Abstract:
Background: In October 2010 an outbreak of cholera
began among a group of small-scale gold miners in the
East-Akim Municipality (EAM), Eastern Region. We
investigated to verify the diagnosis, identify risk
factors and recommend control measures.
Methods: We conducted a descriptive investigation,
active case-search and an unmatched case-control
study. A cholera case-patient was a person with acute
watery diarrhoea, with or without vomiting in EAM
from 1st October to 20th November, 2010. Stool from
case-patients and water samples were taken for
laboratory diagnosis. We performed univariate and
bivariate analysis using epi-info version 3.3.
Results: Of 136 case-patients, 77 (56.6%) were males,
of which 40% were miners or from miners households.
Index case, a 20 yr-old male miner from Apapam
village reported on October 13th, and case-patients
peaked (18.4%) 20 days later. Attack rate was 2/1000
population with no fatality. Ages ranged from 1-84
years; mean of 34±18 yrs. Age-group 20-29 yrs was
mostly affected (30.1%) with Apapam village having
most case-patients (19.9%). Vibrio cholera serotype
ogawa was isolated from stool samples. The main
water source, Birim river was polluted by small-scale
miners through defecation, post-defecation baths and
sand-washings. Compared to controls, case-patients
were more likely to have drunk from Birim-River
[OR= 6.99, 95% CI: 2.75-18].
Conclusion: Vibrio cholera serotype ogawa caused the
EAM cholera-outbreak affecting many young adultmales.
Drinking water from contaminated communitywide
-River was the major risk factors. Boiling or
chlorination of water was initiated based on our
recommendations and this controlled the outbreak.