Risk factors for diarrhea hospitalization in Bangladesh, 2000–2008: a case-case study of cholera and shigellosis
Danny V. Colombaraa b✉, Abu SG Faruquec, Karen D. Cowgilld e f g, Jonathan D. Mayerb h
- aDepartment of Epidemiology, University of Washington, Seattle, WA, USA. dvc2@uw.edu
- bDepartment of Epidemiology, University of Washington, Seattle, USA
- cInternational Centre for Diarrheal Disease Research, Dhaka, Bangladesh
- dDepartment of Global Health, University of Washington, Seattle, WA, USA
- eSeattle University College of Nursing, Seattle, WA, USA
- fDepartment of Global Health, University of Washington, Seattle, USA
- gSeattle University College of Nursing, Seattle, USA
- hDepartment of Epidemiology, University of Washington, Seattle, WA, USA
- ✉Corresponding author
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Abstract
BACKGROUND: Cholera and shigellosis are endemic on the Indian subcontinent. Our objective was to identify cholera-specific risk factors distinct from shigellosis risk factors. METHODS: We conducted a case-case study among hospitalized diarrheal patients, comparing those with cholera and shigellosis in International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) hospitals in Matlab (rural) and Dhaka (urban) between January 1, 2000 and December 31, 2008. RESULTS: Multivariable Poisson regression models revealed that having more than nine years of education, compared to no education, was associated with a 39% (adjusted Risk Ratio [aRR] = 0.61, 95% confidence interval [CI]: 0.40-0.93) decreased risk for cholera hospitalization in Matlab and a 16% (aRR = 0.84, 95% CI: 0.75-0.94) decreased risk in Dhaka. Having a family member with diarrhea in the past seven days increased cholera hospitalization risk by 17% (aRR = 1.17, 95% CI: 1.09-1.26) in Matlab. CONCLUSIONS: Further studies are needed to elucidate the pathway through which education impacts cholera risk in order to create targeted interventions in cholera-endemic areas. Interventions seeking to reduce transmission and facilitate hygienic practices among family members of index cases with diarrhea should be considered, especially in rural cholera endemic settings.
TL;DRA case-case study among hospitalized diarrheal patients in Bangladesh comparing those with cholera and shigellosis in International Centre for Diarrhoeal Disease Research, Bangladesh between January 1, 2000 and December 31, 2008 revealed that having more than nine years of education was associated with a decreased risk for cholERA hospitalization. (Semantic Scholar)