A Case-Control Study of Timely Control and Investigation of an Entamoeba Histolytica Outbreak by Primary Health Care in Idahluy-e Bozorg Village, Iran

Abstract

Background and aims: Experience transfer and the knowledge utilization of rapid and timely outbreak<br />control can be the key path-finding to health systems (HSs). The aim of this study was to investigate an<br />Entamoeba histolytica diarrhea outbreak through timely control.<br />Methods: A case-control study and an environmental survey were conducted to identify the source<br />of infection and the outbreak etiological agent. Sixty-two confirmed cases in Idahluye Bozorg village,<br />Iran, and 62 group-matched controls (in terms of age and sex) were selected from the healthy neighbors<br />of the same village during the same period. Then, multiple logistic regression was applied to calculate<br />the adjusted odds ratio for diarrhea risk.<br />Results: Totally, 250 cases were identified by a continuous common source epidemic from January<br />19th to 31st, 2018. Out of the total 36 stool samples, E. histolytica was detected as the common<br />organism. In addition, the final analysis indicated that network drinking water (NDW) increased the<br />odds of diarrhea (16.56, 95% CI = 4.14-64.87), whereas well water and boiling water had protective<br />effects and decreased the odds of diarrhea by 81% and 66%, respectively.<br />Conclusion: Overall, the source of infection was detected due to the contamination of underground<br />NDW by pipe sewage erosion. Therefore, additional monitoring of water systems is necessary,<br />especially during the summer and regarding full readiness for outbreak control.