*[1],2Mengistu, M. D., 1Challa, G., and 1Rorisa,M.
1Department of Internal Medicine, Yekatit-12 Hospital Medical College, Addis Ababa, Ethiopia
2Department of Medical Physiology, School of Medicine, Addis Ababa University, Addis Ababa, Ethiopia
*Correspondence to: mekoyamengistu@gmail.com
Abstract
Background: Cholera remains a major public health concern in low-income countries where the spread of disease is exacerbated by poor water supply, hygiene, and sanitation. Ethiopia has continued to face recurrent cholera outbreaks despite efforts to prevent and control the disease. The aim of the study was to assess the clinical characteristics, and outcomes among patients with acute watery diarrhea admitted to Cholera Treatment Center (CTC) of Yekatit-12 Teaching Hospital, Addis Ababa, Ethiopia.
Methodology: A hospital-based cross-sectional study was conducted from July 1, 2023 to Feb 30, 2025 on 176 patients with acute watery diarrheal disease admitted to the CTC during two major rainy seasons. Relevant clinical variables including socio-demographic data, co-morbidities, clinical presentations, risk factors, complications, outcomes and laboratory investigation results were obtained. Descriptive statistics were used to summarized the data and associations were tested using logistic regressions with statistical significance set at p value <0.05.
Results: Of the 176 patients, 52.0% were female and 90.0% were ≥15 years old. Vomiting and diarrhea were the predominant presenting symptoms (71.8%); 36.7% and 50.8% of patients had some dehydration and severe dehydration at admission, respectively. Electrolytes disturbance was the leading complication with hypokalemia (45.8%) being the most common, followed by hyponatremia (34.5%), and hypochloremia (23.7%). Acute kidney injury (AKI) occurred in 38.4% of the patients. The risk of AKI among patients >45 years was 5.9 times higher than patients <15 years of age (95% CI: 1.501-23.3, p=0.01) and patients with severe dehydration had 3.96 times higher risk of AKI compared with no dehydration (95% CI: 1.205-13.018, p=0.023). The case fatality rate was 6.25%. The common exposures to the disease included eating outside of home (54.0%), and unsafe water consumption (85.0%).
Conclusion: The cholera outbreak was characterized by moderate to severe dehydration, high burden of electrolyte imbalance, AKI and case fatality rate. Early case detection and community water, sanitation and hygiene (WaSH) interventions are recommended to reduce the disease burden, morbidity and mortality.
Keywords: Acute watery diarrhoea, Cholera, Acute kidney injury, Outcome, Ethiopia
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