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. 2024 Jul:23:100362.
doi: 10.1016/j.clinpr.2024.100362.

The prevalence and prognostic value of diabetes and hypertension in patients treated for cholera during the ongoing Syrian conflict

Ibrahim Antoun  1 , Alkassem Alkhayer  2 , Ahmed Kotb  1 , Joseph Barker  1 , Alamer Alkhayer  2   3 , Yaman Mahfoud  2 , Riyaz Somani  1   4 , G André Ng  1   5   4 , Aya Tarraf  2   3 , Daniel Pan  4   6   7   8   9   10
Affiliations

The prevalence and prognostic value of diabetes and hypertension in patients treated for cholera during the ongoing Syrian conflict

Ibrahim Antoun et al. Clin Infect Pract. 2024 Jul.

Abstract

Objectives: Little work has been done investigating the prevalence and impact of comorbidities on cholera outcomes within conflict settings. We describe the clinical outcomes of patients treated for cholera in Latakia, Syria, during the 2022-2023 cholera outbreak.

Methods: We performed a single-centre retrospective observational cohort study of patients admitted to the hospital with suspected cholera between 15th December 2022 and 15th February 2023 at National Hospital, Latakia, Syria. Multivariable negative binomial regression analysis was used to investigate the variables' relationship to hospital length of stay.

Results: The study involved 89 patients admitted to the hospital; none were vaccinated against cholera. Cholera rapid diagnostic test was positive in 91 % of patients. Half of the patients (51 %) were male; a third (35 %) had hypertension, and a fifth (19 %) had diabetes. One patient passed away during admission. Patients who were male, had diabetes and were hypertensive tended to have longer hospital stays in univariable analysis. When these factors were added to a multivariable negative binomial model (consisting of age, gender, hypertension and diabetes), male sex (IRR: 4.1, 95 % CI: 1.28-6.2, p = 0.001), the presence of hypertension (IRR: 2.1,95 % CI: 1.14 to 4.1, p = 0.004) and diabetes (IRR: 2, 95 % CI: 1.2 to 2.7, p = 0.001) were independent predictors of longer hospital stays.

Conclusion: In conflict settings, hypertension and diabetes are common in patients admitted to hospital with cholera and are associated with longer hospital stays. Mortality from cholera, however, was low. Our findings highlight the importance of comorbidity control in mitigating excess morbidity during infectious disease outbreaks within conflict areas.

Keywords: Cholera; Clinical outcomes; Conflict; Earthquake; Multimorbidity; Syria.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
Epidemiological curve of cholera admissions over a 2-month period in the study centre, including the day of the earthquake on 06/02/2023. AWD: acute watery diarrhoea.
See this image and copyright information in PMC

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