[A cholera epidemic in Dijibouti (May 2000-January 2001)]

The purpose of this report is to describe a cholera outbreak that occurred in the Republic of Djibouti from May 2000 to January 2001. Because the Somalian index cases involved were identified, this outbreak can be used as a model for imported epidemics. Development of the disease in the Djibouti City is promoted by a combination of poor living conditions and inadequate water supply. Unlike in previous epidemics in Djibouti, bacteriological study demonstrated the emergence of Vibrio cholerae strains presenting antibiotic resistance similar to that observed in Somalia. At the only facility available for cholera treatment in the country, 1920 patients were admitted and 36(1.9%) died. An epidemiological study of these patients demonstrated that females accounted for most cases in the 15-to-44-year age group (p < 0.0001) whereas males accounted for most cases in the age groups ranging from 0 to 1 year (p = 0.003) and 5 to 14 years (p = 0.002). These findings suggest that the mode of contamination and access to care vary according to sex and age.