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Int J Environ Res Public Health. 2019 Nov 2;16(21). pii: E4257. doi: 10.3390/ijerph16214257.

Spatiotemporal Patterns of Cholera Hospitalization in Vellore, India.

Author information

1
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA. Aishwarya.Venkat@tufts.edu.
2
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA. Tania.Alarcon_Falconi@tufts.edu.
3
Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA 02111, USA. melissa.e.cruz@gmail.com.
4
School of Marine Science and Ocean Engineering, University of New Hampshire, Durham, NH 03824, USA. mah2002@wildcats.unh.edu.
5
Christian Medical College, Vellore, Tamil Nadu 632004, India. shalinianandan@cmcvellore.ac.in.
6
Christian Medical College, Vellore, Tamil Nadu 632004, India. speed.naveen1@gmail.com.
7
Sackler School of Graduate Biomedical Sciences, Tufts University, Boston, MA 02111, USA. hward@tuftsmedicalcenter.org.
8
Christian Medical College, Vellore, Tamil Nadu 632004, India. hward@tuftsmedicalcenter.org.
9
Tufts Medical Center, Boston, MA 02111, USA. hward@tuftsmedicalcenter.org.
10
Christian Medical College, Vellore, Tamil Nadu 632004, India. vbalaji@cmcvellore.ac.in.
11
Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA 02111, USA. Elena.Naumova@tufts.edu.
12
Christian Medical College, Vellore, Tamil Nadu 632004, India. Elena.Naumova@tufts.edu.

Abstract

Systematically collected hospitalization records provide valuable insight into disease patterns and support comprehensive national infectious disease surveillance networks. Hospitalization records detailing patient's place of residence (PoR) can be utilized to better understand a hospital's case load and strengthen surveillance among mobile populations. This study examined geographic patterns of patients treated for cholera at a major hospital in south India. We abstracted 1401 laboratory-confirmed cases of cholera between 2000-2014 from logbooks and electronic health records (EHRs) maintained by the Christian Medical College (CMC) in Vellore, Tamil Nadu, India. We constructed spatial trend models and identified two distinct clusters of patient residence-one around Vellore (836 records (61.2%)) and one in Bengal (294 records (21.5%)). We further characterized differences in peak timing and disease trend among these clusters to identify differences in cholera exposure among local and visiting populations. We found that the two clusters differ by their patient profiles, with patients in the Bengal cluster being most likely older males traveling to Vellore. Both clusters show well-aligned seasonal peaks in mid-July, only one week apart, with similar downward trend and proportion of predominant O1 serotype. Large hospitals can thus harness EHRs for surveillance by utilizing patients' PoRs to study disease patterns among resident and visitor populations.

KEYWORDS:

India; cholera; disease clusters; electronic health records (EHR); hospitalization; mobile population; spatial statistics

PMID:
31684018
PMCID:
PMC6862112
DOI:
10.3390/ijerph16214257
[Indexed for MEDLINE]
Free PMC Article

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