Regional Key Scientific Publications

Yemen

• Responding to epidemics in large-scale humanitarian crises: a case study of the cholera response in Yemen, 2016–2018: Paul Spiegel, Ruwan Ratnayake, etc. (2019/07/15)

The authors conducted interviews with practitioners and advisors on preparedness; surveillance; laboratory; case management; malnutrition; water, sanitation and hygiene (WASH); vaccination; coordination and insecurity. Yemen had high risks of widespread infections due to water scarce and repeated airstrikes damaged water systems; however, it was not prepared for the epidemic.

• Risk factors associated with the recent cholera outbreak in Yemen: a case-control study: Fekri Dureab, Albrecht Jahn, etc. (2019/04/21)

A case-control study was conducted in Aden in 2018 to investigate risk factors for cholera in this still-ongoing outbreak. Behavioral factors and unsafe water appear to be the major risk factors in the recent cholera outbreak in Yemen.  

• The cholera outbreak in Yemen: lessons learned and way forward: Frederik Federspiel and Mohammad Ali. (2018/12/04)

The authors reviewed and discussed the cholera management strategies applied by the major international humanitarian health organizations present in Yemen. We find the response by the organizations examined to have been more focused on case management than on outbreak prevention.

• Cholera epidemic in Yemen, 2016–18: an analysis of surveillance data: Anton Camacho, Malika Bouhenia, etc. (2018/05/03)

The authors found that the cholera epidemic had trend. The small first wave seeded cholera across the country during the dry season and then leading to amplification in a major second wave during the rainy season. These findings have operational implications, including the need for improvements in epidemiological and laboratory surveillance, vaccination, and water and sanitation interventions.

• Yemen in a Time of Cholera: Current Situation and Challenges: Hesham M. Al-Mekhlafi. (2018/03/19)

The country is currently facing a cholera epidemic the world’s largest on record, surpassing one million (1,061,548) suspected cases, with 2,373 related deaths since October 2016. The provision of clean water and adequate sanitation is imperative as an effective long-term solution to prevent the further spread of this epidemic.

• First Wave of the 2016-17 Cholera Outbreak in Hodeidah City, Yemen - ACF Experience and Lessons Learned: Mathias Altmann, Miguel Suarez-Bustamante, etc. (2017/10/13)

This paper described that the international non-governmental organization Action Contre la Faim (ACF) outbreak response in Hodeidah city from October 28th, 2016 to February 28th, 2017 in order to add knowledge to this large outbreak. Considering the actual context of Yemen and its water infrastructure, much more efforts are needed to control the current outbreak resurgence.

Iraq

• Oral Cholera Vaccine Coverage during an Outbreak and Humanitarian Crisis, Iraq, 2015: Eugene Lam, Wasan Al-Tamimi, etc. (2017 January)

The authors conducted a multistage cluster survey to obtain OCV coverage estimates in 10 governorates that were targeted during the campaign. The experience in Iraq demonstrates that OCV campaigns can be successfully implemented as part of a comprehensive response to cholera outbreaks among high-risk populations in conflict settings.

• A five-year study on the epidemiological approaches to cholera in Iran: Moharam Mafi, Mohammad Mahdi Goya, etc. (2016 Summer)

The present study aimed to analyze the available information regarding cholera outbreaks since 2010 in Iran. The most cholera prevalent provinces in order of frequency were Baluchistan, Alborz, Gilan, Golestan and Qom, as well as Tehran.

Iran

• The epidemiology and antimicrobial resistance of cholera cases in Iran during 2013: Hossein Masoumi-Asl, Mohammad Mehdi Gouya, etc. (2016 Aug)

Migrants from neighboring countries played a key role in cholera outbreak in Iran during 2013. The results of antimicrobial susceptibility testing on 60 V. cholerae, serotype Inaba showed an increasing resistance rate in comparison with previous years.

• A five-year study on the epidemiological approaches to cholera in Iran: Moharam Mafi, Mohammad Mahdi Goya, etc. (2016 May)

This study aimed to identify potential sources of transmission in order to determine suitable interventions in similar outbreaks. In order to reduce the risk of cholera, sanitary standards for fruits and vegetables should be observed at all points from production to consumption, the population should be educated regarding hygienic food storage during outbreaks, and sanitary standards should be maintained when traveling during cholera outbreaks.

Lebanon

• Non-O1, non-O139 Vibrio cholerae septicemia at a tertiary care center in Beirut, Lebanon; a case report and review: Carla Zmeter, Hussam Tabaja, etc. (2018/9-10)

More clinical infections with non-O1, non-O139 Vibrio cholerae have been recently reported. These pathogens usually do not cause the epidemic and pandemic cases of cholera seen with choleragenic vibrios. However, they can still cause intestinal as well as extra-intestinal disease and can be associated with significant mortality.