Epidemiological Investigation of a Cholera Outbreak in Nepal-India Border Communities: Public Health Implications

Abstract

ObjectivesOn October 4, 2021, a cholera outbreak was reported in Kapilvastu district, one of the 26 districts in Nepal bordering India. This study examined the outbreak's characteristics, response efforts, and the challenges faced. MethodsA descriptive cross-sectional design was applied for the outbreak investigation. Data was gathered through a review of cases registered in three local health facilities and community-based active case searching. Descriptive analysis was conducted for data analysis. ResultsBetween 4 October and 2 December 2021, 1,570 cases were reported across 10 municipalities in Kapilvastu, with 84% of cases occurring in communities bordering India. Most affected were females (55%) and children aged 5-14 years (32%). A total of 39% cases were confirmed to have Vibrio cholerae O1 Ogawa serotype, which showed resistance to cotrimoxazole. Additionally, 453 cases of acute watery diarrhea were identified in the community, with 23% showing the signs of dehydration. Of 29 water samples, 17 (59%) were contaminated with fecal coliform. ConclusionCommunities along the Nepal-India border are highly vulnerable to cholera outbreaks, highlighting the urgent need for improved water, sanitation and hygiene practices. A coordinated approach to cholera surveillance and preparedness is crucial to prevent future outbreaks.