1123. Individual and Household Risk Factors for Symptomatic Cholera Infection: A Systematic Review and Meta-Analysis

BACKGROUND: Cholera has caused seven global pandemics, including the current one which has been ongoing since 1961. A systematic review of risk factors for symptomatic cholera infection has not been previously published. METHODS: In accordance with PRISMA guidelines, we performed a systematic review and meta-analysis of individual and household risk factors for symptomatic cholera infection. RESULTS: We identified 110 studies eligible for inclusion in qualitative synthesis. Factors associated with symptomatic cholera that were eligible for meta-analysis included education less than secondary level (summary OR 2.64, 95% CI 1.41–4.92, I(2) = 8%), unimproved water source (summary OR 4.78, 95% CI 3.02–7.57, I(2) = 49%), open container water storage (summary OR 2.51, 95% CI 1.57–4.01, I(2) = 33%), consumption of food outside the home (summary OR 5.02, 95% CI 2.34–10.76, I(2) = 61%), household contact with cholera (summary OR 3.99, 95% CI 2.03–7.87, I(2) = 89%), water treatment (summary OR 0.22, 95% CI 0.13–0.36, I(2) = 37%), and handwashing (summary OR 0.17, 95% CI 0.10–0.30, I(2) = 37%). Other notable associations with symptomatic infection included income/wealth, blood group, gastric acidity, infant breastfeeding status, and HIV infection. CONCLUSION: We identified potential risk factors for symptomatic cholera infection including environmental characteristics, socioeconomic factors, and intrinsic patient factors. Ultimately, a combination of interventional approaches targeting various groups with risk-adapted intensities may prove to be the optimal strategy for cholera control. DISCLOSURES: All authors: No reported disclosures.