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Comparative Study
. 2008 Feb 20;2(2):e173.
doi: 10.1371/journal.pntd.0000173.

The high burden of cholera in children: comparison of incidence from endemic areas in Asia and Africa

Jacqueline L Deen  1 , Lorenz von Seidlein, Dipika Sur, Magdarina Agtini, Marcelino E S Lucas, Anna Lena Lopez, Deok Ryun Kim, Mohammad Ali, John D Clemens
Affiliations
Comparative Study

The high burden of cholera in children: comparison of incidence from endemic areas in Asia and Africa

Jacqueline L Deen et al. PLoS Negl Trop Dis. .

Abstract

Background: Cholera remains an important public health problem. Yet there are few reliable population-based estimates of laboratory-confirmed cholera incidence in endemic areas around the world.

Methods: We established treatment facility-based cholera surveillance in three sites in Jakarta (Indonesia), Kolkata (India), and Beira (Mozambique). The annual incidence of cholera was estimated using the population census as the denominator and the age-specific number of cholera cases among the study cohort as the numerator.

Findings: The lowest overall rate was found in Jakarta, where the estimated incidence was 0.5/1000 population/year. The incidence was three times higher in Kolkata (1.6/1000/year) and eight times higher in Beira (4.0/1000/year). In all study sites, the greatest burden was in children under 5 years of age.

Conclusion: There are considerable differences in cholera incidence across these endemic areas but in all sites, children are the most affected. The study site in Africa had the highest cholera incidence consistent with a growing impression of the large cholera burden in Africa. Burden estimates are useful when considering where and among whom interventions such as vaccination would be most needed.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Cholera incidence (per 1000 population per year) in study sites in three countries.
See this image and copyright information in PMC

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