Factors associated with fatal outcomes following cholera-like syndrome in Far North Region of Cameroon: A community based survey


Fabrice N Djouma, Jerome Ateudjieu, David A Sack


CaHReF 2016, Yaoundé Conges hall, 23 – 26 August 2016 ,PL020


During the last 20 years Cameroon has experienced 14 documented cholera epidemics with high case fatality rates. Understanding the determinants of death from cholera is a necessary step toward reducing the burden of the disease in Cameroon. The main objective of this study was to assess the effect of delays in seeking care and the locations of the care as possible risk factors for cholera mortality. 

A community based survey collected data on the circumstances of deaths following cholera-like syndrome occurring in villages that registered cholera -like diseases during the cholera outbreaks in Cameroon in 2009-2011. A case-control design was used to assess factors associated with such deaths.  Cases were deaths following cholera-like syndrome and controls were cases of cholera-like syndrome that survived. The estimation of associations was made by calculating the odds ratios, adjusting for age, sex and health district of residence.

Information on 97 patients who died and 197 patients who survived was obtained. The deaths occurred in one of four environments: the community, in a temporary community treatment center TCTC), in transit to a treatment center, or in a hospital.  The proportions for each were 39%; 32%; 5% and 24% respectively. Factors that were associated with the deaths included: the non-use of a cholera treatment center, receiving health care in a TCTC instead of a hospital, and greater than 4 hours delay between the onset of symptoms and the decision to go to a treatment center (odds ratios of 17.1 (CI: 11.7- 87.7), 2.5 (CI: 1.8- 17.9), and 2.2 (CI: 1.2- 7.6) respectively).

: During cholera epidemics, a higher proportion of deaths are still occurring in communities. The non-use and delays in deciding to go a treatment center, and treatment at TCTC rather than hospital were risk factors for death among patients with cholera-like syndrome in Cameroon. Educating people on community management of cholera-like syndrome and improving care in all health facilities are needed to reduce deaths during cholera epidemics.


cholera, death, factors, Cameroon, case fatality rate, mortality