@article{fdi:010081511,
  title = {{I}nfluence of community-led total sanitation and water coverages in the control of cholera in {M}adarounfa, {N}iger (2018)},
  author = {{G}raveleau, {J}. and {R}eserva, {M}. {E}. and {K}eita, {A}. and {M}olinari, {R}. and {C}onstantin de {M}agny, {G}uillaume},
  editor = {},
  language = {{ENG}},
  abstract = {{E}very year, cholera affects 1.3-4.0 million people worldwide with a particularly high presence in {A}frica. {B}ased on recent studies, effective targeting interventions in hotspots could eliminate up to 50% of cases in {S}ub-{S}aharan {A}frica. {T}hose interventions include {W}ater, {S}anitation, and {H}ygiene ({WASH}) programs whose influence on cholera control, up to the present, has been poorly quantified. {A}mong the few studies available, {D}'{M}ello-{G}uyett et al. underline how the distribution of hygiene kits is a promising form of intervention for cholera control and that the integration of a {WASH} intervention at the point of admission of suspected cases is new in cholera control efforts, particularly in outbreaks and complex emergencies. {C}onsidering the limited number of studies on {C}ommunity-{L}ed {T}otal {S}anitation ({CLTS}) and water coverages related to cholera control, the aim of our work is to determine whether these interventions in cholera hotspots (geographic areas vulnerable to disease transmission) have significant impact on cholera transmission. {I}n this study, we consider data collected on 125 villages of the {M}adarounfa district ({N}iger) during the 2018 cholera outbreak. {U}sing a hurdle model, our findings show that full access to improved sanitation significantly decreases the likelihood of cholera by 91% ({P} < 0.0001) compared to villages with no access to sanitation at all. {C}onsidering only the villages affected by cholera in the studied area, cholera cases decrease by a factor of 4.3 in those villages where there is partial access to at least quality water sources, while full access to improved water sources decreases the cholera cases by a factor of 6.3 when compared to villages without access to water ({P} < 0.001). {I}n addition, villages without access to safe water and sanitation are 6.7 times ({P} < 0.0001) more likely to get cholera. {A}lternatively, villages with full sanitation and water coverage are 9.1 ({P} < 0.0001) less likely to get cholera. {T}he findings of our study suggest that significant access to improved water and sanitation at the village level offer a strong barrier against cholera transmission. {H}owever, it requires full {CLTS} coverage of the village to observe a strong impact on cholera, as partial access only has a limited impact.},
  keywords = {cholera ; {WASH} ; {A}frica ; hurdle model ; odd-ratio ; {NIGER}},
  booktitle = {},
  journal = {{F}rontiers in {P}ublic {H}ealth},
  volume = {9},
  numero = {},
  pages = {643079 [10 p.]},
  year = {2021},
  DOI = {10.3389/fpubh.2021.643079},
  URL = {https://www.documentation.ird.fr/hor/fdi:010081511},
}