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This Article Figures Only Full Text Full Text (PDF) All Versions of this Article: AJPH.2008.151076v1 99/11/1982    most recent Submit a response View Shopping Cart Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Google Scholar Articles by Sasaki, S. Articles by Cheelo, M. PubMed PubMed Citation Articles by Sasaki, S. Articles by Cheelo, M. Related Collections Geography Global Health Other Infections Other Environment

Satoshi Sasaki, PhD, Hiroshi Suzuki, MD, PhD, Yasuyuki Fujino, MA, Yoshinari Kimura, MA and Meetwell Cheelo

Satoshi Sasaki, Hiroshi Suzuki, Yasuyuki Fujino, and Yoshinari Kimura are with the Division of Public Health, Department of Infectious Disease Control and International Medicine, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan. Meetwell Cheelo is with the Lusaka District Health Management Team, Ministry of Health, Lusaka, Zambia.

Correspondence: Correspondence should be sent to Satoshi Sasaki, PhD, MA, Division of Public Health, Department of Infectious Disease Control and International Medicine, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori Chuo ward, Niigata, 951-8510, Japan (e-mail: ssasaki{at}med.niigata-u.ac.jp). Reprints can be ordered at http://www.ajph.org by clicking the "Reprints/Eprints" link.

Objectives. We investigated the association between precipitation patterns and cholera outbreaks and the preventative roles of drainage networks against outbreaks in Lusaka, Zambia.

Methods. We collected data on 6542 registered cholera patients in the 2003–2004 outbreak season and on 6045 cholera patients in the 2005–2006 season. Correlations between monthly cholera incidences and amount of precipitation were examined. The distribution pattern of the disease was analyzed by a kriging spatial analysis method. We analyzed cholera case distribution and spatiotemporal cluster by using 2590 cholera cases traced with a global positioning system in the 2005–2006 season. The association between drainage networks and cholera cases was analyzed with regression analysis.

Results. Increased precipitation was associated with the occurrence of cholera outbreaks, and insufficient drainage networks were statistically associated with cholera incidences.

Conclusions. Insufficient coverage of drainage networks elevated the risk of cholera outbreaks. Integrated development is required to upgrade high-risk areas with sufficient infrastructure for a long-term cholera prevention strategy.