TY - JOUR
T1 - Cholera outbreaks in sub-Saharan Africa during 2010-2019
T2 - a descriptive analysis
AU - Zheng, Qulu
AU - Luquero, Francisco J.
AU - Ciglenecki, Iza
AU - Wamala, Joseph F.
AU - Abubakar, Abdinasir
AU - Welo, Placide
AU - Hussen, Mukemil
AU - Wossen, Mesfin
AU - Yennan, Sebastian
AU - Keita, Alama
AU - Lessler, Justin
AU - Azman, Andrew S.
AU - Lee, Elizabeth C.
N1 - Publisher Copyright:
© 2022 The Authors
PY - 2022/9
Y1 - 2022/9
N2 - Background: Cholera remains a public health threat but is inequitably distributed across sub-Saharan Africa. Lack of standardized reporting and inconsistent outbreak definitions limit our understanding of cholera outbreak epidemiology. Methods: From a database of cholera incidence and mortality, we extracted data from sub-Saharan Africa and reconstructed outbreaks of suspected cholera starting in January 2010 to December 2019 based on location-specific average weekly incidence rate thresholds. We then described the distribution of key outbreak metrics. Results: We identified 999 suspected cholera outbreaks in 744 regions across 25 sub-Saharan African countries. The outbreak periods accounted for 1.8 billion person-months (2% of the total during this period) from January 2010 to January 2020. Among 692 outbreaks reported from second-level administrative units (e.g., districts), the median attack rate was 0.8 per 1000 people (interquartile range (IQR), 0.3-2.4 per 1000), the median epidemic duration was 13 weeks (IQR, 8-19), and the median early outbreak reproductive number was 1.8 (range, 1.1-3.5). Larger attack rates were associated with longer times to outbreak peak, longer epidemic durations, and lower case fatality risks. Conclusions: This study provides a baseline from which the progress toward cholera control and essential statistics to inform outbreak management in sub-Saharan Africa can be monitored.
AB - Background: Cholera remains a public health threat but is inequitably distributed across sub-Saharan Africa. Lack of standardized reporting and inconsistent outbreak definitions limit our understanding of cholera outbreak epidemiology. Methods: From a database of cholera incidence and mortality, we extracted data from sub-Saharan Africa and reconstructed outbreaks of suspected cholera starting in January 2010 to December 2019 based on location-specific average weekly incidence rate thresholds. We then described the distribution of key outbreak metrics. Results: We identified 999 suspected cholera outbreaks in 744 regions across 25 sub-Saharan African countries. The outbreak periods accounted for 1.8 billion person-months (2% of the total during this period) from January 2010 to January 2020. Among 692 outbreaks reported from second-level administrative units (e.g., districts), the median attack rate was 0.8 per 1000 people (interquartile range (IQR), 0.3-2.4 per 1000), the median epidemic duration was 13 weeks (IQR, 8-19), and the median early outbreak reproductive number was 1.8 (range, 1.1-3.5). Larger attack rates were associated with longer times to outbreak peak, longer epidemic durations, and lower case fatality risks. Conclusions: This study provides a baseline from which the progress toward cholera control and essential statistics to inform outbreak management in sub-Saharan Africa can be monitored.
KW - Cholera
KW - Outbreaks
KW - Sub-Saharan Africa
UR - http://www.scopus.com/inward/record.url?scp=85131936017&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85131936017&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.05.039
DO - 10.1016/j.ijid.2022.05.039
M3 - Article
C2 - 35605949
AN - SCOPUS:85131936017
SN - 1201-9712
VL - 122
SP - 215
EP - 221
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
ER -