{
    "abstract": "The Ethiopian government has developed the multisectoral cholera elimination plan (NCP) with an aim of reducing cholera incidence and case fatality rate (CFR). To better understand and monitor the progress of this plan, a comprehensive review of national cholera epidemiology is needed.\nReported data on cholera/acute watery diarrhea (AWD) cases in the past 20 years were extracted from the Ethiopian Public Health Institute and World Health Organization databases. Descriptive statistics, Pearson \u03c72, and logistic regression analyses were conducted.\nFrom January 2001 to November 2023, a total of 215 205 cholera/AWD cases, 2355 deaths with a cumulative CFR of 1.10% (95% confidence interval [CI], 1.092-1.095), and a mean annual incidence rate of 8.9/100 000 (95% CI, 6.5-11.3) were reported. Two major upsurges of cholera epidemics were found in the last two decades with mean attack rate (AR) of 20.57/100 000 in 2006-2010 and 14.83/100 000 in 2016-2020. Another resurgence of outbreaks occured in 2021-2023 (mean AR, 8.63/100 000). In 2015-2023, 54.0% (53 990/99 945) of cases were aged 15-44 years. National cholera CFR (3.13% [95% CI: 2.1-4.5]) was the highest in 2022. The 2015-2023 cumulative cholera CFR was different across regions: Benishangul Gumuz (6.07%), Gambela (1.89%), Sidama (1.42%), Southern Nation, Nationalities, and Peoples' (1.34%), Oromia (1.10%), and Amhara (1.09%). Cholera/AWD patients in older adults (\u226545 years), severe dehydration, peak rainy season (June-August), and outpatients were associated with higher risk of death.\nCholera has been a public health problem in Ethiopia with case fatalities still above the global target. Case management needs to be improved particularly in outpatients and older populations. Outbreak preparedness should be rolled out well in advance of the typical rainy seasons. Significant investments are essential to advance the cholera surveillance system at healthcare setting and community level. Underlying factors of cholera deaths per areas should be further investigated to guide appropriate interventions to meet the NCP target by 2028.",
    "authors": [
        {
            "affiliation": "Diseases Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia.",
            "firstname": "Yeshambel",
            "initials": "Y",
            "lastname": "Worku Demlie"
        },
        {
            "affiliation": "Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea.\nCollege of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia.",
            "firstname": "Abel",
            "initials": "A",
            "lastname": "Gedefaw"
        },
        {
            "affiliation": "Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea.",
            "firstname": "Yeonji",
            "initials": "Y",
            "lastname": "Jeon"
        },
        {
            "affiliation": "Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea.\nSchool of Public Health, Hawassa University, Hawassa, Ethiopia.",
            "firstname": "Dejene",
            "initials": "D",
            "lastname": "Hailu"
        },
        {
            "affiliation": "Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia.",
            "firstname": "Tomas",
            "initials": "T",
            "lastname": "Getahun"
        },
        {
            "affiliation": "Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea.",
            "firstname": "Ondari D",
            "initials": "OD",
            "lastname": "Mogeni"
        },
        {
            "affiliation": "Biostatistics and Data Management Department (BDM), International Vaccine Institute, Seoul, Republic of Korea.",
            "firstname": "David",
            "initials": "D",
            "lastname": "Mukasa"
        },
        {
            "affiliation": "Biostatistics and Data Management Department (BDM), International Vaccine Institute, Seoul, Republic of Korea.",
            "firstname": "Geun Hyeog",
            "initials": "GH",
            "lastname": "Jang"
        },
        {
            "affiliation": "Biostatistics and Data Management Department (BDM), International Vaccine Institute, Seoul, Republic of Korea.",
            "firstname": "Gi Deok",
            "initials": "GD",
            "lastname": "Pak"
        },
        {
            "affiliation": "Biostatistics and Data Management Department (BDM), International Vaccine Institute, Seoul, Republic of Korea.",
            "firstname": "Deok Ryun",
            "initials": "DR",
            "lastname": "Kim"
        },
        {
            "affiliation": "Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia.",
            "firstname": "Edlawit Mesfin",
            "initials": "EM",
            "lastname": "Getachew"
        },
        {
            "affiliation": "Bacterial and Viral Disease Research Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia.",
            "firstname": "Biruk",
            "initials": "B",
            "lastname": "Yeshitela"
        },
        {
            "affiliation": "Data Science Division, Armauer Hansen Research Institute, Addis Ababa, Ethiopia.",
            "firstname": "Samuyel",
            "initials": "S",
            "lastname": "Ayele Abebe"
        },
        {
            "affiliation": "Diseases Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia.",
            "firstname": "Moti",
            "initials": "M",
            "lastname": "Edosa"
        },
        {
            "affiliation": "Diseases Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia.",
            "firstname": "Mesfin",
            "initials": "M",
            "lastname": "Wossen"
        },
        {
            "affiliation": "Clinical Trials Directorate, Armauer Hansen Research Institute, Addis Ababa, Ethiopia.",
            "firstname": "Mekonnen",
            "initials": "M",
            "lastname": "Teferi"
        },
        {
            "affiliation": "Clinical, Assessment, Regulatory, Evaluation (CARE) Unit, International Vaccine Institute, Seoul, Republic of Korea.\nDepartment of Global Health and Disease Control, Yonsei University Graduate School of Public Health, Seoul, Republic of Korea.",
            "firstname": "Se Eun",
            "initials": "SE",
            "lastname": "Park"
        }
    ],
    "conclusions": null,
    "copyrights": "\u00a9 The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America.",
    "doi": "10.1093/cid/ciae236\n10.1111/mcn.13280",
    "journal": "Clinical infectious diseases : an official publication of the Infectious Diseases Society of America",
    "keywords": [
        "Ethiopia",
        "case fatality rate",
        "cholera",
        "incidence",
        "seasonality"
    ],
    "methods": null,
    "publication_date": "2024-07-12",
    "pubmed_id": "38996039\n26043000\n22461716\n31326254\n4875613\n19121605\n38570534\n35712321\n38996038\n34738323\n33278375\n28396423\n36648460\n35605949\n34819175\n36977170\n38996038\n23301694\n24340106\n27802834\n38996036",
    "results": "From January 2001 to November 2023, a total of 215 205 cholera/AWD cases, 2355 deaths with a cumulative CFR of 1.10% (95% confidence interval [CI], 1.092-1.095), and a mean annual incidence rate of 8.9/100 000 (95% CI, 6.5-11.3) were reported. Two major upsurges of cholera epidemics were found in the last two decades with mean attack rate (AR) of 20.57/100 000 in 2006-2010 and 14.83/100 000 in 2016-2020. Another resurgence of outbreaks occured in 2021-2023 (mean AR, 8.63/100 000). In 2015-2023, 54.0% (53 990/99 945) of cases were aged 15-44 years. National cholera CFR (3.13% [95% CI: 2.1-4.5]) was the highest in 2022. The 2015-2023 cumulative cholera CFR was different across regions: Benishangul Gumuz (6.07%), Gambela (1.89%), Sidama (1.42%), Southern Nation, Nationalities, and Peoples' (1.34%), Oromia (1.10%), and Amhara (1.09%). Cholera/AWD patients in older adults (\u226545 years), severe dehydration, peak rainy season (June-August), and outpatients were associated with higher risk of death.",
    "title": "Retrospective Analysis of Cholera/Acute Watery Diarrhea Outbreaks in Ethiopia From 2001 To 2023: Incidence, Case Fatality Rate, and Seasonal and Multiyear Epidemic Patterns.",
    "xml": "<Element 'PubmedArticle' at 0x788505d8a430>"
}