Treatment Of Cholera Research Articles

Genomic epidemiology reveals multidrug resistant plasmid spread between Vibrio cholerae lineages in Yemen

Since 2016, Yemen has been experiencing the largest cholera outbreak in modern history. Multidrug resistance (MDR) emerged among Vibrio cholerae isolates from cholera patients in 2018. Here, to characterize circulating genotypes, we analysed 260 isolates sampled in Yemen between 2018 and 2019. Eighty-four percent of V. cholerae isolates were serogroup O1 belonging to the seventh pandemic El Tor (7PET) lineage, sub-lineage T13, whereas 16% were non-toxigenic, from divergent non-7PET lineages. Treatment of severe cholera with macrolides between 2016 and 2019 coincided with the emergence and dominance of T13 subclones carrying an incompatibility type C (IncC) plasmid harbouring an MDR pseudo-compound transposon. MDR plasmid detection also in endemic non-7PET V. cholerae lineages suggested genetic exchange with 7PET epidemic strains. Stable co-occurrence of the IncC plasmid with the SXT family of integrative and conjugative element in the 7PET background has major implications for cholera control, highlighting the importance of genomic epidemiological surveillance to limit MDR spread.

Cholera: An Overview with Reference to the Syrian Outbreak.

Cholera is an acute type of diarrheal disease caused by intestinal infection with the toxin-producing bacteria Vibrio cholerae. The disease is still endemic in almost 69 countries, accounting for around 2.86 million cases and 95,000 deaths annually. Cholera is associated with poor infrastructure, and lack of access to sanitation and clean drinking water. The current cholera outbreak in Syria is associated with more than 10 years of conflict, which has devastated infrastructures and health services. There were 132,782 suspected cases reported between August 25, 2022 and May 20, 2023 in all 14 governorates, including 104 associated deaths. The recent earthquake in the region has complicated the situation, with an increase in cholera cases, and hindrance to a response to the disease. Climate change has driven a number of large cholera outbreaks around the world this year. The World Health Organization prequalifies three oral cholera vaccines. Cholera treatment mainly depends on rehydration, with the use of antibiotics in more severe infections. This review gives an overview of cholera bacteriology, pathogenesis, epidemiology, clinical manifestations, diagnosis, management, and prevention in light of global climate change and the ongoing outbreak in Syria, which poses a significant public health threat that requires urgent attention.

Calcium-sensing receptor activator cinacalcet for treatment of cyclic nucleotide-mediated secretory diarrheas

Cyclic nucleotide elevation in intestinal epithelial cells is the key pathology causing intestinal fluid loss in secretory diarrheas such as cholera. Current secretory diarrhea treatment is primarily supportive, and oral rehydration solution is the mainstay of cholera treatment. There is an unmet need for safe, simple and effective diarrhea treatments. By promoting cAMP hydrolysis, extracellular calcium-sensing receptor (CaSR) is a regulator of intestinal fluid transport. We studied the antidiarrheal mechanisms of FDA-approved CaSR activator cinacalcet and tested its efficacy in clinically relevant human cell, mouse and intestinal organoid models of secretory diarrhea. By using selective inhibitors, we found that cAMP agonists-induced secretory short-circuit currents (Isc) in human intestinal T84 cells are mediated by collective actions of apical membrane cystic fibrosis transmembrane conductance regulator (CFTR) and Clc-2 Cl− channels, and basolateral membrane K+ channels. 30 μM cinacalcet pretreatment inhibited all 3 components of forskolin and cholera toxin-induced secretory Isc by ∼75%. In mouse jejunal mucosa, cinacalcet inhibited forskolin-induced secretory Isc by ∼60% in wild type mice, with no antisecretory effect in intestinal epithelia-specific Casr knockout mice (Casr-flox; Vil1-cre). In suckling mouse model of cholera induced by oral cholera toxin, single dose (30 mg/kg) oral cinacalcet treatment reduced intestinal fluid accumulation by ∼55% at 20 hours. Lastly, cinacalcet inhibited forskolin-induced secretory Isc by ∼75% in human colonic and ileal organoids. Our findings suggest that CaSR activator cinacalcet has antidiarrheal efficacy in distinct human cell, organoid and mouse models of secretory diarrhea. Considering its excellent clinical safety profile, cinacalcet can be repurposed as a treatment for cyclic nucleotide-mediated secretory diarrheas including cholera.

Cholera in Syria, a crisis following crises: Assessment of knowledge, attitude, and practice in a cohort of syrian population

Cholera is an acute bacterial disease caused by intestinal infection with Vibrio cholerae. It is one of the major re-emerging communicable diseases in Syria following the Syrian crisis and the Covid-19 pandemic. The current study was undertaken to explore the level of awareness in a cohort of the Syrian population by testing their knowledge and investigating their attitudes and practices. An internet-based survey that queried knowledge of cholera transmission, prevention, risk factors, and treatment was designed. Of particular interest was revealing sources of information associated with higher knowledge. Furthermore, individual attitudes and practices towards the disease were collected and analyzed. Participants were 1521, mostly females (68.3%), 18–25 years old (56.4%), single (72.7%), and college degree holders (75.9%). The main sources of information on cholera were school/college (31.7%), social media (28.7%), family and friends (13.2%), and online search engines (11.3%). The average total knowledge of the cohort was 40.39%. The participants >40 years old, highly educated, living in urban areas, and females demonstrated higher knowledge of cholera. Schools/colleges and online search engines were associated with better knowledge. Most of the cohort showed serious attitudes and considered cholera a very dangerous disease. They were very concerned about cholera resurfacing in the country and were worried about getting infected. The majority of the cohort were leading their lives favorably by eating out/takeaway <5 times a month; however, their practices regarding handling raw produce were suboptimal. Succeeding cholera re-emergence, females, highly educated, and >40 years old participants were more committed to changing practices and taking stricter safety measures. As cholera imposes a health threat not only to Syrians but to the people of the whole Middle East, preventive strategies were suggested, mainly raising awareness with more focused media means and vaccination of people at high risk in the affected areas of the governorates.

Review on Chloramphenicol Antibiotic

The Chloramphenicol is d-threo-2,2-dichloro-N-[β-hydroxy-α-(hydroxymethyl)]-n-nitropheny-lacetamide, a bacterioststic and highly effective antibacterial against $ (+) and gr (-) ocular pathogenic bacteria causing conjunctivitis or corneal ulcers. Chloramphenicol is used in the treatment of bacterial infections. It is used to treat certain types of serious infections caused by bacteria when other antibiotics cannot be used Chloramphenicol is used to treat serious infections in different parts of the body. It is sometimes given with other antibiotics. However, chloramphenicol should not be used for colds, flu, other virus infections, sore throats or other minor infections, or to prevent infections. Chloramphenicol widely used in Chloramphenicol is a medication used in the management and treatment of superficial eye infections such as bacterial conjunctivitis, and otitis externa. It has also been used for the treatment of typhoid and cholera. Chloramphenicol is an antibiotic and is in the class of antimicrobials that inhibits protein synthesis. Chloramphenicol is evaluated for Haemophilus influenzae infections, anaerobic infections, salmonellosis, Rocky Mountain spotted fever, and eye infections.

Food as a Driver of a Cholera Epidemic in Jijiga, Ethiopia-June 2017.

We conducted a case-control study to identify risk and protective factors during a cholera outbreak in Jijiga, Ethiopia, in June 2017. A case-patient was defined as anyone > 5 years old with at least three loose stools in 24 hours who was admitted to a cholera treatment center in Jijiga on or after June 16, 2017. Two controls were matched to each case by type of residency (rural or urban) and age group. We enrolled 55 case-patients and 102 controls from June 16 to June 23, 2017. Identified risk factors for cholera were male sex, eating cold food, and eating food outside the home. Eating hot food was protective, as was reported handwashing after defecation; no other reported water, sanitation, and hygiene factors were associated with cholera risk. Recommendations included continuing messaging about safe food handling practices at home, the dangers of consuming meals prepared away from home, and the importance of hand hygiene practices.

Sensitivity to antibacterial drugs of biofilms formed by strains of vibrio cholerae of various serogroups.

The ability of Vibrio cholerae to form biofilms may cause ineffectiveness of cholera treatment and prevention. The aim of the study was to determine the antibiotic sensitivity of V.cholerae in biofilms. Material and methods. Sensitivity to 11 antibacterial agents was determined for biofilms of 10 strains of V.cholerae of different serogroups isolated from humans and from water obtained for 48 hours at 37°C on plastic plates in vials with autoclaved tap water infected with a suspension of 104 V.cholerae microbial cells. For this purpose the plates were washed three times in physiological solution and transferred into penicillin vials with double dilutions of antibacterial agents in liquid nutrient medium (Martin's broth, pH 7.7). After 24 hours of cultivation in the thermostat (37°C), the biofilms were imprinted and 0.1 ml of plankton culture was seeded onto plates with Marten's agar (pH 7.7). After 24 hours in the thermostat (37°C), the biofilms were imprinted and 0.1 ml of plankton culture was sown on plates with Marten's agar (pH 7.7). The result was counted after 24 h, determining the minimum suppressive concentrations of preparations by the presence or absence of V.cholerae growth. Results. The strains studied in biofilm communities, in contrast to the planktonic form, were highly resistant to all antibacterial drugs taken in the study, except for ciprofloxacin and ceftazidime. To improve the effectiveness of treatment of cholera and other infections whose causative agents are cholera vibrio, it is necessary to determine the antibiotic sensitivity of V.cholerae biofilms.

Screening of Antimicrobial Activity of Poly Herbal Extracts against Bacterial Pathogens Causing Gastroenteritis in Tharaka Nithi County, Kenya

Herbals have been used for decades to treat gastrointestinal infections across the world, including in Tharaka-Nithi County, Kenya. Crude extracts from herbs have long been prescribed by traditional healers for treatment of typhoid, cholera, and shigellosis. However, the effectiveness of extracts obtained using different extraction solvents such as methanol, acetone, and hexane have not fully been evaluated. This study aimed at evaluating the effect of solvents (Ethanol, hexane, and methanol) on the yield of crude extract from plants (Erythrinna abyssinica, Aspilia pluriseta, Vangueria infausta, Ficus sycomorus, and Carissa edulis), assessing the effect of the solvents on extracted active metabolites, and determining the effect of these solvents on extract’s bioactivity against Vibrio cholerae, Shigella flexneri, and Salmonella typhimuriumi and, Escherichia coli that served as a model organism for screening plant extracts against Gram-negative bacteria. Crude extracts were obtained by soaking dried ground plant parts in individual solvents, which were then concentrated by a rotary evaporator. The phytochemical screening to detect plant metabolites was done qualitatively. Bioassays to analyze the efficacy of the plant crude extracts against the microbes were carried out in 4×3×3×5 factorial experiment laid out in a completely randomized design. The determination of bioactivity of herbal extracts was carried out using minimal inhibition concentration and minimum bactericidal concentration methods. Data obtained on the bioactivity assay (Count of the bacteria colony forming units) was analyzed using the Kruskal-Wallis test at α = 0.05, and medians were compared by the Wilcoxon rank sum test in Scientific Analysis System version 9.4. Methanol solvent produced higher quantities of crude extracts for all the herbal samples used with, Vangueria infausta producing the highest extract (5.06g). Most phytochemicals were present in Methanolic extracts compared to hexane and acetone extracts. There was a significant (p &lt; 0.05) difference in the bioactivity of different herbal plants against bacterial pathogens at different concentrations of crude extract. The efficacy of plant extract increased progressively from 100ppm to 1000ppm concentration. Methanol is recommended for use in the extraction of medicinal plant extracts as it leads to improved potency as compared to hexane and acetone.

On the Politics of Viruses and Visibility

On the Politics of Viruses and Visibility

Cholera Prevention and Treatment Policy Analysis in India

In India, cholera has been a problem for a long time, yet it is still widespread. Cholera can cause severe diarrhea and dehydration, with a high mortality rate in untreated patients. Despite the efforts of the government of India, the cholera pandemic in India has not yet been eradicated. Consequently, it is essential to analyze the reasons. This presentation will also present a possible reaction mechanism from the standpoint of public policy. Even though cholera is a preventable and curable illness, it is seen as a severe public health issue in a developing and densely populated nation such as India. Cholera is transmitted primarily through contaminated water, and migration, restricted access to clean drinking water, poor sanitation, a climate conducive to virus transmission, overcrowding, religious beliefs, open defecation, and ignorance of disease transmission are the primary causes of its rapid spread in India. Awareness of cholera control, the development of public restrooms, and the availability of vaccines are therefore crucial.

Recent surge in cholera outbreaks globally during the COVID-19 pandemic era: a potential threat to the African continent and salient counteracting strategies.

Recent surge in cholera outbreaks globally during the COVID-19 pandemic era: a potential threat to the African continent and salient counteracting strategies.

The Challenges of Building Sustainable Cities in Cameroon: Health Issues Associated with a Rapid Urban Population Increase in Buea Municipality.

Rapid urbanization compounded by urban poverty is one of the main challenges facing many Sub-Saharan African countries. The Buea municipality is the 10th largest city in Cameroon and equally faces such problems brought about by unplanned development in the past four decades. In 2020, the population growth rate in Buea rose to 42% compared to 5.6% in 2005, especially in the peri-urban areas. This resulted in direct and indirect pressures on available resources. Since 2019, Buea has been hosting close to 100,000 Internally Displaced Persons (IDPs) fleeing from the conflict between the defense and security forces and the separatist groups operating in the South West and North West Regions. Consequently, this expansion of urban agglomerations in Buea brings about challenges for the urbanites whose standard of living within the urban space is affected. This article seeks to qualitatively examine how this rapid urbanization has contributed to this recurrence of cholera outbreak since 2019 and the effects on the healthcare system and measures that are in place to mitigate this outbreak. In addressing these issues, the study administered in-depth phone Interviews with medical practitioners at Buea Regional Hospital, which is the main Cholera Treatment Centre in Buea. It also conducted in-depth phone interviews with public health experts at the South West Regional Delegation of Public Health and Buea Council personnel incharge of hygiene and sanitation. The study also made use of direct observation of the researcher on the field during sensitization campaigns in the affected communities in Buea. Base on the results the influx of IDPs have stress the already existing sanitation and shortage/rationing of water in the town. The study also found out that governance and cultural issues are equally associated to the problem of recurrence of the cholera disease in Buea Municipality.

New Insights into Vibrio cholerae Biofilms from Molecular Biophysics to Microbial Ecology.

With the discovery that 48% of cholera infections in rural Bangladesh villages could be prevented by simple filtration of unpurified waters and the detection of Vibrio cholerae aggregates in stools from cholera patients it was realized V. cholerae biofilms had a central function in cholera pathogenesis. We are currently in the seventh cholera pandemic, caused by O1 serotypes of the El Tor biotypes strains, which initiated in 1961. It is estimated that V. cholerae annually causes millions of infections and over 100,000 deaths. Given the continued emergence of cholera in areas that lack access to clean water, such as Haiti after the 2010 earthquake or the ongoing Yemen civil war, increasing our understanding of cholera disease remains a worldwide public health priority. The surveillance and treatment of cholera is also affected as the world is impacted by the COVID-19 pandemic, raising significant concerns in Africa. In addition to the importance of biofilm formation in its life cycle, V. cholerae has become a key model system for understanding bacterial signal transduction networks that regulate biofilm formation and discovering fundamental principles about bacterial surface attachment and biofilm maturation. This chapter will highlight recent insights into V. cholerae biofilms including their structure, ecological role in environmental survival and infection, regulatory systems that control them, and biomechanical insights into the nature of V. cholerae biofilms.

Altered molecular attributes and antimicrobial resistance patterns of Vibrio cholerae O1 El Tor strains isolated from the cholera endemic regions of India.

The present study aimed to document the comparative analysis of differential hypervirulent features of Vibrio cholerae O1 strains isolated during 2018 from cholera endemic regions in Gujarat and Maharashtra (Western India) and West Bengal (Eastern India). A total of 87V. cholerae O1 clinical strains from Western India and 48 from Eastern India were analysed for a number of biotypic and genotypic features followed by antimicrobial resistance (AMR) profile. A novel polymerase chain reaction was designed to detect a large fragment deletion in the Vibrio seventh pandemic island II (VSP-II) genomic region, which is a significant genetic feature of the V. cholerae strains that have caused Yemen cholera outbreak. All the strains from Western India belong to the Ogawa serotype, polymyxin B-sensitive, hemolytic, had a deletion in VSP-II (VSP-IIC) region and carried Haitian genetic alleles of ctxB, tcpA and rtxA. Conversely, 14.6% (7/48) of the strains from Eastern India belonged to the Inaba serotype, polymyxin B-resistant, nonhemolytic, harboured VSP-II other than VSP-IIC type, classical ctxB, Haitian tcpA and El Tor rtxA alleles. Resistance to tetracycline and chloramphenicol has been observed in strains from both regions. This study showed hypervirulent, polymyxin B-sensitive epidemic causing strains in India along with the strains with polymyxin B-resistant and nonhemolytic traits that may spread and cause serious disease outcomes in future. The outcomes of this study can help to improve the understanding of the hyperpathogenic property of recently circulating pandemic Vibrio cholerae strains in India. Special attention is also needed for the monitoring of AMR surveillance because V. cholerae strains are losing susceptibility to many antibiotics used as a second line of defence in the treatment of cholera.

An Assessment of Household Knowledge and Practices during a Cholera Epidemic- Dar es Salaam, Tanzania, 2016.

From August 15, 2015 to March 5, 2016, Tanzania reported 16,521 cholera cases and 251 deaths, with 4,596 cases and 44 deaths in its largest city, Dar es Salaam. To evaluate outbreak response efforts, we conducted a household survey with drinking water testing in the five most affected wards in Dar es Salaam. We interviewed 641 households 6 months after the beginning of the outbreak. Although most respondents knew that cholera causes diarrhea (90%) and would seek care if suspecting cholera (95%), only 45% were aware of the current outbreak in the area and only 5% would use oral rehydration salts (ORS) if ill. Of 200 (31%) respondents reporting no regular water treatment, 46% believed treatment was unnecessary and 18% believed treatment was too expensive. Fecal contamination was found in 45% of water samples and was associated with water availability (P = 0.047). Only 11% of samples had detectable free chlorine residual, which was associated with water availability (P = 0.025), reported current water treatment (P = 0.006), and observed free chlorine product in the household (P = 0.015). The provision of accessible, adequately chlorinated water supply, and implementation of social mobilization campaigns advocating household water treatment and use of ORS should be prioritized to address gaps in cholera prevention and treatment activities.

Medicinal Plants Used for Treatment of Gastrointestinal Infections in Tharaka-Nithi County

Health care is a basic need to humans which can only be achieved with medicines with high efficacy against disease causing pathogens. Globally, gastrointestinal infections are major health concern particularly to travelers since over 60% visiting tropical and subtropical regions develop diarrhea. Herbal plants have been used for decades to treat gastrointestinal infections globally including Tharaka-Nithi County in Kenya. However, there is little information on the demography of herbalist and the plants used in treatment of gastrointestinal infections such as typhoid, cholera and shigellosis. A cross sectional survey was carried out involving thirty herbalists to assess their demographic data and to establish herbs commonly used to treat typhoid, cholera and shigellosis in Tharaka-Nithi County. Data collected was subjected to Chi square test of association and descriptive statistics and presented in percentages. There were more male herbalists (65.52%) in the study than female herbalist (34.48%). Most of the herbalist (65.52%) were aged above 70 years. There was a significant (p &lt; 0.05) association between herbalists’ level of education and age (X2 (6, N = 30) = 17.349, p = 0.008). Most herbalists were found to have below primary education level 58.62%. Aloe vera, Aspilia pluriseta, Ficus sycomorus and Physalis peruviana were identified as commonly used plants for treatment of cholera with Aspilia pluriseta being most preferred (27%) by herbalist above the age of 70 years. Vangueria infausta, Eucalyptus globulus, Carissa edulis and Erythrina abysinnica were commonly used for treatment of shigellosis with Eucalyptus globulus being most preferred (58.6%) by herbalist above the age of 70 years. Erythrina abysinnica, Carissa edulis, Vangueria infausta and Eucalyptus globulus were commonly used for treatment of typhoid while 50.0% of herbalist above the age of 70 preferred Erythrina abysinnica. Most of the herbalists had below primary education level. In conclusion, herbal medicine is mostly dispensed by older people in Tharaka-Nithi County in Kenya. Different herbal plants are used in the treatment of cholera, shigellosis and typhoid.

Cholera prevention and management in Yemen

Cholera is an acute, watery diarrheal disease. It can cause people to vomit and diarrhea, dehydration and even death, it is caused by vibrio cholerae. Cholera is very severe in south America and some underdeveloped poor countries, it can be translated by water, food, mosquito, and it can be transmitted through contact with infected people. A country with a low level of education is more vulnerable to cholera because the people don’t have an awareness that they must keep their food clean and take some defensive measures when contacting patients. The main means of preventing cholera is to improve water quality and hygiene, which, despite improvements in hygiene and clinical treatment of cholera, still causes about 100,000 deaths a year. In conclusion, even if humans have mastered many ways to control cholera, cholera will still cause a lot of death in a few underdeveloped countries.

Exploring Japanese Kampo medicine in fighting epidemics: discovering and popularising croton and satou as 'specific drugs' to treat cholera

Japanese Kampo medicine (medicine with Han Fang) was found effective to treat some epidemic diseases.Historical records show that Namikawa Saimin, a Kampo medicine (Han Fang Medicine) practitioner during the cholera pandemic in the period of Ansei in Japan (1858-1860), discovered that the treatment effect of croton fruit against cholera was remarkable. Another physician in Naniwa also found that satou (Zhǎ Dá, visceral stones of animals and livestock) had the same effect in treating cholera. Subsequently, Wani Tadatane, an official physician in Komatsu Han of Iyo Province, learned about Namikawa Saimin and the use of croton fruit, and a medical officer in Kohofu, Masugi Fuminori, also heard of the story of the physician from Naniwa. Wani Tadatane and Masugi Fuminori verified the effect of croton fruit and satou on cholera treatment respectively. They regarded these two medical materials as the 'specific drugs' for cholera treatment by drawing on the interpretation and understanding of traditional Chinese medicine in terms of the efficacy of these two drugs. In this sense, croton fruit as a 'specific drug' for cholera treatment was widely accepted in the Kampo medical field (Han medicine area in Japan). The development of the use of satou by Masugi Fuminori could not be traced back because of the lack of historical records.

CHOLERA IN SANA'A, YEMEN: CLINICAL FEATURES, RISK FACTORS AND ANTIBIOTIC SENSITIVITY OF VIBRIO CHOLERAE

Background: Cholera, caused by Vibrio cholerae O1 or O139 serotypes, is one of the most important healthcare associated infections (HAI) among patients in Yemen.&#x0D; Aim: This study aimed to determine the risk factors associated with cholera outbreaks, clinical presentations, and antibiotic susceptibility of the V. cholerae strains isolated among inpatient in Diarrheal Treatment Centers (DTCs) in Sana’a City.&#x0D; Methods: This is a matched case-control study carried out on 134 DTC inpatients (cases) aged from 2 to 85 years who had a mean age of 26.8 years; and 134 community healthy individuals (control), ranged in age from 2 to 85 years with a mean age of 27.1 years in Sana'a. The identified isolates were tested for antibiotics susceptibility using disc diffusion technique. Data were analyzed using Epi Info 7.2. Express the quantitative data as mean values, standard deviation (SD), when the data are normally distributed.&#x0D; Results: Among the cases, females are more susceptible to cholera than males (62.7% vs. 37.3%), and there is an increase in the incidence of cholera with age as 32.8% of cases were in the ≥35-year age group. There were significant risk factors for cholera with unwashed fruits (OR=33, p&lt;0.001), unwashed vegetables (OR=5.3, p=0.001), outside foods (OR=129, p&lt;0.001), and leftovers un-cooled food (OR=2, p=0.04). Also, collapsed drinking water and sanitation system (OR=4.5, p&lt;0.001), sewage running in street (OR=8.7, p&lt;0.001), and contact with diarrhea persons in the home (OR=33.3, p&lt;0.001) were factors associated with cholera, while being vaccinated with cholera vaccines (OR=0.11, p&lt;0.001) and use of pipes for sewage disposal (OR=0.5, p=0.02) were factors protectively associated with cholera.&#x0D; Conclusion: Cholera affects all age groups in Sana’a, with females and persons of the age group greater than 35 years mostly affected. The most common clinical presentations were watery diarrhea and abdominal pain. Consumption of unwashed fruits, vegetables, outside food, unrefrigerated food, use of breakdown sewage system, dilapidated sewage near the home, running of street sewage, and contact with diarrhea in the home were risk factors, while cholera vaccination was protective against it. Therefore there is need to ensure that proper hygiene and sanitation to prevent infection.&#x0D; &#x0D; Peer Review History: &#x0D; Received: 1 May 2022; Revised: 12 June; Accepted: 28 June, Available online: 15 July 2022&#x0D; Academic Editor: Dr. Asia Selman Abdullah, Pharmacy institute, University of Basrah, Iraq, asia_abdullah65@yahoo.com&#x0D; UJPR follows the most transparent and toughest ‘Advanced OPEN peer review’ system. The identity of the authors and, reviewers will be known to each other. This transparent process will help to eradicate any possible malicious/purposeful interference by any person (publishing staff, reviewer, editor, author, etc) during peer review. As a result of this unique system, all reviewers will get their due recognition and respect, once their names are published in the papers. We expect that, by publishing peer review reports with published papers, will be helpful to many authors for drafting their article according to the specifications. Auhors will remove any error of their article and they will improve their article(s) according to the previous reports displayed with published article(s). The main purpose of it is ‘to improve the quality of a candidate manuscript’. Our reviewers check the ‘strength and weakness of a manuscript honestly’. There will increase in the perfection, and transparency. &#x0D; Received file: Reviewer's Comments:&#x0D; Average Peer review marks at initial stage: 6.0/10&#x0D; Average Peer review marks at publication stage: 7.0/10&#x0D; Reviewers:&#x0D; Dr. Bountain Welcome Tebeda,Chemical Pathology Department, Federal Medical Centre, Yenagoa, Nigeria. bountaintebeda@yahoo.com&#x0D; Dr. Esther Marguerite Chase DJANGA, Faculty of Medicine and Biomedical Sciences. Department of Public Health. University of Yaoundé I, Cameroon. e.djanga@yahoo.com&#x0D; Similar Articles: &#x0D; EPIDEMICITY OF VIBRIO CHOLERA IN SANA’A CITY, YEMEN: PREVALENCE AND POTENTIAL DETERMINANTS&#x0D; SURVEY OF SAFETY PRACTICES IN DIARRHEAL TREATMENT CENTERS: CHOLERA TREATMENT CENTERS IN YEMEN

Renewed Interest in Cholera Control

Cholera is an ancient disease of significant public health importance accounting for approximately 1.3-4 million cases worldwide and about 21000–143,000 deaths. Cholera is endemic in many developing countries where sanitation is poor and lack in safe water. The disease has the potential to cause large-scale epidemics and pandemics. The ongoing seventh pandemic has spread to more than 100 countries since its origin in 1961 in Indonesia. Travellers from developed countries travelling to cholera endemic areas are at higher risk of getting cholera. Oral rehydration therapy (ORT) has revolutionized the treatment of cholera and causes reduction of mortality. ORT has saved the lives of millions of children all over the world and is considered the single most significant discovery in medicine of the century. Effective oral cholera vaccines have been developed and are being used but not to its full potential to control cholera. Since the disease burden due to cholera is huge and we have the tools to combat cholera, particularly reduce mortality, it is imperative that the global communities should embark on cholera control as an urgent priority of human health. Cholera control should be viewed as a poverty alleviation programme for the marginalised population. The current pandemic of COVID-19 overwhelmed the economy and healthcare systems so much so that the health authorities undermined the cholera control measures even during ongoing epidemics of cholera. The World Health Organization (WHO) has reframed the strategy with renewed interest on cholera control with a target of reducing the mortality from cholera by 90 percent by 2030. Member countries should mobilize enough funds for the programme and actively implement it. Improvement of sanitation and safe water for all should continue as long-term solution for combating the menace of cholera.