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Pharmacy sales may be useful in tracking cholera outbreaks
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Sales of oral rehydration may be an effective tool for tracking cholera outbreaks in a resource-limited setting, according to study findings presented at the American Society of Tropical Medicine and Hygiene annual meeting in Washington, D.C.
"Pharmacies often serve as the first point of contact with the medical sector when individuals become ill," the researchers wrote. "In Bangladesh, people commonly use oral rehydration solution (ORS) purchased at pharmacies to treat diarrhea. Many cholera cases first purchase ORS within their communities before going to clinics."
Andrew S. Azman, a PhD student at the department of epidemiology, Johns Hopkins Bloomberg School of Public Health, and colleagues tracked daily sales of ORS at a random sample of pharmacies and drug retailers in a population of approximately 130,000 in urban Bangladesh between March and September.
Using their cellphones, pharmacists called an interactive voice response system to report the number of customers who purchased ORS. Those purchases were correlated with the number of patients presenting at two local primary hospitals with bacteriologically confirmed cholera and non-cholera diarrhea. In their analyses, the researchers accounted for healthy customers who had purchased ORS for hydration only, as well as for the acquisition of cholera in subsequent days.
Results indicated that, on average, each pharmacy made 4.2 ORS sales each week, with a median of six customers daily. There was a significant association between ORS sales and cholera cases presenting to the two hospitals. For each extra community-wide ORS customer, Azman and colleagues expected a 6.4 fold increase in the risk of cholera in the community the next day. The researchers said more research is needed to confirm the utility of using pharmacy sales as a means of tracking cholera outbreaks.
"These preliminary data suggest that tracking pharmacy ORS sales could be a useful early warning system of detecting cholera outbreaks; however, more data, some of which we are currently collecting, are needed to explore its full utility," Azman told Infectious Disease News.
Andrew S. Azman can be reached at azman@jhu.edu.
For more information:
Azman AS. Abstract #LB-2153. Presented at: American Society of Tropical Medicine and Hygiene annual meeting; Nov. 13-17, 2013; Washington, D.C.
Disclosure: The researchers report no relevant financial disclosures.