Abstract
BackgroundCholera has claimed many lives throughout history and it continues to be a global threat, especially in countries in Africa. The disease is listed as one of three internationally quarantinable diseases by the World Health organization, along with plague and yellow fever. Between 1999 and 2005, Africa alone accounted for about 90% of over 1 million reported cholera cases worldwide. In Ghana, there have been over 27000 reported cases since 1999. In one of the affected regions in Ghana, Ashanti region, massive outbreaks and high incidences of cholera have predominated in urban and overcrowded communities.ResultsA GIS based spatial analysis and statistical analysis, carried out to determine clustering of cholera, showed that high cholera rates are clustered around Kumasi Metropolis (the central part of the region), with Moran's Index = 0.271 and P < 0.001. Furthermore, A Mantel-Haenszel Chi square for trend analysis reflected a direct spatial relationship between cholera and urbanization (χ2 = 2995.5, P < 0.0001), overcrowding (χ2 = 1757.2, P < 0.0001), and an inverse relationship between cholera and order of neighborhood with Kumasi Metropolis (χ2 = 831.38, P < 0.0001).ConclusionThe results suggest that high urbanization, high overcrowding, and neighborhood with Kumasi Metropolis are the most important predictors of cholera in Ashanti region.
Highlights
Cholera has claimed many lives throughout history and it continues to be a global threat, especially in countries in Africa
This study focuses on the application of a Geographical Information Systems (GIS) based spatial analyses and statistical technology to study the spatial patterns of cholera, identify territories of high risk, and determine demographic risk factors that contribute to high rates of cholera
Clustering of high rates of cholera was persistent at Kumasi Metropolis and its adjoining neighbors in the years 1998, 1999, and 2001 (See Figures 2a, 2b, 2c)
Summary
Cholera has claimed many lives throughout history and it continues to be a global threat, especially in countries in Africa. Between 1999 and 2005, Africa alone accounted for about 90% of over 1 million reported cholera cases worldwide. In one of the affected regions in Ghana, Ashanti region, massive outbreaks and high incidences of cholera have predominated in urban and overcrowded communities. Africa alone accounted for about 90% of the cases and 96% of the deaths worldwide [2,3,4,5,6,7,8] Cholera has gained both global and public health attention due to its mode of transmission and severity. For instance it has become one of the most researched communicable diseases. In addition to human suffering and lives loss, cholera outbreak causes panic, disrupts the social and economic structure and can impede development in the affected communities [6]
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