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Spat Spatiotemporal Epidemiol. 2018 Feb;24:1-9. doi: 10.1016/j.sste.2017.09.001. Epub 2017 Oct 16.

Spatial and population drivers of persistent cholera transmission in rural Bangladesh: Implications for vaccine and intervention targeting.

Author information

1
Department of Environmental Science & Management, North South University Plot # 15, Block # B, Bashundhara, Dhaka-1229, Bangladesh. Electronic address: nusnazia@gmail.com.
2
Johns Hopkins Bloomberg School of Public Health, USA.
3
Department of Environmental Science & Management, North South University Plot # 15, Block # B, Bashundhara, Dhaka-1229, Bangladesh.
4
icddr,b, 68,Shahid Tajuddin Ahmed Sarani, Mohakhali, Dhaka, Bangladesh.
5
University of North Carolina at Chapel Hill, USA.

Abstract

We identify high risk clusters and measure their persistence in time and analyze spatial and population drivers of small area incidence over time. The geographically linked population and cholera surveillance data in Matlab, Bangladesh for a 10-year period were used. Individual level data were aggregated by local 250 × 250 m communities. A retrospective space-time scan statistic was applied to detect high risk clusters. Generalized estimating equations were used to identify risk factors for cholera. We identified 10 high risk clusters, the largest of which was in the southern part of the study area where a smaller river flows into a large river. There is persistence of local spatial patterns of cholera and the patterns are related to both the population composition and ongoing spatial diffusion from nearby areas over time. This information suggests that targeting interventions to high risk areas would help eliminate locally persistent endemic areas.

KEYWORDS:

Cholera; Endemic area; Matlab; Spatiotemporal cluster; Vaccine

PMID:
29413709
DOI:
10.1016/j.sste.2017.09.001
[Indexed for MEDLINE]

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