Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017.
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 implemented...
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ftdoajarticles:oai:doaj.org/article:ce77f21b53f9417387dbbca288fd9e5e 2023-05-15T15:18:18+02:00 Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017. John Mwaba Amanda K Debes Patrick Shea Victor Mukonka Orbrie Chewe Caroline Chisenga Michelo Simuyandi Geoffrey Kwenda David Sack Roma Chilengi Mohammad Ali 2020-04-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0008227 https://doaj.org/article/ce77f21b53f9417387dbbca288fd9e5e EN eng Public Library of Science (PLoS) https://doi.org/10.1371/journal.pntd.0008227 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008227 https://doaj.org/article/ce77f21b53f9417387dbbca288fd9e5e PLoS Neglected Tropical Diseases, Vol 14, Iss 4, p e0008227 (2020) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2020 ftdoajarticles https://doi.org/10.1371/journal.pntd.0008227 2022-12-31T07:16:57Z 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 implemented 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 Statistical 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-year study period. A zero-inflated negative binomial regression model was employed to identify the district level risk factors for cholera. The risk map was generated by classifying the relative risk of cholera in each district, as obtained from the space-scan test statistic. In total, 34,950 cases of cholera were reported in Zambia between 2008 and 2017. Cholera cases varied spatially by year. During the study period, Lusaka District had the highest burden of cholera, with 29,080 reported cases. The space-time scan statistic identified 16 districts to be at a significantly higher risk of having cholera. The relative risk of having cholera in these districts was significantly higher and ranged from 1.25 to 78.87 times higher when compared to elsewhere in the country. Proximity to waterbodies was the only factor associated with the increased ... Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 14 4 e0008227 |
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English |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 John Mwaba Amanda K Debes Patrick Shea Victor Mukonka Orbrie Chewe Caroline Chisenga Michelo Simuyandi Geoffrey Kwenda David Sack Roma Chilengi Mohammad Ali Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
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 implemented 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 Statistical 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-year study period. A zero-inflated negative binomial regression model was employed to identify the district level risk factors for cholera. The risk map was generated by classifying the relative risk of cholera in each district, as obtained from the space-scan test statistic. In total, 34,950 cases of cholera were reported in Zambia between 2008 and 2017. Cholera cases varied spatially by year. During the study period, Lusaka District had the highest burden of cholera, with 29,080 reported cases. The space-time scan statistic identified 16 districts to be at a significantly higher risk of having cholera. The relative risk of having cholera in these districts was significantly higher and ranged from 1.25 to 78.87 times higher when compared to elsewhere in the country. Proximity to waterbodies was the only factor associated with the increased ... |
format |
Article in Journal/Newspaper |
author |
John Mwaba Amanda K Debes Patrick Shea Victor Mukonka Orbrie Chewe Caroline Chisenga Michelo Simuyandi Geoffrey Kwenda David Sack Roma Chilengi Mohammad Ali |
author_facet |
John Mwaba Amanda K Debes Patrick Shea Victor Mukonka Orbrie Chewe Caroline Chisenga Michelo Simuyandi Geoffrey Kwenda David Sack Roma Chilengi Mohammad Ali |
author_sort |
John Mwaba |
title |
Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017. |
title_short |
Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017. |
title_full |
Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017. |
title_fullStr |
Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017. |
title_full_unstemmed |
Identification of cholera hotspots in Zambia: A spatiotemporal analysis of cholera data from 2008 to 2017. |
title_sort |
identification of cholera hotspots in zambia: a spatiotemporal analysis of cholera data from 2008 to 2017. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2020 |
url |
https://doi.org/10.1371/journal.pntd.0008227 https://doaj.org/article/ce77f21b53f9417387dbbca288fd9e5e |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 14, Iss 4, p e0008227 (2020) |
op_relation |
https://doi.org/10.1371/journal.pntd.0008227 https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0008227 https://doaj.org/article/ce77f21b53f9417387dbbca288fd9e5e |
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https://doi.org/10.1371/journal.pntd.0008227 |
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PLOS Neglected Tropical Diseases |
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e0008227 |
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