Association between Cholera Outbreak and Traditional Gold Mining in Northern State, Sudan 2017

Mohamed Ali Alzain; Mogahid Hassan Haruwn; Mohamed Osman Abdelaziz; Mohamed Elsheikh; Collins Otieno Asweto; Fahad D Algahtani; Adeniyi Abolaji Adeboye; Najm Eldinn Elsser Elhassan; Ramaiah Itumalla

doi:10.4103/jgid.jgid_47_20

Association between Cholera Outbreak and Traditional Gold Mining in Northern State, Sudan 2017

J Glob Infect Dis. 2021 Aug 19;13(3):115-119. doi: 10.4103/jgid.jgid_47_20. eCollection 2021 Jul-Sep.

Authors

Affiliations

¹ Department of Public Health, College of Public Health and Health Informatics, University of Hail, Hail 81451, Kingdom of Saudi Arabia.
² Department of Community Medicine, Faculty of Medicine and Health Sciences, University of Dongola, Dongola, PO BOX 47, Dongola 41111, Sudan.
³ Primary Health Care, Ministry of Health Northern State, Dongola, Sudan.
⁴ Department of Internal Medicine, Faculty of Medicine and Health Sciences, University of Dongola, Dongola, PO BOX 47, Dongola 41111, Sudan.
⁵ Department of Physiology, Faculty of Medicine and Health Sciences, University of Dongola, Dongola, PO BOX 47, Dongola 41111, Sudan.
⁶ Department of Community Health, School of Nursing, University of Embu, PO Box 6-60100 Embu, Kenya.
⁷ Molecular Diagnostic and Personalized Therapeutic Unit, Hail, PO BOX 2440, Hail 81451, Kingdom of Saudi Arabia.
⁸ Department of Public Health, University of Texas Health Sciences at Houston, Houston, TX 77030, USA.
⁹ Department of Environmental Health, College of Public and Environmental Health, University of Bahri, Khartoum, PO BOX 166011111, Sudan.
¹⁰ Department of Health Management, College of Public Health and Health Informatics, University of Hail, Hail, PO BOX 2440, Hail 81451, Kingdom of Saudi Arabia.

Abstract

Introduction: Cholera is one of the health problems causing considerable morbidity and mortality. The Northern State of Sudan experienced a recent cholera outbreak, however, there are limited data on the outbreak.

Methods: The objective of this study was to assess the magnitude and risk factors associated with the cholera outbreak in the Northern State of Sudan. A retrospective case series study was conducted in the Northern State of Sudan, which involved tracing cases of cholera outbreak of 2017. Data were collected through reports and interviews. A geographical information system was used to map all cases during the outbreak. Chi-square test and logistic regression were used to identify associated factors.

Results: There were 957 cholera cases reported in the state with an attack rate of 14.2/10,000 persons. Dalgo locality had the highest number (415) of cases reported with an attack rate of 167.2/10,000 persons. About 78% of cases were adult males, while 56.2% of cases were immigrants from other states. Immigrants in Halfa and Dalgo localities were four times (odds ratio [OR] = 4.031, 95% confidence interval [CI]: 2.482-6.547) and eight times (OR = 8.318, 95% CI: 5.674-12.193), respectively, at risk of cholera infection compared to immigrants in Dongola locality. The overall case-fatality rate was 1.9%. This was significantly higher in younger (5.8%) and older (22.7%) age groups (P < 0.05).

Conclusions: The study revealed that the cholera outbreak spread highly along with traditional gold mining areas due to poor sanitation. Therefore, improving sanitation services and establishing an effective surveillance system in these areas are essential to prevent future occurrence of outbreaks.

Keywords: Cholera; Northern State; Sudan; outbreak; traditional gold mining.