{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T23:02:43Z","timestamp":1788217363531,"version":"build-2803163510"},"reference-count":13,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,12,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This study demonstrates that most cholera deaths in this region of Cameroon occur out of hospital. This is a region which is prone to cholera, and interventions are needed to improve access to emergency medical care, especially during cholera outbreaks. Cameroon has experienced 14 cholera epidemics during the last 20 years, and these have had high case fatality rates. This study attempted to assess the effect of delays in seeking care and the locations of care as possible risk factors for cholera mortality. The study used data from a community-based survey regarding the circumstances of 97 fatal cases and 197 control (nonfatal) cases following a cholera-like syndrome in villages with cholera-like diseases during cholera outbreaks in Cameroon during 2009\u20132011. Deaths occurred in one of four environments: the community, in a temporary community treatment center (TCTC), in transit to a treatment center, or in a hospital (39%, 32%, 5%, and 24%, respectively). Using a case\u2013control analysis, factors associated with deaths included the nonuse of a cholera treatment center, receiving health care in a TCTC instead of a hospital, and greater than 4 hours delay between the onset of symptoms and the decision to go to a treatment center (odds ratios of 17.1 [confidence interval (CI): 7.0\u201341.8], 2.5 [CI: 1.2\u20135.0], and 2.2 [CI: 1.0\u20134.6], respectively). During cholera epidemics, a higher proportion of deaths are still occurring in communities. The nonuse and delays in deciding to go a treatment center, and treatment at TCTC rather than a hospital were risk factors for death among patients with cholera-like syndrome in Cameroon. Informing people on community management of cholera-like syndrome and improving care in all health facilities are needed to reduce deaths during cholera epidemics.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0300","type":"journal-article","created":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T16:13:13Z","timestamp":1476807193000},"page":"1287-1291","source":"Crossref","is-referenced-by-count":25,"title":["Factors Associated with Fatal Outcomes Following Cholera-Like Syndrome in Far North Region of Cameroon: A Community-Based Survey"],"prefix":"10.4269","volume":"95","author":[{"given":"Fabrice N.","family":"Djouma","sequence":"first","affiliation":[{"name":"Meilleur Acc\u00e8s aux Soins de Sant\u00e9 (M.A. SANTE), Yaound\u00e9, Cameroon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerome","family":"Ateudjieu","sequence":"additional","affiliation":[{"name":"Meilleur Acc\u00e8s aux Soins de Sant\u00e9 (M.A. SANTE), Yaound\u00e9, Cameroon."},{"name":"Department of Biomedical Sciences, University of Dschang, Dschang, Cameroon."},{"name":"Division of Health Operations Research, Ministry of Public Health, Yaound\u00e9, Cameroon."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malathi","family":"Ram","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amanda K.","family":"Debes","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Sack","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"ref1","series-title":"Lancet","first-page":"223","article-title":"Cholera","volume":"363","author":"Sack","year":"2004"},{"key":"ref2","series-title":"PLoS Negl Trop Dis","first-page":"e0003832","article-title":"Updated global burden of cholera in endemic countries","volume":"9","author":"Ali","year":"2015"},{"issue":"(Suppl 1)","key":"ref3","series-title":"J Infect Dis","first-page":"S92","article-title":"National surveillance data on the epidemiology of cholera in Cameroon","volume":"208","author":"Djomassi","year":"2013"},{"key":"ref4","series-title":"Cholera Outbreak. Assessing the Outbreak Response and Improving Preparedness","author":"World Health Organization (WHO)","year":"2004"},{"key":"ref5","series-title":"J Health Popul Nutr","first-page":"1","article-title":"Epidemiology of rotavirus and cholera in children aged less than five years in rural Bangladesh","volume":"29","author":"Siddique","year":"2011"},{"key":"ref6","series-title":"Vaccine","first-page":"469","article-title":"Field trial of oral cholera vaccines in Bangladesh: evaluation of anti-bacterial and anti-toxic breast-milk immunity in response to ingestion of the vaccines","volume":"8","author":"Clemens","year":"1990"},{"key":"ref7","series-title":"Indian J Public Health","first-page":"68","article-title":"Effectiveness of oral rehydration salt solution (ORS) in reduction of death during cholera epidemic","volume":"34","author":"Sircar","year":"1990"},{"key":"ref8","series-title":"Johns Hopkins Med J","first-page":"197","article-title":"Oral fluid therapy of cholera among Bangladesh refugees","volume":"132","author":"Mahalanabis","year":"1973"},{"issue":"(Suppl 2)","key":"ref9","series-title":"Int J Gynaecol Obstet","first-page":"S23","article-title":"The strategic model for the PMM Network","volume":"59","author":"Maine","year":"1997"},{"key":"ref10","series-title":"Int J Infect Dis","first-page":"8","article-title":"Epidemic cholera in Guinea-Bissau: the challenge of preventing deaths in rural west Africa","volume":"4","author":"Gunnlaugsson","year":"2000"},{"key":"ref11","series-title":"Am J Trop Med Hyg","first-page":"597","article-title":"Epidemic cholera in the Amazon: the challenge of preventing death","volume":"48","author":"Quick","year":"1993"},{"key":"ref12","series-title":"Am J Trop Med Hyg","first-page":"645","article-title":"Community mortality from cholera: urban and rural districts in Zimbabwe","volume":"88","author":"Morof","year":"2013"},{"key":"ref13","series-title":"Lancet","first-page":"379","article-title":"Failure of treatment centres to prevent cholera deaths in Goma","volume":"346","author":"Siddique","year":"1995"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/95\/6\/article-p1287.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/95\/6\/article-p1287.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/95\/6\/article-p1287.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T17:51:27Z","timestamp":1723053087000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/95\/6\/article-p1287.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,12,7]]},"references-count":13,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.16-0300","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,12,7]]}}}