Determinants of Cholera Endemicity in the Buhimba Health Area, Democratic Republic of Congo: A Community-Based Study
Déterminants de l’Endémicité du Choléra dans la Zone de Santé de Buhimba, République Démocratique du Congo : Une Étude Communautaire
DOI:
https://doi.org/10.67260/hra.v3i11.7127Keywords:
Cholera, Endemicity, Risk Factors, Unsanitary Environment, WaterAbstract
ABSTRACT
Introduction. Cholera persists as a significant global public health threat, with a high burden in sub-Saharan Africa. The Democratic Republic of Congo faces recurrent outbreaks, yet local drivers of transmission in specific settings like the Buhimba health area require detailed characterization to inform targeted control. This study aimed to identify the socio-economic, behavioral, and environmental determinants associated with cholera infection in this endemic area of eastern DR Congo. Methodology. We conducted an observational case-control study. Cases (n=142) were individuals with a positive cholera test, and controls (n=235) were negative individuals from the same community. Participants were selected using stratified probability sampling. Data collection employed KoBoToolbox, and analysis used SPSS 27, involving Chi-square tests and Odds Ratio (OR) calculation. Results. The study included 377 participants. Cholera cases constituted 37.7% of the sample, with a higher proportion among young adults (18-30 years) and women (62.9%). Key risk factors identified were the absence of cholera vaccination and lower education levels. Critical behavioral and environmental risks included drinking unsafe water (OR=6.44), practicing open defecation (OR=3.70), and poor hand hygiene. The strongest predictor was the absence of a clean latrine, which increased the odds of cholera 37-fold (OR=37.30). Storing water for three or more days was also significantly associated with the disease. Conclusion. Cholera in the Buhimba health area is strongly driven by inadequate water, sanitation, and hygiene (WASH) infrastructures and practices. Sustainable cholera control must prioritize universal access to safe water, promotion of latrine construction and maintenance, and reinforcement of vaccination campaigns alongside community hygiene education.
RÉSUMÉ
Introduction. Le choléra demeure une menace mondiale de santé publique, pesant particulièrement lourd en Afrique subsaharienne. La RD Congo subit des épidémies récurrentes, mais les facteurs locaux de transmission dans des contextes spécifiques comme l'aire de santé de Buhimba nécessitent une caractérisation détaillée pour guider les interventions. Cette étude visait à identifier les déterminants socio-économiques, comportementaux et environnementaux associés à l'infection cholérique dans cette zone endémique de l’est de la RD Congo. Méthodologie. Nous avons mené une étude observationnelle de type cas-témoins. Les cas (n=142) étaient des individus avec un test de choléra positif, et les témoins (n=235) étaient des individus négatifs de la même communauté. Un échantillonnage probabiliste stratifié a été utilisé. La collecte des données s'est faite via KoBoToolbox, et l'analyse a utilisé SPSS 27, incluant le test du Chi-deux et le calcul de l'Odds Ratio (OR). Résultats. L'étude a inclus 377 participants. Les cas de choléra constituaient 37,7% de l'échantillon, avec une proportion plus élevée chez les jeunes adultes (18-30 ans) et les femmes (62,9%). Les principaux facteurs de risque identifiés étaient l'absence de vaccination anti-cholérique et un faible niveau d'instruction. Les risques comportementaux et environnementaux critiques comprenaient la consommation d'eau non potable (OR=6,44), la défécation en plein air (OR=3,70) et une mauvaise hygiène des mains. Le prédicteur le plus puissant était l'absence de latrines propres, multipliant le risque de choléra par 37 (OR=37,30). Le stockage de l'eau pendant trois jours ou plus était également significativement associé à la maladie. Conclusion. Le choléra dans l'aire de santé de Buhimba est fortement déterminé par des infrastructures et pratiques inadéquates en eau, assainissement et hygiène. La lutte durable contre le choléra doit prioriser l'accès universel à l'eau potable, la promotion de la construction et de l'entretien des latrines, et le renforcement des campagnes de vaccination parallèlement à l'éducation communautaire à l'hygiène.
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Copyright (c) 2025 Neema Mbuzukongira Prince, Byaruhanga Ngbape Olivier, Bitwe Mihanda Richard, Mashako Ruhanga Many, Mutubuki Herbert
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