{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,10,18]],"date-time":"2026-10-18T02:45:20Z","timestamp":1792291520880,"version":"4.4.0"},"posted":{"date-parts":[[2024,12,16]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":29,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2024,12,16]],"date-time":"2024-12-16T00:00:00Z","timestamp":1734307200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2024,12,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>\n                    The aim of this prospective cohort study is to build evidence on transmission dynamics and risk factors for\n                    <jats:italic>Vibrio cholerae<\/jats:italic>\n                    infections in cholera patient households.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>\n                    Household contacts of cholera patients were observed for 1-month after the index cholera patient was admitted to a health facility for stool, serum, and water collection in urban Bukavu in South Kivu, Democratic Republic of the Congo. A\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    infection was defined as a\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    bacterial culture positive result during the 1-month surveillance period and\/or a four-fold rise in a\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    O1 serological antibody from baseline to the 1-month follow-up.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>\n                    Twenty-seven percent of contacts (134 of 491) of cholera patients had a\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    infection during the surveillance period. Twelve percent (9 of 77) of cholera patient households had a stored water sample with\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    by bacterial culture, and 7% (5 of 70) had a water source sample with\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    . Significant risk factors for symptomatic\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    infections among contacts were stored food left uncovered (Odds Ratio (OR): 2.39, 95% Confidence Interval (CI): 1.13, 5.05) and younger age (children &lt;5 years) (OR: 2.09, 95% CI: 1.12, 3.90), and a drinking water source with &gt;1 colony forming unit\n                    <jats:italic>E<\/jats:italic>\n                    .\n                    <jats:italic>coli<\/jats:italic>\n                    \/ 100mL (OR: 3.59, 95% CI: 1.46, 8.84) for\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    infections.\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>\n                    The findings indicate a high risk of cholera among contacts of cholera patients in this urban cholera endemic setting, and the need for targeted water treatment and hygiene interventions to prevent household transmission of\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    .\n                  <\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Summary<\/jats:title>\n                  <jats:p>\n                    In this prospective cohort study in the Democratic Republic of the Congo, the majority of cholera patient households had multiple\n                    <jats:italic>Vibrio cholerae<\/jats:italic>\n                    infected household members and both source water and stored drinking water samples had\n                    <jats:italic>V. cholerae<\/jats:italic>\n                    .\n                  <\/jats:p>\n                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