Our Advisory Council
To respond to the increasin...
An alliance of prominent or...
An advocacy tool
A contagious diarrhoeal dis...
Our prevention strategy
Methodology for the elimina...
A best practice model in th...
A best practice model in the Democratic Republic of Congo
Cholera Source Areas in DRC
A multisectorial action plan
Logos & banners
full text open access
case-area targeted interventions
Estimating effectiveness of case-area targeted response interventions against cholera in Haiti
Edwige Michel | Jean Gaudart | Samuel Beaulieu | Gregory Bulit | Martine Piarroux | Jacques Boncy | Patrick Dely | Renaud Piarroux | Stanislas Rebaudet
Date of Publication:
Dec 30, 2019
Case-area targeted interventions (CATIs) against cholera are conducted by rapid response teams, and may include various activities like water, sanitation, hygiene measures. However, their real-world effectiveness has never been established. We conducted a retrospective observational study in 2015-2017 in the Centre department of Haiti. Using cholera cases, stool cultures and CATI records, we identified 238 outbreaks that were responded to. After adjusting for potential confounders, we found that a prompt response could reduce the number of accumulated cases by 76% (95% confidence interval, 59 to 86) and the outbreak duration by 61% (41 to 75) when compared to a delayed response. An intense response could reduce the number of accumulated cases by 59% (11 to 81) and the outbreak duration by 73% (49 to 86) when compared to a weaker response. These results suggest that prompt and repeated CATIs were significantly effective at mitigating and shortening cholera outbreaks in Haiti.
The potential impact of case-area targeted interventions in response to cholera outbreaks: A modeling study
Flavio Finger | Enrico Bertuzzo | Francisco J. Luquero | Nathan Naibei | Brahima Touré | Maya Allan | Klaudia Porten | Justin Lessler | Andrea Rinaldo | Andrew S. Azman
Date of Publication:
Cholera prevention and control interventions targeted to neighbors of cholera cases (case-area targeted interventions [CATIs]), including improved water, sanitation, and hygiene, oral cholera vaccine (OCV), and prophylactic antibiotics, may be able to efficiently avert cholera cases and deaths while saving scarce resources during epidemics. Efforts to quickly target interventions to neighbors of cases have been made in recent outbreaks, but little empirical evidence related to the effectiveness, efficiency, or ideal design of this approach exists. Here, we aim to provide practical guidance on how CATIs might be used by exploring key determinants of intervention impact, including the mix of interventions, “ring” size, and timing, in simulated cholera epidemics fit to data from an urban cholera epidemic in Africa. We developed a micro-simulation model and calibrated it to both the epidemic curve and the small-scale spatiotemporal clustering pattern of case households from a large 2011 cholera outbreak in N’Djamena, Chad (4,352 reported cases over 232 days), and explored the potential impact of CATIs in simulated epidemics. In conclusion, we found that CATIs using OCV, antibiotics, and water treatment interventions at an appropriate radius around cases could be an effective and efficient way to fight cholera epidemics. They can provide a complementary and efficient approach to mass intervention campaigns and may prove particularly useful during the initial phase of an outbreak, when there are few cases and few available resources, or to shorten the often protracted tails of cholera epidemics.