ABSTRACT Cholera is an acute enteric infection caused by the ingestion of bacterium Vibrio cholera present in faecally contaminated water or food. Primarily linked to insufficient access to safe water and proper sanitation, its impact can be even more dramatic in areas where basic environmental infrastructures are disrupted or have been destroyed. The aim of the study was to investigate the factors contributing to the prevalence of cholera and the environmental risk factors associated with cholera in the Magale sub county, Manafwa district. The objectives of the study were to identify environmental risk factors for cholera and to determine the number of cholera cases in the Magale sub county, Manafwa district. The study used a quantitative, retrospective and cross-sectional research method. The records of 317 patients who met the study criteria were reviewed using an audit tool. The Statistical Package for Social Sciences (SPSS) version 22 was used to analyze the data. The results revealed that lack of adequate hygiene practices, limited access to safe drinking water, lack of safe food preparation and handling, and inadequate sanitation system are risk factors associated with cholera. The study recommends prevention, control of cholera outbreak and case management. Keywords: Cholera, outbreak, Vibrio cholerae 01 and 0139, Watery diarrhea (ricewater),Prevalence, Risk factors.

TABLE OF CONTENT

DECLARATION

SUPERVISOR’S APPROVAL ii

LIST OF ABBREVIATIONS iii

TABLE OF CONTENT iv

ABSTRACT vi

CHAPTER ONE 1

1. INTRODUCTION 1

1.1 BACKGROUND 1

1.2 Problem statement 3

1.3 AIMOFTHESTUDY 4

1.4 OBJECTIVES OF THE STUDY 4

1.5 RESEARCH QUESTIONS 4

1.6 Scope of the Study 5

1.7 SIGNIFICANCE OF THE STUDY 5

1.8 Operational definitions 6

1.9 Conceptual Frame work 7

CHAPTERTWO 9

REVIEW OF THE RELATED LITERATURE 9

CHAPTER THREES 18

3.1METHODOLOGY 18

3.2.1 Research design 18

3.2.2 Data collection method 18

3.2.3 Area of Study 19

3.2.4 Study Population 19

3.2.5 Sample Size 19

3.2.6 Sampling procedures 19

3.2.7Research instruments 19

3.2.8 Sources of Data 20

3.2.9 Ethical considerations 20

3.2.10 Data Analysis 21

3.2.11 Data Presentation 21

3.2.12 Limitations of the study 21

CHAPTER FOUR 22

RESULTS AND DISCUSSION 22

4.1 INTRODUCTION 22

4.2 BIOGRAPHIC DATA 22

4.2.1 Age 22

4.2.2 Gender 23

4.2 DEMOGRAPHIC RESULTS 27

4.2.1 Parishes 27

4.2.3 Sanitation systems 28

4.2.4 Food sources 30

4.2.5 Period of occurrence 32

4.2.6 Clinical features 33

CHAPTER FIVE 35

SUMMARY, LIMITATIONS, RECOMMENDATIONS AND CONCLUSION 35

5.1 INTRODUCTION 35

5.2 SUMMARY 35

5.2.1 The research questions 35

5.3 LIMITATIONS OF THE STUDY 36

5.4 RECOMMENDATIONS 36

5.4.1 Prevention of cholera 36

5.4.2 Control of cholera 37

5.4.3 Unaffected neighboring regions 38

5.4.4 Areas for local environment development 39

5.4.5 Parishes’ managers 39

5.4.6 Governments Agencies 40

5.4.7 Provincial and National governments 40

5.4.8 Areas for further research 41

5.5 CONCLUSION 41

REFERENCES 42

APPENDIX 1: AUDIT TOOL FOR PATIENTS RECORDS 46