ムゼンボ バシルア アンドレ

BACKGROUND: Cholera cases have increased globally across the Eastern Mediterranean, Africa, Southeast Asia, and parts of Europe since early 2024. This study aims to identify cholera hotspots and understand the spatial distribution of cholera in Kolkata and surrounding regions, a key cholera reservoir. Additionally, we examine sociodemographic factors and aspects related to water, sanitation, and hygiene (WASH). METHODS: Cholera clusters were detected using kernel density estimation and spatial autocorrelation through Global Moran's-I statistics, with local cluster patterns examined using Local Moran's-I statistics. Cholera cases from August 2021 to December 2023, treated at two tertiary care facilities in Kolkata: Infectious Diseases and Beleghata General Hospital and Dr. B C Roy Post Graduate Institute of Paediatric Sciences Hospital were included. Additionally, through a case-control study, 196 culture-confirmed cholera cases and 764 age/sex-matched neighborhood controls were enrolled, to investigate cholera risk factors. FINDINGS: Spatial analysis revealed a concentration of 196 cholera cases in Kolkata and its surrounding regions of Howrah, Hooghly, and North and South 24 Parganas. Hotspot analysis showed significant clustering in several Kolkata wards (31, 33, 56, 46, 57, 58, 59, 61, 66, 71, and 107), particularly in the northern, central, and east Kolkata wetlands areas (Global Moran's I statistic = 0.14, p < 0.001). These clusters had proximity between cases, with a median distance of 187.7 m, and 25.5% of cases as close as 73.9 m apart, suggesting localized transmission. Hotspots were identified with an average distance of 1600 m between them. Local Moran's I analysis found dense "high-high" clusters in these areas (p < 0.01), with a mean Moran's I index of 0.3, (range 0.1-4.6). The case-control study revealed that males were more likely to contract cholera, with an adjusted odds ratio of 2.4 (p < 0.01). There was no significant association found between cholera infection and sociodemographic factors or various WASH practices. INTERPRETATION: The findings emphasize the importance of targeted interventions, especially in identified hotspots, to mitigate cholera transmission. Addressing Socio-economic, and environmental factors especially improvement in WASH practices may further enhance prevention effects. FUNDING: The author KK, received funding from the program of the Japan Initiative for Global Research Network on Infectious Diseases, (grant id: JP23wm0125004), from the Ministry of Education, Culture, Sports, Science and Technology in Japan, and Japan Agency for Medical Research and Development.

We meta-analyzed the diagnostic accuracy of rapid diagnostic tests (dipsticks) and loop-mediated isothermal amplification (LAMP) method to detect Shigella species. We searched MEDLINE, Embase, Web of Science and Google Scholar from inception to 2023 for studies reporting on the performance of Shigella dipstick and LAMP tests compared with culture or polymerase chain reaction (PCR). Our search identified 2618 studies, of which fourteen met the inclusion criteria for the systematic review. Ten studies covering 4056 tests (from twelve countries) were included in the meta-analysis. The overall pooled sensitivity and specificity were 98% (95% CI: 94-100) and 97% (95% CI: 92-99), respectively. Pooled sensitivity and specificity of dipsticks were 95% and 98%, respectively. In contrast, LAMP showed higher pooled sensitivity (100%) and diagnostic odds ratio (431752), but similar specificity (97%). LAMP and dipstick tests exhibited promising performance, suggesting that they could be useful for assisting in the diagnosis of shigellosis.