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Zheng Q, Luquero FJ, Ciglenecki I, Wamala JF, Abubakar A, Welo P, Hussen M, Wossen M, Yennan S, Keita A, Lessler J, Azman AS, Lee EC. Cholera outbreaks in sub-Saharan Africa during 2010-2019: a descriptive analysis. Int J Infect Dis 2022; 122:215-221. [PMID: 35605949 PMCID: PMC9439956 DOI: 10.1016/j.ijid.2022.05.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 05/17/2022] [Indexed: 01/13/2023] Open
Abstract
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.
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Affiliation(s)
- Qulu Zheng
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Francisco J Luquero
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Global Alliance for Vaccines and Immunization (GAVI), Geneva, Switzerland
| | | | | | | | - Placide Welo
- PNECHOL-MD, Community IMCI, Ministry of Health, Democratic Republic of the Congo
| | - Mukemil Hussen
- Disease and Health Events Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Mesfin Wossen
- Disease and Health Events Surveillance and Response Directorate, Ethiopia Public Health Institute, Addis Ababa, Ethiopia
| | - Sebastian Yennan
- Surveillance and Epidemiology, Nigeria Centre for Disease Control, Abuja, Nigeria
| | - Alama Keita
- Regional Office for West & Central Africa, UNICEF, Dakar, Senegal
| | - Justin Lessler
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA,Corresponding author
| | - Andrew S Azman
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Corresponding author
| | - Elizabeth C Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA,Corresponding author
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Fontanelli O, Miramontes P, Mansilla R, Cocho G, Li W. Beta rank function: A smooth double-Pareto-like distribution. COMMUN STAT-THEOR M 2020. [DOI: 10.1080/03610926.2020.1800739] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Oscar Fontanelli
- Centro de Investigaciones Interdisciplinarias en Ciencias y Humanidades, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Pedro Miramontes
- Departamento de Matemáticas, Facultad de Ciencias, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Ricardo Mansilla
- Centro de Investigaciones Interdisciplinarias en Ciencias y Humanidades, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Germinal Cocho
- Instituto de Física, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Wentian Li
- The Robert S. Boas Center for Genomics and Human Genetics, The Feinstein Institutes for Medical Research, Manhasset, New York, USA
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