Socio-demographic Determinants of Water Treatment in Cholera Patients and Clinical Presentation of Disease: A Decade of Observation from a Large Urban Diarrhoeal Disease Hospital in Bangladesh

Abstract

Cholera remains a health problem around the globe including Bangladesh, and  claims thousands of lives and places a substantial strain on public health resources. Data collected from 4,894 cholera patients who presented to Dhaka Hospital of icddr,b between 2004 and 2013, and were analysed to assess the socio-demographic determinants of water treatment and their impact on cholera, and examine the possible influence of water treatment on changing clinico-pathologic predictors in cholera patients. Results of this study consistently showed strong association between water treatment and male sex, family income, slum residence and hygiene. Stool characteristics, vomiting, concomitant infection with ETEC, dehydration and rehydration with IV fluids were clinically significant factors. Although socio-demographic factors remain strong determinants of water treatment among cholera patients, increasing severity of the clinical manifestations of cholera as indicated by this study suggest greater burden of inoculation or more possibly increased virulence of these organisms.