Dual tension as Nigeria battles cholera during the COVID-19 pandemic

Musa, Shuaibu Saidu; Gyeltshen, Dawa; Manirambona, Emery; Wada, Yusuf Hassan; Sani, Abubakar Faizah; Ullah, Irfan; Lucero‐Prisno, Don Eliseo

doi:10.1016/j.cegh.2021.100913

Cited by 7 publications

(10 citation statements)

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“…Despite accounting for a large proportion of cholera cases, Africa is a chronically understudied continent compared to the Indian subcontinent and Haiti. Other disease outbreaks have drawn attention away from cholera in Africa in recent years, including COVID-19 and Ebola 23,24 . Research linking several social and environmental extremes to diseases is a global research gap.…”

Section: Introductionmentioning

confidence: 99%

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The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria

Charnley

Yennan

Ochu

et al. 2022

Preprint

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Cholera is reported as endemic in more than 50 countries, many of which are in sub-Saharan Africa. Nigeria currently reports the second highest number of cases, with several risk factors potentially contributing to this including poverty, water, sanitation and climate. Enteric pathogens have a significant global burden, especially on children and those most vulnerable. Despite this, attention is often drawn away from these diseases, most recently to Ebola and COVID-19. To address the need for more research and focus on cholera, a covariate selection process and machine learning was used. Data for environmental (floods, droughts) and social (conflicts) extremes, along with pre-existing social vulnerabilities, were fit to time varying reproductive number in Nigeria. We analysed this both spatially and temporally and used it to create a traffic-light system for cholera transmission, highlighting potential thresholds and triggers for outbreak. Improved access to sanitation, number of monthly conflict events, Multidimensional Poverty Index and Palmers Drought Severity Index were retained in the best fit model. Varying exposure periods showed that those living in decreased poverty, with more access to sanitation were not as vulnerable to changes and offset some of the cholera risk caused by extremes. The work presented here shows the need to address these pre-existing vulnerabilities and sustainable development for disaster prevention and mitigation and improve health and quality of life.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria

Charnley

Yennan

Ochu

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…It has since caused significant mortality and morbidity, especially amongst the most vulnerable, such as children under five [1]. Despite this, other disease outbreaks have drawn attention away from cholera in Africa in recent years, including COVID-19 and Ebola [2,3]. Explosive cholera outbreaks are not uncommon due to the short incubation period (2 hours to 5 days) and high numbers of asymptomatic infections, which when contaminating the environment can sustain transmission [4].…”

Section: Introductionmentioning

confidence: 99%

The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria

Charnley

Yennan

Ochu

et al. 2022

PLOS Glob Public Health

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Nigeria currently reports the second highest number of cholera cases in Africa, with numerous socioeconomic and environmental risk factors. Less investigated are the role of extreme events, despite recent work showing their potential importance. To address this gap, we used a machine learning approach to understand the risks and thresholds for cholera outbreaks and extreme events, taking into consideration pre-existing vulnerabilities. We estimated time varying reproductive number (R) from cholera incidence in Nigeria and used a machine learning approach to evaluate its association with extreme events (conflict, flood, drought) and pre-existing vulnerabilities (poverty, sanitation, healthcare). We then created a traffic-light system for cholera outbreak risk, using three hypothetical traffic-light scenarios (Red, Amber and Green) and used this to predict R. The system highlighted potential extreme events and socioeconomic thresholds for outbreaks to occur. We found that reducing poverty and increasing access to sanitation lessened vulnerability to increased cholera risk caused by extreme events (monthly conflicts and the Palmers Drought Severity Index). The main limitation is the underreporting of cholera globally and the potential number of cholera cases missed in the data used here. Increasing access to sanitation and decreasing poverty reduced the impact of extreme events in terms of cholera outbreak risk. The results here therefore add further evidence of the need for sustainable development for disaster prevention and mitigation and to improve health and quality of life.

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“…Cameroon's health care system is faced with the worst cholera outbreak in decades. Cholera is an acute diarrheal disease caused by the ingestion of food or water contaminated with toxin-producing strains of Vibrio Cholerae [ 1 ]. The disease has been particularly prevalent in the two most vulnerable continents -Africa and Asia.…”

Section: Introductionmentioning

confidence: 99%

“…The disease has been particularly prevalent in the two most vulnerable continents -Africa and Asia. Its transmission results from poor sanitary practices and conditions such as open defecation, unhygienic food handling and lack of safe drinking water [ 1 ]. Cholera can be severe, although people who get sick with the disease often develop mild or no symptoms.…”

Section: Introductionmentioning

confidence: 99%