Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria.
<h4>Background</h4>Cholera outbreaks are surging worldwide. Growing research supports case-area targeted interventions (CATIs), whereby teams provide a package of interventions to case and neighboring households, as an effective strategy in cholera outbreak control, particularly in human...
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Public Library of Science (PLoS)
2025-01-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://doi.org/10.1371/journal.pntd.0012731 |
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| author | Lindsay Salem-Bango Jennifer OKeeffe Michael R Desjardins Daniele Lantagne Chiara Altare Gurpreet Kaur Kanaganathan Rangaiya Patricia Oke-Oghene Obroh Ahmadu Audu Chimda Emmanuel Solomon Thomas Heath Emmanuel Emeka Ihemezue Solomon Aye Baptiste Lecuyot Mustafa Sikder Shannon Doocy Melody Xiao Paul B Spiegel |
| author_facet | Lindsay Salem-Bango Jennifer OKeeffe Michael R Desjardins Daniele Lantagne Chiara Altare Gurpreet Kaur Kanaganathan Rangaiya Patricia Oke-Oghene Obroh Ahmadu Audu Chimda Emmanuel Solomon Thomas Heath Emmanuel Emeka Ihemezue Solomon Aye Baptiste Lecuyot Mustafa Sikder Shannon Doocy Melody Xiao Paul B Spiegel |
| author_sort | Lindsay Salem-Bango |
| collection | DOAJ |
| description | <h4>Background</h4>Cholera outbreaks are surging worldwide. Growing research supports case-area targeted interventions (CATIs), whereby teams provide a package of interventions to case and neighboring households, as an effective strategy in cholera outbreak control, particularly in humanitarian settings. While research exists on individual CATI interventions, research gaps exist on outcomes of integrated interventions during CATI responses.<h4>Methodology/principal findings</h4>We conducted a prospective observational cohort study on CATIs during the 2021 cholera outbreak in Northeast Nigeria. During CATI response in Borno, Adamawa, and Yobe, research enumerators accompanied CATI teams to households and observed interventions (including provision of soap, Aquatabs, educational materials, and jerrycans; latrine and bedding disinfection; and hygiene promotion) and collected data on demographics, existing household water, sanitation, and hygiene, and household water free chlorine residual (FCR). Enumerators returned to households 10-14 days later to conduct follow-up surveys. We tested differences in reported delivery and receipt of interventions, and household drinking water FCR concentrations before and after CATIs. We also analyzed the associated relationship between CATI and environmental factors and odds of FCR <0.2 mg/L using quasi-Poisson multivariate logistic regression models with generalized estimating equations (GEE). We found household drinking water FCR significantly increased (p<0.001) post-CATI in Adamawa state. Self-reported receipt of Aquatabs and handwashing station availability were significantly associated with reduced odds of FCR <0.2 mg/L at follow-up. Self-reported receipt of hygiene promotion lacked significant associations with FCR in both Adamawa and Borno. These associations varied by type of water source.<h4>Conclusions/significance</h4>These findings suggest that CATIs improved household drinking water FCR, a key protective measure against cholera, in Northeast Nigeria. Our research highlights factors associated with FCR concentrations <0.2 mg/L post-CATI in Adamawa and Borno, offering valuable insights for response planning, and overall supports the continued use of CATIs in humanitarian settings. |
| format | Article |
| id | doaj-art-aadc8458b9f6441c87e671a5eb7baf2d |
| institution | Kabale University |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Public Library of Science (PLoS) |
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| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-aadc8458b9f6441c87e671a5eb7baf2d2025-02-05T05:33:30ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352025-01-01191e001273110.1371/journal.pntd.0012731Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria.Lindsay Salem-BangoJennifer OKeeffeMichael R DesjardinsDaniele LantagneChiara AltareGurpreet KaurKanaganathan RangaiyaPatricia Oke-Oghene ObrohAhmadu AuduChimda Emmanuel SolomonThomas HeathEmmanuel Emeka IhemezueSolomon AyeBaptiste LecuyotMustafa SikderShannon DoocyMelody XiaoPaul B Spiegel<h4>Background</h4>Cholera outbreaks are surging worldwide. Growing research supports case-area targeted interventions (CATIs), whereby teams provide a package of interventions to case and neighboring households, as an effective strategy in cholera outbreak control, particularly in humanitarian settings. While research exists on individual CATI interventions, research gaps exist on outcomes of integrated interventions during CATI responses.<h4>Methodology/principal findings</h4>We conducted a prospective observational cohort study on CATIs during the 2021 cholera outbreak in Northeast Nigeria. During CATI response in Borno, Adamawa, and Yobe, research enumerators accompanied CATI teams to households and observed interventions (including provision of soap, Aquatabs, educational materials, and jerrycans; latrine and bedding disinfection; and hygiene promotion) and collected data on demographics, existing household water, sanitation, and hygiene, and household water free chlorine residual (FCR). Enumerators returned to households 10-14 days later to conduct follow-up surveys. We tested differences in reported delivery and receipt of interventions, and household drinking water FCR concentrations before and after CATIs. We also analyzed the associated relationship between CATI and environmental factors and odds of FCR <0.2 mg/L using quasi-Poisson multivariate logistic regression models with generalized estimating equations (GEE). We found household drinking water FCR significantly increased (p<0.001) post-CATI in Adamawa state. Self-reported receipt of Aquatabs and handwashing station availability were significantly associated with reduced odds of FCR <0.2 mg/L at follow-up. Self-reported receipt of hygiene promotion lacked significant associations with FCR in both Adamawa and Borno. These associations varied by type of water source.<h4>Conclusions/significance</h4>These findings suggest that CATIs improved household drinking water FCR, a key protective measure against cholera, in Northeast Nigeria. Our research highlights factors associated with FCR concentrations <0.2 mg/L post-CATI in Adamawa and Borno, offering valuable insights for response planning, and overall supports the continued use of CATIs in humanitarian settings.https://doi.org/10.1371/journal.pntd.0012731 |
| spellingShingle | Lindsay Salem-Bango Jennifer OKeeffe Michael R Desjardins Daniele Lantagne Chiara Altare Gurpreet Kaur Kanaganathan Rangaiya Patricia Oke-Oghene Obroh Ahmadu Audu Chimda Emmanuel Solomon Thomas Heath Emmanuel Emeka Ihemezue Solomon Aye Baptiste Lecuyot Mustafa Sikder Shannon Doocy Melody Xiao Paul B Spiegel Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria. PLoS Neglected Tropical Diseases |
| title | Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria. |
| title_full | Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria. |
| title_fullStr | Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria. |
| title_full_unstemmed | Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria. |
| title_short | Case-area targeted interventions and free chlorine residual in household drinking water: An observational cohort study during a cholera outbreak in Northeast Nigeria. |
| title_sort | case area targeted interventions and free chlorine residual in household drinking water an observational cohort study during a cholera outbreak in northeast nigeria |
| url | https://doi.org/10.1371/journal.pntd.0012731 |
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