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Research Snapshot: Reducing the spread of cholera

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Preventing transmission of cholera remains an important priority in many countries and humanitarian settings. This study tested and evaluated commonly used interventions for reducing cholera’s spread.

Testing commonly used interventions

There are several interventions recommended to prevent interhousehold transmission of cholera when an outbreak occurs. Two are at the household level: household spraying, where a response team sprays surfaces in cholera patients’ houses with chlorine, and household disinfection kits (HDKs) which are distributed (sometimes with training) and contain cleaning materials for household members living with cholera patients to complete disinfection themselves.

Additionally, bucket chlorination (where workers stationed at water sources manually add chlorine solution to recipients’ water containers during collection) is a common community-based intervention.

This study team undertook lab-based research at Tufts and field evaluations in Bangladesh,
Democratic Republic of Congo, Haiti, Mozambique, and Nigeria. They generated evidence and practical recommendations on both bucket chlorination and household spraying; however, no HDK intervention could be found to evaluate in the field, suggesting that field implementation practices may be falling behind global recommendations.


Many low-and-middle-income countries still experience cholera outbreaks. Access to water and sanitation supplies can reduce the likelihood, but this access is often reduced or compromised in humanitarian emergencies. Community- and household-level water, sanitation, and hygiene (WASH) interventions are key to reducing cholera transmission in these circumstances. Common interventions deployed by humanitarian actors focus on the water supply; water treatments (including household treatments and bucket chlorination), sanitation options (latrines) and promotion of handwashing and environmental hygiene. The effectiveness of interventions varies; little evidence is available on those evaluated by Tufts. The Global Task Force for Cholera Control (GTFCC) WASH Working Group has called for more evidence on cholera response interventions to inform policy and practice.