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Volume 99, Issue 11 (November 2009)
Satoshi Sasaki, Hiroshi Suzuki, Yasuyuki Fujino, Yoshinari Kimura, and Meetwell Cheelo Impact of Drainage Networks on Cholera Outbreaks in Lusaka, Zambia. American Journal of Public Health: November 2009, Vol. 99, No. 11, pp. 1982-1987.
doi: 10.2105/AJPH.2008.151076

Accepted on: Jan 29, 2009

Impact of Drainage Networks on Cholera Outbreaks in Lusaka, Zambia

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 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: ). Reprints can be ordered at http://www.ajph.org by clicking the “Reprints/Eprints” link.

Peer Reviewed

Contributors

S. Sasaki designed and completed the analysis of the study and led the writing. H. Suzuki supervised all aspects of the study. Y. Fujino and M. Cheelo assisted with field research. Y. Kimura assisted with spatial analysis. All authors helped interpret findings and reviewed drafts of the article.



ABSTRACT

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.