1. Mortality, morbidity, and microbiology of endemic cholera among hospitalized patients in Dhaka, Bangladesh
- Author
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Mohammed Abdus Salam, Stephen B. Calderwood, George J. Fuchs, Ujjwal Dhar, Edward T. Ryan, Michael L. Bennish, Wasif A. Khan, and Abu Syed Golam Faruque
- Subjects
Adult ,Diarrhea ,Male ,Serotype ,medicine.medical_specialty ,Adolescent ,Prevalence ,Cholera ,Virology ,Internal medicine ,Epidemiology ,Pneumonia, Bacterial ,medicine ,Humans ,Child ,Intensive care medicine ,Cause of death ,Bangladesh ,business.industry ,Mortality rate ,Infant ,Odds ratio ,Length of Stay ,medicine.disease ,Pneumonia ,Infectious Diseases ,Child, Preschool ,Female ,Parasitology ,business - Abstract
Mortality and morbidity associated with cholera acquired in a modern endemic setting have not been well defined. In Dhaka, Bangladesh from 1986 to 1996, we found that causative agents of cholera shifted over time, varying by serogroup, biotype, and serotype. At the International Centre for Diarrhoeal Disease Research (ICDDR,B: Centre for Health and Population Research) in 1996, 19,100 cholera patients were treated, 887 (4.6%) were admitted, and 33 died (mortality rate = 3.7% of cholera inpatients, 0.14% of all cholera patients). When cholera inpatients who were discharged improved were compared with those who died, bacteremia (odds ratio [OR] = 10.5, 95% confidence interval [CI] = 2.9-37.9), radiographic evidence of pneumonia (OR = 3.1, 95% CI = 1.2-7.7), and acidosis as estimated by the serum bicarbonate value (OR = 0.893, 95% CI = 0.825-0.963) were independently associated with death by multivariate analysis. Pneumonia was the leading cause of death and accounted for two-thirds of all deaths among individuals with cholera in this study. Death in hospitalized patients with cholera acquired in a modern endemic setting is, therefore, extremely rare, and most frequently due to concomitant infection, especially pneumonia.
- Published
- 2000
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