George, Christine Marie
Public Health - International Health
A Hospital Based Cholera Intervention for Household Contacts of Cholera Cases
Previous studies in Bangladesh have demonstrated that household contacts of cholera cases are at a much higher risk of developing cholera than the general population (200-240/1000 cases vs. 2.5/1000, respectively). However, little work has been done to develop interventions for this high risk population. We hypothesize that providing a cholera prevention package, containing chlorine tablets and a narrow neck water vessel, and delivering communication messages on cholera to cholera cases at the hospital prior to discharge will reduce the incidence of cholera cases among household contacts in comparison to a standard message given at discharge on the proper use of oral rehydration therapy. To test this hypothesis we would like to conduct an intervention study of 172 cholera cases and their corresponding household contacts at hospital discharge in rural Bangladesh: 86 cases will receive a cholera prevention package and 86 cases will receive the standard message. We will compare drinking water collected from these households with regard to the presence of residual chlorine and V. cholerae. We will use this award for a pilot study which will provide preliminary data necessary for a R01 submission for the larger intervention study. Specifically we would like to: (1) conduct the first field based evaluation of the dipstick method for measuring V. cholerae in water; (2) pilot our developed communication materials for cholera; and (3) conduct multilocus variable-number tandem-repeat analysis to examine V. cholerae isolates from environmental samples and cholera cases to determine the transmission routes for cholera infection to household contacts.