Info.Results:There were 309 suspected cases with two deaths, and the most affected age group was children under five years (45%). Eight cases were positive for Vibrio cholerae Ogawa El Tor and one for Non-01. Water samples were positive for faecal coliforms and Aeromonas caviae. The case-control study showed that cases had a higher odds than controls of using unchlorinated water sources (odds ratio [OR] = 3.6; 95% confidence interval [CI]:1.6–8.5) and having toilets located within 20 m of a septic tank (OR = 2.7; 95% CI: 1.4–5.3). In multivariate analysis, the only significant factor was drinking from piped water (OR = 0.21; 95% CI: 0.09–0.49).Discussion:In this cholera outbreak, drinking-water from unchlorinated wells was a significant risk factor. Future cholera control efforts should include not just improving water and sanitation systems but also intensified behaviour change campaigns.