Cholera Outbreak Among the T’boli Tribe in a Municipality in Mindanao, Philippines: A case-control study from August to October 2021.

  • Water or foodborne
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The regional health office reported clustering of diarrhea cases among the T’boli tribe members in Kiamba, Sarangani. Field Epidemiology Training Program fellows were deployed to conduct an epidemiologic investigation to establish the existence of an outbreak, determine mode of transmission, risk and protective factors.

We conducted an unmatched 1:2 case-control study at a T’boli tribal community. A suspect case was a previously well individual from T’boli tribe with onset of diarrhea from August 28 to October 14, 2021. A control was a well individual negative for any pathogen within same area and time period. A questionnaire was utilized to collect data on risk and protective factors. Environmental surveys and key informant interviews were also conducted. Rectal swabs and fresh stool were collected among cases and controls for confirmatory testing.

There were 91 cases with five deaths (CFR = 5%). Fifty-two (57%) were females. Ages ranged from 1 year to 86 years (Median=20). Cases started to appear on August 29 and peaked on September 21, 2021. The main drinking water supply was an unprotected water spring along the river. Water sources were contaminated due to open defecation practices. No access to health and sanitation facilities makes the tribe prone to outbreak. Nineteen (15%) cases were positive for Vibrio cholerae. Identified risk factors were drinking untreated water (AOR = 3, 95% CI = 1.33-8.81) and being aged 0-9 years old (AOR = 4, 95% CI = 1.69-11.12).

There was a Cholera outbreak among T’boli tribe members. Unprotected water sources were contaminated due to poor environmental sanitation practices and lack of community and household water treatment. The outbreak was controlled after the LGU provided latrines and chlorination tabs. We recommended rehabilitation of unprotected water sources, construction of more latrines, and compliance to the “no open defecation” ordinances.

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