Cholera

Cholera is caused by the bacteria Vibrio Cholerae (V. Cholerae). (1) The bacteria enter the human small intestines-often through contaminated water, and releases toxins that attack the cells lining the gastrointestinal tract (1). In response, chloride channels open, and water diffuses out of the cells causing loss of excessive fluid. This is followed by vomiting and excessive dehydration, often leading to death. A Global survey carried out by the World Health Organization (2) reported approximately 190130 cases of cholera in 2008 and 160 801 of these cases were reported in African region, were epidemics have become more widespread and frequent. Research has been conducted to understand the social determinants of cholera (3, 4, 5, 6, 7, 8), the effect of these determinants on the prevalence and severity of the disease (12, 13, 16, 15) and the urge for more robust policies at the National level to cope with spread of the disease (17, 18, 19, 20).

There are many social determinants that affect the prevalence of cholera (3, 4, 5, 6, 7, 8). For example, transportation of goods and produce around the world are part of our daily life. It has been hypothesized that a possible factor for cholera outbreak in Peru was due to a ship discharging the V. cholerae contaminated ballast (material used to provide desired draft and stability in ships ) into the ocean (4). Literature has also found that cultural factors can also play a role (6). For example, Karamoja people in Uganda saw 557 cases of cholera being reported within two months (6). The people believe that they should not mix human waste with in-laws and that it is a taboo for pregnant women to ease themselves from bathrooms. As a result, they resort to open defecation (contaminating t...

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...Bangladesh and Guatemala that saw 14-48 % reduction in cholera incidence, after implementing educational policies (17, 18)

Second suggested policy is the introduction of clean management plants and proper infrastructure (13). This will allow access to clean drinkable water regardless of income status of an individual. Successful example includes the Implementation of water management in Dar es Salaam, Tanzania, that reported 39% decline in cholera (19). These policies will be challenging to un-developed or developing nation- due to the lack of materialistic strength, but it can be achieved if the global community can muster the will necessary to extend their resources. Lastly, cheap Antibiotic and vaccines can be provided with contribution from the global community, but due to the constant evolution of bacteria, it will fail to provide a long term benefits. (20)