{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:30:47Z","timestamp":1787009447536,"version":"build-2736575974"},"reference-count":25,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,8]],"date-time":"2025-05-08T00:00:00Z","timestamp":1746662400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004532","name":"Japan International Cooperation Agency","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004532","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Zambia experienced the largest cholera outbreak in the country history in 2023\u20132024 in the capital, Lusaka. This study aimed to identify the clinical characteristics of the adult patients hospitalized at the community and referral cholera treatment centers (CTCs) to determine factors associated with their severe clinical outcomes during the outbreak.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Clinical information on the adult patients with cholera in the community and referral CTCs was retrospectively analyzed. Clinical factors associated with the fatal outcome were explored by multivariate analysis, using Firth's penalized logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 6578 adult cases were identified. The overall case fatality rate was 1.0% (51 of 5020), and it was highest in a referral CTC specializing in patients with underlying conditions (4.1% [32 of 772]). In the multivariate analysis, age (odds ratio, 1.05 [95% confidence interval, 1.02\u20131.09]), human immunodeficiency virus infections (5.68 [2.12\u201315.30]), diabetes mellitus (8.21 [1.38\u201334.00]), and severe dehydration at admission (5.97 [1.29\u201356.94]) were independently correlated with fatal outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinical factors, including age, underlying conditions, and disease severity at admission, were shown to be associated with severe clinical outcomes in adult patients with cholera. Enhanced case management strategies targeted for such high-risk groups might be beneficial in reducing the case fatality rate during cholera outbreaks.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ofid\/ofaf277","type":"journal-article","created":{"date-parts":[[2025,5,6]],"date-time":"2025-05-06T07:42:12Z","timestamp":1746517332000},"source":"Crossref","is-referenced-by-count":5,"title":["Clinical Characteristics of 6578 Adult Patients With Cholera Admitted to Community and Referral Cholera Treatment Centers in Lusaka, Zambia, October 2023 to April 2024"],"prefix":"10.1093","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3309-0538","authenticated-orcid":false,"given":"Nyuma","family":"Mbewe","sequence":"first","affiliation":[{"name":"Cholera Incident Management System, Zambia National Public Health Institute , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadatsugu","family":"Imamura","sequence":"additional","affiliation":[{"name":"Project for Strengthening Laboratory-based Surveillance for Infectious Diseases, Japan International Cooperation Agency , Tokyo ,","place":["Japan"]},{"name":"Center for Postgraduate Education and Training, National Center for Child Health and Development , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suilanji","family":"Sivile","sequence":"additional","affiliation":[{"name":"Adult Infectious Disease Center, University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-4463-5614","authenticated-orcid":false,"given":"Annel","family":"Sinkala","sequence":"additional","affiliation":[{"name":"Adult Infectious Disease Center, University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2653-4428","authenticated-orcid":false,"given":"Paul","family":"Zulu","sequence":"additional","affiliation":[{"name":"Cholera Incident Management System, Zambia National Public Health Institute , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1186-5045","authenticated-orcid":false,"given":"Chitalu","family":"Chanda","sequence":"additional","affiliation":[{"name":"Adult Infectious Disease Center, University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil","family":"Naik","sequence":"additional","affiliation":[{"name":"Adult Infectious Disease Center, University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-5133-0830","authenticated-orcid":false,"given":"Nawa","family":"Kalima","sequence":"additional","affiliation":[{"name":"National Heart Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roy","family":"Tepa","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Levy Mwanawasa University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-1594-8556","authenticated-orcid":false,"given":"Kabaso","family":"Mwewa","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Levy Mwanawasa University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenneth","family":"Kapololwe","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Levy Mwanawasa University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anchindika","family":"Mugala","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Levy Mwanawasa University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aggrey","family":"Mweemba","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Levy Mwanawasa University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Davie","family":"Simwaba","sequence":"additional","affiliation":[{"name":"Cholera Incident Management System, Zambia National Public Health Institute , Lusaka 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Lusaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aspha","family":"Choonga","sequence":"additional","affiliation":[{"name":"Luska Provincial Health Office , Lusaka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bob","family":"Chirwa","sequence":"additional","affiliation":[{"name":"Adult Infectious Disease Center, University Teaching Hospital , Lusaka ,","place":["Zambia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shingo","family":"Mitsushima","sequence":"additional","affiliation":[{"name":"Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuuki","family":"Tsuchihashi","sequence":"additional","affiliation":[{"name":"Center for Field Epidemic Intelligence, Research and Professional Development, National Institute of Infectious Diseases , Tokyo 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