Prioritizing interventions for cholera control in Kenya, 2015-2020

Area of Science:

• Epidemiology
• Public Health
• Infectious Disease Control

Background:

• Kenya has a history of cholera outbreaks, with significant case numbers reported between 2015-2020.
• The Global Task Force for Cholera Control (GTFCC) advocates for targeted interventions in cholera hotspots.
• Effective cholera control requires accurate identification of high-risk areas.

Purpose of the Study:

• To identify cholera hotspots in Kenya at both county and sub-county levels using the GTFCC hotspot method.
• To compare the accuracy of county-level versus sub-county-level analysis for cholera risk assessment.
• To inform targeted cholera intervention and prevention strategies.

Main Methods:

• Utilized GTFCC hotspot identification methodology.
• Analyzed cholera case data from 2015-2020 across Kenyan counties and sub-counties.
• Applied mean annual incidence (MAI) and persistence criteria to define high-risk areas.

Main Results:

• Identified 13 high-risk sub-counties within 8 counties, including Garissa, Tana River, and Wajir.
• Revealed discrepancies between county-level and sub-county-level hotspot classifications.
• Estimated that 3.2 million people were misclassified using county-level analysis compared to sub-county-level analysis.

Conclusions:

• Sub-county level analysis is crucial for accurately identifying cholera hotspots in Kenya.
• Localized risk assessments are essential for effective targeting of cholera interventions.
• Finer-scale data analysis enhances the precision of public health resource allocation for vulnerable populations.