Dynamics of cholera outbreaks in great Lakes region of Africa, 1978-2008

Didier Bompangue Nkoko; Patrick Giraudoux; Pierre Denis Plisnier; Annie Mutombo Tinda; Martine Piarroux; Bertrand Sudre; Stephanie Horion; Jean Jacques Muyembe Tamfum; Benoît Kebela Ilunga; Renaud Piarroux

doi:10.3201/eid1711.110170

Dynamics of cholera outbreaks in great Lakes region of Africa, 1978-2008

Didier Bompangue Nkoko, Patrick Giraudoux, Pierre Denis Plisnier, Annie Mutombo Tinda, Martine Piarroux, Bertrand Sudre, Stephanie Horion, Jean Jacques Muyembe Tamfum, Benoît Kebela Ilunga, Renaud Piarroux^*

^*Corresponding author for this work

74 Citations (Scopus)

Abstract

Cholera outbreaks have occurred in Burundi, Rwanda, Democratic Republic of Congo, Tanzania, Uganda, and Kenya almost every year since 1977-1978, when the disease emerged in these countries. We used a multiscale, geographic information system-based approach to assess the link between cholera outbreaks, climate, and environmental variables. We performed time-series analyses and field investigations in the main affected areas. Results showed that cholera greatly increased during El Niño warm events (abnormally warm El Niños) but decreased or remained stable between these events. Most epidemics occurred in a few hotspots in lakeside areas, where the weekly incidence of cholera varied by season, rainfall, fluctuations of plankton, and fishing activities. During lull periods, persistence of cholera was explained by outbreak dynamics, which suggested a metapopulation pattern, and by endemic foci around the lakes. These links between cholera outbreaks, climate, and lake environments need additional, multidisciplinary study.

Original language	English
Journal	Emerging Infectious Diseases (Print Edition)
Volume	17
Issue number	11
Pages (from-to)	2026-2034
Number of pages	9
ISSN	1080-6040
DOIs	https://doi.org/10.3201/eid1711.110170
Publication status	Published - 2011
Externally published	Yes

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title = "Dynamics of cholera outbreaks in great Lakes region of Africa, 1978-2008",

abstract = "Cholera outbreaks have occurred in Burundi, Rwanda, Democratic Republic of Congo, Tanzania, Uganda, and Kenya almost every year since 1977-1978, when the disease emerged in these countries. We used a multiscale, geographic information system-based approach to assess the link between cholera outbreaks, climate, and environmental variables. We performed time-series analyses and field investigations in the main affected areas. Results showed that cholera greatly increased during El Ni{\~n}o warm events (abnormally warm El Ni{\~n}os) but decreased or remained stable between these events. Most epidemics occurred in a few hotspots in lakeside areas, where the weekly incidence of cholera varied by season, rainfall, fluctuations of plankton, and fishing activities. During lull periods, persistence of cholera was explained by outbreak dynamics, which suggested a metapopulation pattern, and by endemic foci around the lakes. These links between cholera outbreaks, climate, and lake environments need additional, multidisciplinary study.",

author = "Nkoko, {Didier Bompangue} and Patrick Giraudoux and Plisnier, {Pierre Denis} and Tinda, {Annie Mutombo} and Martine Piarroux and Bertrand Sudre and Stephanie Horion and Tamfum, {Jean Jacques Muyembe} and Ilunga, {Beno{\^i}t Kebela} and Renaud Piarroux",

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AU - Nkoko, Didier Bompangue

AU - Giraudoux, Patrick

AU - Plisnier, Pierre Denis

AU - Tinda, Annie Mutombo

AU - Piarroux, Martine

AU - Sudre, Bertrand

AU - Horion, Stephanie

AU - Tamfum, Jean Jacques Muyembe

AU - Ilunga, Benoît Kebela

AU - Piarroux, Renaud

PY - 2011

Y1 - 2011

N2 - Cholera outbreaks have occurred in Burundi, Rwanda, Democratic Republic of Congo, Tanzania, Uganda, and Kenya almost every year since 1977-1978, when the disease emerged in these countries. We used a multiscale, geographic information system-based approach to assess the link between cholera outbreaks, climate, and environmental variables. We performed time-series analyses and field investigations in the main affected areas. Results showed that cholera greatly increased during El Niño warm events (abnormally warm El Niños) but decreased or remained stable between these events. Most epidemics occurred in a few hotspots in lakeside areas, where the weekly incidence of cholera varied by season, rainfall, fluctuations of plankton, and fishing activities. During lull periods, persistence of cholera was explained by outbreak dynamics, which suggested a metapopulation pattern, and by endemic foci around the lakes. These links between cholera outbreaks, climate, and lake environments need additional, multidisciplinary study.

AB - Cholera outbreaks have occurred in Burundi, Rwanda, Democratic Republic of Congo, Tanzania, Uganda, and Kenya almost every year since 1977-1978, when the disease emerged in these countries. We used a multiscale, geographic information system-based approach to assess the link between cholera outbreaks, climate, and environmental variables. We performed time-series analyses and field investigations in the main affected areas. Results showed that cholera greatly increased during El Niño warm events (abnormally warm El Niños) but decreased or remained stable between these events. Most epidemics occurred in a few hotspots in lakeside areas, where the weekly incidence of cholera varied by season, rainfall, fluctuations of plankton, and fishing activities. During lull periods, persistence of cholera was explained by outbreak dynamics, which suggested a metapopulation pattern, and by endemic foci around the lakes. These links between cholera outbreaks, climate, and lake environments need additional, multidisciplinary study.

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Dynamics of cholera outbreaks in great Lakes region of Africa, 1978-2008

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