Determinants of Cholera in Selected Districts of Southeastern Part of Oromia Region, Ethiopia: A Case-Control Study

Abstract

Background: Cholera is a significant public health issue in low- and middle-income countries. Understanding the specific factors contributing to outbreaks is crucial for designing effective control strategies, especially in prolonged outbreak situations. Therefore, this study aimed to identify determinants of cholera outbreaks in the southeastern part of Oromia, Ethiopia. Methods: A community-based, unmatched case-control study was conducted involving 10 districts across 4 zones of the Oromia region, Ethiopia. Cases were individuals with laboratory-confirmed Vibrio cholerae infection or those linked to a confirmed case, while controls were asymptomatic individuals without symptoms. The association between risk factors and cholera was studied using a logistic regression model. Variables with P -values less than .25 were included in the multivariable logistic regression model. The Hosmer-Lemeshow test assessed the goodness-of-fit of the final model. Adjusted odds ratios were calculated to determine independent determinants of cholera outbreaks. Results: The study involved 1218 individuals, 424 (34.8%) being cases and 794 (65.2%) controls. The study found that household heads with no formal education [AOR: 3.65; 95% CI: 1.92-6.95] and primary education [AOR: 1.99; 95% CI: 1.05-3.78], households that were farmer/housewives [AOR: 2.49, 95% CI: 1.26-4.93], pastoralists [AOR: 4.20; 95% CI: 1.73-10.20], eating raw or uncooked food [AOR: 1.57; 95% CI: 1.18-2.10], storing water every day [AOR: 2.51; 95% CI: 1.21-5.22], and a low information index [AOR: 1.79; 95% CI: 1.25-2.56] increase the odds of being a case compared to their counterparts. Married respondents [AOR = 0.46; 95% CI: 0.34-0.62], good latrine utilization [AOR: 0.59; 95% CI: 0.40-0.85], and very good latrine utilization [AOR: 0.40; 95% CI: 0.26-0.61] are associated with lower odds of cholera infection. Therefore, targeted interventions, such as improving education, sanitation, and household-level food hygiene practice, would have a significant impact on the control and prevention of cholera in the setting.