Highly targeted spatiotemporal interventions against cholera epidemics, 2000-19: a scoping review

Lancet Infect Dis. 2021 Mar;21(3):e37-e48. doi: 10.1016/S1473-3099(20)30479-5. Epub 2020 Oct 20.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Antibiotic Prophylaxis
  • Case Management / standards
  • Cholera / prevention & control*
  • Cholera / therapy*
  • Cholera / transmission
  • Cholera Vaccines / therapeutic use
  • Epidemics*
  • Geography
  • Health Plan Implementation / standards
  • Humans
  • Hygiene
  • Models, Theoretical
  • Spatio-Temporal Analysis*
  • Water Purification / standards

Substances

  • Cholera Vaccines