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Epidemiology and Health 2019;e2019015.
DOI: https://doi.org/10.4178/epih.e2019015    [Accepted] Published online April 21, 2019.
Risk Factors Associated with the Recent Cholera Outbreak in Yemen: A Case-Control Study
Fekri Ali Dureab1  , Albrecht Jahn2, Johannes Krisam3, Asma Dureab4, Omer Zain5, Sameh Al-Awlaq1,6, Olaf Müller2
1Modern Social Association, Aden, Yemen
2Heidelberg Institute of Global Health, Medical School, Heidelberg University, Heidelberg, Germany
3Institute of Medical Biometry and Informatics, Medical School, Heidelberg University, Heidelberg, Germany
4Health and Education Association for Development (SAWT), Aden, Yemen
5Faculty of Medicine, University of Aden, Aden, Yemen
6Institute of Public Health, Medical College, Jagiellonian University, Krakow, Poland
Correspondence  Fekri Ali Dureab ,Tel: 009672301054, Email: fekridureab@yahoo.com
Received: March 21, 2019  Accepted after revision: April 21, 2019
The cholera outbreak in Yemen has become the largest one in the recent history of cholera records, having reached more than 1.4 million cases since it started in late 2016. Therefore, this study aims to identify these risk factors for the recent large cholera outbreak in Yemen.
A case-control study has been conducted in Aden in the year 2018 to investigate risk factors for the still ongoing outbreak. 59 cholera cases and 118 community controls were studied.
The following risk factors were associated with being a cholera case in the bivariate analysis: a history of travelling and having had external visitors, eating outside the house, not having washed fruits, vegetables, and Khat before use, use of common source water, and not using chlorine and soap in households. The multivariate analysis showed that not washing Khat (local herbal stimulant) and the use of common source water remained significant factors for being a cholera case.
Behavioural factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen. In order to reduce the risk of cholera, hygiene practices for washing Khat and vegetable and the use and access to safe drinking safe water should be promoted at the community level.
Keywords: Cholera ; Case Control study; Yemen ; conflict; Khat


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