We detected V. cholerae O1 in stool of 6.2% (1604/25 958) of patients. Among those younger than 5 years, 2.1% (253/11 968) of diarrheal cases were positive for cholera, with 72.3% (183/253) of cases occurring in the under-2-year age and 27.7% (70/253) in 2–4-year age group. Among those who were older, 9.5% (1351/14 253) of cases were positive for cholera, of which 13.4% (181/1351) were aged 5–17 years, 67.4% (910/1351) were 18–45 years, and 19.2% (260/1351) were 46 years or older. The age distribution of cholera cases was qualitatively similar among the different Divisions and 53% were male. The majority (82.4%) of cholera cases had primary or no formal schooling (which included children and those who did not complete primary school). Most cholera cases had some or severe dehydration (78%), vomiting (75%), and abdominal cramps (71%).
Approximately 30% had eaten food from roadside vendors, 14% had eaten food in large gatherings, while 17.5% had neighbors with diarrhea in the week prior to illness (Table 1).
Table 1. Distribution of demographic, clinical factors and history of exposures of V. cholerae culture positives by divisions, May 2014-June 2018, Bangladesh
Characteristics | Divisions | |
Overall n(%), N=1604 | Dhaka n(%), N=405 | Chittagong n(%), N=572 | Barisal n(%), N=181 | Sylhet n(%), N=133 | Khulna n(%), N=200 | Rajshahi, n(%), N=94 | Rangpur n(%), N=19 | |
Age (years) | |
<5 | 253 (15.8) | 48 (11.9) | 63 (11.0) | 40 (22.1) | 37 (27.8) | 35 (17.5) | 15 (15.9) | 15 (78.9) | |
5-17 | 181 (11.3) | 48 (11.8) | 70 (12.2) | 19 (10.5) | 20 (15.0) | 17 (8.5) | 7 (7.5) | 0 (0.0) | |
18-45 | 910 (56.7) | 237 (58.5) | 346 (60.5) | 94 (51.9) | 61 (45.9) | 117 (58.5) | 52 (55.3) | 3 (15.8) | |
>46 | 260 (16.3) | 72 (17.8) | 93 (16.3) | 28 (15.5) | 15 (11.3) | 31 (15.5) | 20 (21.3) | 1 (5.3) | |
Sex (Male) | 853 (53.2) | 227 (55.9) | 295 (51.6) | 84 (46.4) | 71 (53.4) | 105 (52.5) | 58 (61.7) | 13 (68.4) | |
Education status | |
No formal schooling (child, not completed primary) | 630 (39.3) | 138 (34.1) | 208 (36.4) | 70 (38.7) | 78 (58.7) | 93 (46.5) | 28 (29.8) | 15 (78.9) | |
Primary | 691 (43.1) | 191 (47.2) | 281 (49.1) | 60 (33.2) | 50 (37.6) | 64 (32.0) | 43 (45.7) | 2 (10.5) | |
Secondary and above | 28 (17.6) | 76 (18.8) | 83 (14.5) | 51 (28.2) | 5 (3.8) | 43 (21.5) | 23 (24.5) | 2 (10.5) | |
Occupation | |
Service holder | 290 (18.1) | 127 (31.3) | 130 (22.7) | 8 (4.4) | 4 (3.0) | 13 (6.5) | 7 (7.5) | 1 (5.3) | |
Agricultural worker | 84 (5.2) | 12 (2.9) | 14 (2.5) | 8 (4.4) | 16 (12.0) | 24 (12.0) | 10 (10.6) | 0 (0.0) | |
Businessman | 104 (6.5) | 26 (6.4) | 35 (6.1) | 12 (6.6) | 3 (2.3) | 14 (7.0) | 13 (13.8) | 1 (5.3) | |
Housewife | 456 (28.4) | 96 (23.7) | 156 (27.3) | 72 (39.8) | 33 (24.8) | 72 (36.0) | 26 (27.7) | 1 (5.3) | |
Day laborer | 131 (8.2) | 32 (7.9) | 70 (12.2) | 5 (2.8) | 8 (6.0) | 6 (3.0) | 10 (10.6) | 0 (0.0) | |
Students & unemployed | 254 (15.8) | 51 (12.6) | 94 (16.4) | 36 (19.9) | 28 (21.1) | 32 (16.0) | 12 (12.8) | 1 (5.3) | |
Baby/Child (up to 10 years) | 275 (17.1) | 55 (13.6) | 73 (12.8) | 40 (22.1) | 39 (29.3) | 37 (18.5) | 16 (17.0) | 15 (78.9) | |
Others | 10 (0.6) | 6 (1.5) | 0 (0.0) | 0 (0.0) | 2 (1.5) | 2 (1.0) | 0 (0.0) | 0 (0.0) | |
Clinical characteristics | | | | | | | | | |
Fever | 804 (50.1) | 293 (72.4) | 235 (41.1) | 49 (27.1) | 81 (61.0) | 106 (53.0) | 30 (31.6) | 10 (52.6) | |
Vomiting | 1207 (75.3) | 363 (89.6) | 414 (72.4) | 139 (76.8) | 72 (54.1) | 133 (66.5) | 72 (76.6) | 14 (73.7) | |
Dehydration status | |
None | 358 (22.3) | 26 (6.4) | 197 (34.4) | 48 (26.5) | 41 (30.8) | 21 (10.5) | 24 (26.5) | 1 (5.3) | |
Some | 875 (54.6) | 170 (41.9) | 280 (48.9) | 118 (65.2) | 79 (59.4) | 161 (80.5) | 62 (65.9) | 5 (26.3) | |
Severe | 371 (23.1) | 209 (51.6) | 95 (16.6) | 15 (8.3) | 13 (9.8) | 18 (9.0) | 8 (8.5) | 13 (68.4) | |
Abdominal cramp | 1141 (71.2) | 352 (86.9) | 366 (63.9) | 152 (83.9) | 75 (56.4) | 121 (60.5) | 72 (76.6) | 3 (15.8) | |
Behavioral Exposures | |
Water treatment habit (Boiled) | 130 (8.1) | 67 (16.5) | 49 (8.6) | 7 (3.9) | 1 (0.8) | 2 (1.0) | 4 (4.3) | 0 (0.0) |
Taken Food from road side vendors | 485 (30.2) | 68 (16.8) | 216 (37.8) | 48 (26.5) | 35 (26.3) | 75 (37.5) | 43 (45.7) | 0 (0.0) |
Taken of food from large gatherings | 226 (14.1) | 21 (5.2) | 132 (23.1) | 12 (6.6) | 17 (12.8) | 27 (13.5) | 17 (18.1) | 0 (0.0) |
HH members suffered from diarrhea during last week | 158 (9.9) | 21 (5.2) | 92 (16.1) | 13 (7.2) | 4 (3.0) | 15 (7.5) | 13 (13.8) | 0 (0.0) |
Neighbors had diarrhea during last week | 280 (17.5) | 18 (4.4) | 132 (23.1) | 90 (49.7) | 14 (10.5) | 18 (9.0) | 7 (7.5) | 1 (5.3) |