The Cure for Cholera - Improving Access to Safe Water and Sanitation
ABSTRACT Whenever epidemics of cholera occur, the global public health community is energized. Experts meet, guidelines for control are reviewed and reissued, and new and modified interventions are proposed and promoted. In the past two decades, these things happened after cholera appeared in Latin America in 1991, in the wake of the Rwandan genocide and the ensuing refugee crisis in Zaire (now Democratic Republic of Congo) in 1994, in Zimbabwe in 2008, and in October 2010, at the onset of the ongoing epidemic in Haiti (see article by Barzilay et al.). But even when it is not covered in the news . . .
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ABSTRACT: Effective response to infectious disease epidemics requires focused control measures in areas predicted to be at high risk of new outbreaks. We aimed to test whether mobile operator data could predict the early spatial evolution of the 2010 Haiti cholera epidemic. Daily case data were analysed for 78 study areas from October 16 to December 16, 2010. Movements of 2.9 million anonymous mobile phone SIM cards were used to create a national mobility network. Two gravity models of population mobility were implemented for comparison. Both were optimized based on the complete retrospective epidemic data, available only after the end of the epidemic spread. Risk of an area experiencing an outbreak within seven days showed strong dose-response relationship with the mobile phone-based infectious pressure estimates. The mobile phone-based model performed better (AUC 0.79) than the retrospectively optimized gravity models (AUC 0.66 and 0.74, respectively). Infectious pressure at outbreak onset was significantly correlated with reported cholera cases during the first ten days of the epidemic (p < 0.05). Mobile operator data is a highly promising data source for improving preparedness and response efforts during cholera outbreaks. Findings may be particularly important for containment efforts of emerging infectious diseases, including high-mortality influenza strains.Scientific Reports 03/2015; 5:8923. DOI:10.1038/srep08923 · 5.08 Impact Factor
Dataset: Widmer et al 2014
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ABSTRACT: We inventoried non-surface water sources in the Leogane and Gressier region of Haiti (approximately 270 km2) in 2012 and 2013 and screened water from 345 sites for fecal coliforms and Vibrio cholerae. An international organization/non-governmental organization responsible for construction could be identified for only 56% of water points evaluated. Sixteen percent of water points were non-functional at any given time; 37% had evidence of fecal contamination, with spatial clustering of contaminated sites. Among improved water sources (76% of sites), 24.6% had fecal coliforms versus 80.9% in unimproved sources. Fecal contamination levels increased significantly from 36% to 51% immediately after the passage of Tropical Storm Sandy in October of 2012, with a return to 34% contamination in March of 2013. Long-term sustainability of potable water delivery at a regional scale requires ongoing assessment of water quality, functionality, and development of community-based management schemes supported by a national plan for the management of potable water.The American journal of tropical medicine and hygiene 07/2014; · 2.53 Impact Factor