Outbreak of Cholera in Vea-Gunga, Bongo District of the Upper East Region, Ghana: Impact of Traditional Medicine and the National Health Insurance Scheme

The financial cost of seeking formal health care is often the major barrier to accessing health care in poor countries. Consequently, the governments of several developing countries have introduced free health care in an effort to improve their nation's health. There is evidence that suggests that many Ghanaians patronise both indigenous and orthodox health facilities simultaneously. On the 30 of June, 2015, The Bongo District Hospital prompted the Bongo District Health Directorate (DHD) that they had recorded a positive case of cholera from Kantebge’s house at VeaGunga, in the Bongo District of the Upper East region of Ghana. Weinvestigated to verify the diagnosis, identify risk factors and recommend control measures.We conducted a descriptive investigation and active case-search.We defined a cholera case-patient as a person with vibrio cholera isolated from stool sample or epidemiologically-linked to a person with vibrio cholera from the 1 of June to 20 of July at Valley View Sub-district of Bongo district.Stool from case-patients were taken for laboratory diagnosis. We performed univariate analysis by person, place and time using Epi-info version 3.3.The result of the 933 community members, 13 were affected. The overall attack rate was 1.4% (13/933) with a case fatality 15.4% (2/13). The mean age of case-patients was 28.5 years (±18 SD) with females 69.2% (9/13) mostly affected. Sex specific attack rates were 0.9% (4/447) and 1.6 % (9/486) for males and females respectively. The index case was 45yr-old man who reported at the Bongo District Hospital on the 30 of June. He took care of the primary case and also participated in the preparation and burial of the corpse. All the cases were recorded from VeaGunga, in the Bongo District. Vibrio choleraeserotype ogawa was isolated from stool samples. It was a point source outbreak that affected mainly women from the community. It is however hypothesized that the source of infection could be from the beans cake, the water from the Vea Dam or the primary case being a vibrio cholera carrier. Two (2) persons died as a result of taking some local concoction due to lack of money and the national health insurance scheme.An outbreak of ogawa serotype cholera with some fatalities was established in Vea-Gunga community in the Bongo district of the Upper East region. It was a point source outbreak that affected mainly women from the community. It is however hypothesized that the source of infection could be from the beans cake, the water from the Vea Dam or from avibrio cholera carrier. The need for health care financial protection and avoidance of concoctions in the management of cholera case patients are basic requirements in avoidance of unnecessary death. Prompt outbreak response, case management and education about causes and prevention of diarrhea played a significant role in controlling the outbreak.