Association between cholera outbreak and traditional gold mining in Northern State, Sudan 2017

Introduction: Cholera is one of the health problems causing considerable morbidity and mortality. The Northern State of Sudan experienced a recent cholera outbreak, however, there are limited data on the outbreak. Methods: The objective of this study was to assess the magnitude and risk factors associated with the cholera outbreak in the Northern State of Sudan. A retrospective case series study was conducted in the Northern State of Sudan, which involved tracing cases of cholera outbreak of 2017. Data were collected through reports and interviews. A geographical information system was used to map all cases during the outbreak. Chi-square test and logistic regression were used to identify associated factors. Results: There were 957 cholera cases reported in the state with an attack rate of 14.2/10,000 persons. Dalgo locality had the highest number (415) of cases reported with an attack rate of 167.2/10,000 persons. About 78% of cases were adult males, while 56.2% of cases were immigrants from other states. Immigrants in Halfa and Dalgo localities were four times (odds ratio [OR] = 4.031, 95% confidence interval [CI]: 2.482–6.547) and eight times (OR = 8.318, 95% CI: 5.674–12.193), respectively, at risk of cholera infection compared to immigrants in Dongola locality. The overall case-fatality rate was 1.9%. This was significantly higher in younger (5.8%) and older (22.7%) age groups (P