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What are the drivers of recurrent cholera transmission in Nigeria? Evidence from a scoping review
Kelly Osezele Elimian | Somto Mezue | Anwar Musah | Oyeronke Oyebanji | Ibrahima Soce Fall | Sebastian Yennan | Michel Yao | Patrick Okumu Abok | Nanpring Williams | Lynda Haj Omar | Thieno Balde | Kobina Ampah | Ifeanyi Okudo | Luka Ibrahim | Arisekola Jinadu | Wondimagegnehu Alemu | Clement Peter | Chikwe Ihekweazu
Date of Publication:
BMC Public Health
The 2018 cholera outbreak in Nigeria affected over half of the states in the country, and was characterised by high attack and case fatality rates. The country continues to record cholera cases and related deaths to date. However, there is a dearth of evidence on context-specific drivers and their operational mechanisms in mediating recurrent cholera transmission in Nigeria. This study therefore aimed to fill this important research gap, with a view to informing the design and implementation of appropriate preventive and control measures.
The narrative analysis indicates that social, biological, environmental and climatic, health systems, and a combination of two or more factors appear to drive cholera transmission in Nigeria. Regarding operational dynamics, a substantial number of the identified drivers appear to be functionally interdependent of each other.
In conclusion, the drivers of recurring cholera transmission in Nigeria are diverse but functionally interdependent; thus, underlining the importance of adopting a multi-sectoral approach for cholera prevention and control.
Incubation periods impact the spatial predictability of cholera and Ebola outbreaks in Sierra Leone
Rebecca Kahn | Corey M. Peak | Juan Fernández-Gracia | Alexandra Hill | Amara Jambai | Louisa Ganda | Marcia C. Castro | Caroline O. Buckee
Date of Publication:
Proceedings of the National Academy of Sciences
Forecasting the spatiotemporal spread of infectious diseases during an outbreak is an important component of epidemic response. However, it remains challenging both methodologically and with respect to data requirements, as disease spread is influenced by numerous factors, including the pathogen's underlying transmission parameters and epidemiological dynamics, social networks and population connectivity, and environmental conditions. Here, using data from Sierra Leone, we analyze the spatiotemporal dynamics of recent cholera and Ebola outbreaks and compare and contrast the spread of these two pathogens in the same population. We develop a simulation model of the spatial spread of an epidemic in order to examine the impact of a pathogen's incubation period on the dynamics of spread and the predictability of outbreaks. We find that differences in the incubation period alone can determine the limits of predictability for diseases with different natural history, both empirically and in our simulations. Our results show that diseases with longer incubation periods, such as Ebola, where infected individuals can travel farther before becoming infectious, result in more long-distance sparking events and less predictable disease trajectories, as compared to the more predictable wave-like spread of diseases with shorter incubation periods, such as cholera.