Abstract
BackgroundTemperature and precipitation are known to affect Vibrio cholerae outbreaks. Despite this, the impact of drought on outbreaks has been largely understudied. Africa is both drought and cholera prone and more research is needed in Africa to understand cholera dynamics in relation to drought.MethodsHere, we analyse a range of environmental and socioeconomic covariates and fit generalised linear models to publicly available national data, to test for associations with several indices of drought and make cholera outbreak projections to 2070 under three scenarios of global change, reflecting varying trajectories of CO2 emissions, socio-economic development, and population growth.ResultsThe best-fit model implies that drought is a significant risk factor for African cholera outbreaks, alongside positive effects of population, temperature and poverty and a negative effect of freshwater withdrawal. The projections show that following stringent emissions pathways and expanding sustainable development may reduce cholera outbreak occurrence in Africa, although these changes were spatially heterogeneous.ConclusionsDespite an effect of drought in explaining recent cholera outbreaks, future projections highlighted the potential for sustainable development gains to offset drought-related impacts on cholera risk. Future work should build on this research investigating the impacts of drought on cholera on a finer spatial scale and potential non-linear relationships, especially in high-burden countries which saw little cholera change in the scenario analysis.
Highlights
Temperature and precipitation are known to affect Vibrio cholerae outbreaks
Temperature and precipitation are considered important in cholera outbreak occurrence, with temperature driving epidemics and precipitation acting as a dispersal mechanism [9]
In this study, we aimed to understand the implications of drought for cholera outbreak occurrence at a continental scale across Africa, after accounting for important socioeconomic factors
Summary
The impact of drought on outbreaks has been largely understudied. Vibrio cholerae is a water-borne bacterial pathogen, causing profuse watery diarrhoea and rapid dehydration in symptomatic cases. This can lead to death within 2 h of symptom onset and case fatality ranging from 3 to 40% [1, 2]. Temperature and precipitation are considered important in cholera outbreak occurrence, with temperature driving epidemics and precipitation acting as a dispersal mechanism [9]. Drought and cholera in Africa are understudied in isolation and links have more commonly been made between flooding, despite droughts potentially posing a considerably greater risk than floods [11]
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