{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:05:00Z","timestamp":1788825900528,"version":"build-2803163510"},"update-to":[{"DOI":"10.1371\/journal.pntd.0010574","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2023,2,16]],"date-time":"2023-02-16T00:00:00Z","timestamp":1676505600000}}],"reference-count":47,"publisher":"Public Library of Science (PLoS)","issue":"2","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["OPP1148213"],"award-info":[{"award-number":["OPP1148213"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"crossref","award":["NIAIDR0199243"],"award-info":[{"award-number":["NIAIDR0199243"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000862","name":"Doris Duke Charitable Foundation","doi-asserted-by":"publisher","award":["Doris Duke International Clinical Research Fellowship at Harvard Medical School"],"award-info":[{"award-number":["Doris Duke International Clinical Research Fellowship at Harvard Medical School"]}],"id":[{"id":"10.13039\/100000862","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Food insecurity has been independently associated with developing cholera and there is an inverse relationship between national food security and annual cholera incidence. However, the factors that mediate the risk of cholera among food insecure households remain largely unexplored.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology and principal findings<\/jats:title>\n<jats:p>In a cross-sectional survey of rural households in Haiti, we explored the role of food behaviors (i.e., dietary choices and food-handling practices) as mediators of cholera risk among food-insecure families. We generated a series of multivariable regression models to test hypothesized associations between the severity of food insecurity (measured by the Household Hunger Scale), hygiene and food behaviors, and history of severe, medically-attended cholera.<\/jats:p>\n<jats:p>Moderate household hunger (Adjusted Odds Ratio [AOR] 1.47, 95% Confidence Interval (CI) 1.05\u20132.04; p = 0.021) and severe hunger (AOR 2.45, 95% CI 1.45\u20134.15; p = 0.001) were positively associated with a history of severe, medically-attended cholera compared with little to no household hunger. Household hunger was positively associated with three behaviors: antacid use, consumption of leftover non-reheated food, and eating food and beverages prepared outside of the home (i.e., at a restaurant or from a vendor). Consumption of outside food items and antacid use were positively associated with a history of cholera.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our findings suggest that food behaviors may mediate the association between food insecurity and cholera and contribute to an understanding of how interventions could be designed to target food insecurity as part of cholera prevention and control.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0010574","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T18:41:32Z","timestamp":1675708892000},"page":"e0010574","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":7,"title":["Food insecurity and risk of cholera: A cross-sectional study and exploratory analysis of potential 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Cene","family":"Augustin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ralph","family":"Ternier","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2314-9230","authenticated-orcid":true,"given":"Louise C.","family":"Ivers","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2023,2,6]]},"reference":[{"key":"pntd.0010574.ref001","volume-title":"About Cholera\u2013Global Task Force on Cholera Control [Internet]"},{"key":"pntd.0010574.ref002","volume-title":"9th-annual-meeting-gtfcc-2022-report.pdf [Internet]"},{"key":"pntd.0010574.ref003","volume-title":"Monitoring food security in countries with conflict situations.","author":"Food and Agriculture Organization of the United Nations\/World Food 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the National Health Examination and Nutrition Examination Survey (NHANES) 1999\u20132002","volume":"22","author":"HK Seligman","year":"2007","journal-title":"J Gen Intern Med"},{"issue":"5","key":"pntd.0010574.ref008","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1016\/j.ypmed.2009.03.003","article-title":"Food insecurity and dyslipidemia among adults in the United States","volume":"48","author":"FA Tayie","year":"2009","journal-title":"Prev Med"},{"issue":"1","key":"pntd.0010574.ref009","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1093\/jn\/nxz212","article-title":"Food Insecurity May Be an Independent Risk Factor Associated with Nonalcoholic Fatty Liver Disease among Low-Income Adults in the United States","volume":"150","author":"I Golovaty","year":"2020","journal-title":"J Nutr"},{"issue":"4","key":"pntd.0010574.ref010","doi-asserted-by":"crossref","first-page":"ofz102","DOI":"10.1093\/ofid\/ofz102","article-title":"More Than Malnutrition: A Review of the 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