{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T12:41:56Z","timestamp":1793104916874,"version":"4.5.0"},"reference-count":26,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,6,7]]},"abstract":"<jats:p>Household contacts of cholera patients are at a 100 times higher risk of a <jats:italic>Vibrio cholerae<\/jats:italic> infection than the general population. To examine risk factors for <jats:italic>V. cholerae<\/jats:italic> infections and investigate intervention strategies among this population, we followed household contacts of cholera patients for the 1-week high-risk period after the index patient obtained care. This study was nested within a randomized controlled trial of the Cholera-Hospital-Based-Intervention-for-7-days (CHoBI7), a handwashing with soap and water treatment intervention in Dhaka, Bangladesh. Rectal swab results were available from 320 household contacts of cholera patients at five time points over a 1-week period. Fecal and water samples were analyzed for <jats:italic>V. cholerae<\/jats:italic> by bacterial culture. All analyses were stratified by study arm. Within the intervention arm, stored household drinking water with a median free chlorine concentration below 0.5 mg\/L was associated with a three times higher odds of a cholera infection (odds ratio [OR]: 3.0; 95% confidence interval [CI]: 1.32, 6.63). In the control arm, having <jats:italic>V. cholerae<\/jats:italic> in stored water was associated with a significantly higher odds of a symptomatic cholera infection (OR: 8.66; 95% CI: 2.11, 35.48). No association was found between observed handwashing with soap at food and stool-related events and <jats:italic>V. cholerae<\/jats:italic> infections. Stored household drinking water with detectable <jats:italic>V. cholerae<\/jats:italic> and chlorine concentrations below the World Health Organization guideline were found to be important risk factors for cholera infection among household contacts of cholera patients. These findings emphasize the need for water treatment interventions targeting this high risk population.<\/jats:p>","DOI":"10.4269\/ajtmh.16-0871","type":"journal-article","created":{"date-parts":[[2017,3,27]],"date-time":"2017-03-27T19:53:33Z","timestamp":1490644413000},"page":"1382-1387","source":"Crossref","is-referenced-by-count":27,"title":["Risk Factors for Household Transmission of Vibrio cholerae in Dhaka, Bangladesh (CHoBI7 Trial)"],"prefix":"10.4269","volume":"96","author":[{"given":"Vanessa","family":"Burrowes","sequence":"first","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"Perin","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shirajum","family":"Monira","sequence":"additional","affiliation":[{"name":"Department of International Health, International Centre for Diarrheal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"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"}]},{"given":"Mahamud-ur","family":"Rashid","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toslim","family":"Mahamud","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zillur","family":"Rahman","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munshi","family":"Mustafiz","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sazzadul I.","family":"Bhuyian","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farzana","family":"Begum","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatema","family":"Zohura","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shwapon","family":"Biswas","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tahmina","family":"Parvin","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tasdik","family":"Hasan","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaotong","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradley R.","family":"Sack","sequence":"additional","affiliation":[{"name":"Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. M.","family":"Saif-Ur-Rahman","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Munirul","family":"Alam","sequence":"additional","affiliation":[{"name":"Center for Communicable Diseases, International Center for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine Marie","family":"George","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 Infect Dis","first-page":"521","article-title":"The true burden and risk of cholera: implications for prevention and control","volume":"7","author":"Zuckerman","year":"2007"},{"key":"ref2","series-title":"Clin Infect Dis","first-page":"1473","article-title":"Clinical outcomes in household contacts of patients with cholera in Bangladesh","volume":"49","author":"Weil","year":"2009"},{"key":"ref3","series-title":"S Afr Med J","first-page":"753","article-title":"Determination of the mode of transmission of cholera in Lebowa. An epidemiological investigation","volume":"62","author":"Sinclair","year":"1982"},{"issue":"(Suppl)","key":"ref4","series-title":"Emerg Infect Dis","first-page":"583","article-title":"Cholera outbreak in southern Tanzania: risk factors and patterns of transmission","volume":"7","author":"Acosta","year":"2001"},{"key":"ref5","series-title":"Bull World Health Organ","first-page":"395","article-title":"Epidemiology of eltor cholera in rural Bangladesh: importance of surface water in transmission","volume":"60","author":"Hughes","year":"1982"},{"key":"ref6","series-title":"Epidemiol Infect","first-page":"207","article-title":"Epidemic cholera among refugees in Malawi, Africa: treatment and transmission","volume":"118","author":"Swerdlow","year":"1997"},{"key":"ref7","series-title":"Lancet","first-page":"325","article-title":"Foodborne transmission of cholera in Micronesian households","volume":"1","author":"Holmberg","year":"1984"},{"key":"ref8","series-title":"J Water Health","first-page":"45","article-title":"A large cholera outbreak in Kano City, Nigeria: the importance of hand washing with soap and the danger of street-vended water","volume":"1","author":"Hutin","year":"2003"},{"key":"ref9","series-title":"PLoS Negl Trop Dis","first-page":"e221","article-title":"Susceptibility to Vibrio cholerae infection in a cohort of household contacts of patients with cholera in Bangladesh","volume":"2","author":"Harris","year":"2008"},{"key":"ref10","series-title":"Bull World Health Organ","first-page":"731","article-title":"Microbiological surveillance of intra-neighbourhood E1 Tor cholera transmission in rural Bangladesh","volume":"58","author":"Spira","year":"1980"},{"key":"ref11","series-title":"Bull World Health Organ","first-page":"777","article-title":"The relationship of vibriocidal antibody titre to susceptibility to cholera in family contacts of cholera patients","volume":"38","author":"Mosley","year":"1968"},{"key":"ref12","series-title":"J Infect Dis","first-page":"236","article-title":"Seroepidemiological studies of El Tor cholera in Bangladesh: association of serum antibody levels with protection","volume":"151","author":"Glass","year":"1985"},{"key":"ref13","series-title":"Emerg Infect Dis","first-page":"233","article-title":"Randomized controlled trial of hospital-based hygiene and water treatment intervention (CHoBI7) to reduce cholera","volume":"22","author":"George","year":"2016"},{"key":"ref14","series-title":"Am J Trop Med Hyg","first-page":"428","article-title":"Sustained uptake of a hospital-based handwashing with soap and water treatment intervention (cholera-hospital-based intervention for 7 days [CHoBI7]): a randomized controlled trial","volume":"94","author":"George","year":"2016"},{"key":"ref15","series-title":"Am J Trop Med Hyg","first-page":"1292","article-title":"Promotion of cholera awareness among households of cholera patients: a randomized controlled trial of the CHoBI7 intervention","volume":"95","author":"Saif-Ur-Rahman","year":"2016"},{"key":"ref16","series-title":"J Clin Microbiol","first-page":"3939","article-title":"Use of dipsticks for rapid diagnosis of cholera caused by Vibrio cholerae O1 and O139 from rectal swabs","volume":"41","author":"Bhuiyan","year":"2003"},{"key":"ref17","series-title":"Clin Diagn Lab Immunol","first-page":"476","article-title":"One-step immunochromatographic dipstick tests for rapid detection of Vibrio cholerae O1 and O139 in stool samples","volume":"10","author":"Nato","year":"2003"},{"key":"ref18","series-title":"PLoS One","first-page":"e37360","article-title":"Evaluation of a rapid test for the diagnosis of cholera in the absence of a gold standard","volume":"7","author":"Page","year":"2012"},{"key":"ref19","series-title":"Trop Med Int Health","first-page":"1117","article-title":"Field evaluation of crystal VC Rapid Dipstick test for cholera during a cholera outbreak in Guinea-Bissau","volume":"14","author":"Harris","year":"2009"},{"key":"ref20","series-title":"Guidelines for Drinking-Water Quality, Third Edition incorporating the First and Second Addenda-Volume 1 Recommendations","author":"WHO","year":"2008"},{"key":"ref21","series-title":"Biometrika","first-page":"13","article-title":"Longitudinal data analysis using generalized linear models","volume":"73","author":"Liang","year":"1986"},{"key":"ref22","series-title":"Am J Trop Med Hyg","first-page":"1299","article-title":"Chlorination of household drinking water among cholera patients' households to prevent transmission of toxigenic Vibrio cholerae in Dhaka City: CHoBI7 trial","volume":"95","author":"Rashid","year":"2016"},{"key":"ref23","series-title":"Chlorine in Drinking-Water: Background Document for Development of WHO Guidelines for Drinking-water Quality","author":"World Health Organization","year":"1996"},{"key":"ref24","series-title":"Am J Epidemiol","first-page":"959","article-title":"Endemic cholera in rural Bangladesh, 1966\u20131980","volume":"116","author":"Glass","year":"1982"},{"key":"ref25","series-title":"Am J Epidemiol","first-page":"719","article-title":"Epidemic cholera in west Africa: the role of food handling and high-risk foods","volume":"131","author":"St Louis","year":"1990"},{"key":"ref26","series-title":"Trop Med Int Health","first-page":"233","article-title":"Bacterial hand contamination among Tanzanian mothers varies temporally and following household activities","volume":"16","author":"Pickering","year":"2011"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/96\/6\/article-p1382.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/96\/6\/article-p1382.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/96\/6\/article-p1382.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T22:27:49Z","timestamp":1723069669000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/96\/6\/article-p1382.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,6,7]]},"references-count":26,"journal-issue":{"issue":"6"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.16-0871","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,6,7]]}}}