Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017

by John Mwaba, Amanda K. Debes, Patrick Shea, Victor Mukonka, Orbrie Chewe, Caroline Chisenga, Michelo Simuyandi, Geoffrey Kwenda, David Sack, Roma Chilengi, Mohammad Ali The global burden of cholera is increasing, with the majority (60%) of the cases occurring in sub-Saharan Africa. In Zambia, widespread cholera outbreaks have occurred since 1977, predominantly in the capital city of Lusaka. During both the 2016 and 2018 outbreaks, the Ministry of Health implement ed cholera vaccination in addition to other preventative and control measures, to stop the spread and control the outbreak. Given the limitations in vaccine availability and the logistical support required for vaccination, oral cholera vaccine (OCV) is now recommended for use in the high risk areas (“hotspots”) for cholera. Hence, the aim of this study was to identify areas with an increased risk of cholera in Zambia. Retrospective cholera case data from 2008 to 2017 was obtained from the Ministry of Health, Department of Public Health and Disease Surveillance. The Zambian Central Statisti cal Office provided district-level population data, socioeconomic and water, sanitation and hygiene (WaSH) indicators. To identify districts at high risk, we performed a discrete Poisson-based space-time scan statistic to account for variations in cholera risk across both space and time over a 10-ye ar study period. A zero-inflated negative binomial regression model was employed to identify the district level risk factors fo...
Source: PLoS Neglected Tropical Diseases - Category: Tropical Medicine Authors: Source Type: research