Abstract
An outbreak of acute gastroenteritis due to Shigella flexneri occurred in August 2012 in the catchment area of the Wadi Sahtan Health Center in Rustaq, Al Batinah South Governorate, Oman. The aim of this study was to discover possible causes of this outbreak in the villages of Fassa, Rogh and Amk and to measure the risk of exposure among cases and controls. A case-control study was conducted in September 2012 in Fassa, Rogh and Amk. All households in the three villages were interviewed. Case and control households were compared to determine possible exposure avenues, including place of residence, source of drinking water, hand hygiene levels and practices related to drinking water, food preparation and environmental sanitation. Residing in Fassa (P <0.0001; odds ratio [OR] = 4.86, 95% confidence interval [CI] = 2.22-10.63) and average hand hygiene practices (P = 0.008; OR = 13.97, 95% CI = 1.58-123.36) were associated with an increased risk of contracting shigellosis. No significant differences were found with regards to the other exposure avenues. This was the first study conducted in Oman regarding an outbreak of shigellosis in a community setting. The only variables that significantly impacted the risk of acute gastroenteritis were residing in Fassa and average hand hygiene practices. The source of the outbreak could not be identified. However, septic tank sanitation and water and food consumption practices were not satisfactory in the studied villages. These need to be addressed to prevent similar outbreaks of acute gastroenteritis in this region in the future.
Highlights
An outbreak of acute gastroenteritis due to Shigella flexneri occurred in August 2012 in the catchment area of the Wadi Sahtan Health Center in Rustaq, Al Batinah South Governorate, Oman
Fassa was the village most affected by acute gastroenteritis (n = 33; 75.0%) with only six (13.6%) and five (11.4%) affected households from Rogh and Amk, respectively
The causal agent was not isolated from the water samples taken, various other factors—such as the attack rate and evidence from environmental investigations which showed that the levels of free residual chlorine in the water were not sufficient to prevent the contamination of the water network— suggested that it was a waterborne outbreak.[19]
Summary
Abstract: Objectives: An outbreak of acute gastroenteritis due to Shigella flexneri occurred in August 2012 in the catchment area of the Wadi Sahtan Health Center in Rustaq, Al Batinah South Governorate, Oman. The aim of this study was to discover possible causes of this outbreak in the villages of Fassa, Rogh and Amk and to measure the risk of exposure among cases and controls. Case and control households were compared to determine possible exposure avenues, including place of residence, source of drinking water, hand hygiene levels and practices related to drinking water, food preparation and environmental sanitation. Septic tank sanitation and water and food consumption practices were not satisfactory in the studied villages These need to be addressed to prevent similar outbreaks of acute gastroenteritis in this region in the future. Advances in Knowledge - This is the first study conducted in Oman regarding a shigellosis outbreak in a community setting and investigating sources and risks of exposure. Other sources of drinking water included personal mineral and well water supplies and water supplied through tankers to individual households
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