Global cholera incidence is increasing, particularly in sub-Saharan Africa. We examined the impact of climate and ocean environmental variability on cholera outbreaks, and developed a forecasting model for outbreaks in Zanzibar. Routine cholera surveillance reports between 1997 and 2006 were correlated with remotely and locally sensed environmental data. A seasonal autoregressive integrated moving average (SARIMA) model determined the impact of climate and environmental variability on cholera. The SARIMA model shows temporal clustering of cholera. A 1°C increase in temperature at 4 months lag resulted in a 2-fold increase of cholera cases, and an increase of 200 mm of rainfall at 2 months lag resulted in a 1.6-fold increase of cholera cases. Temperature and rainfall interaction yielded a significantly positive association (P < 0.04) with cholera at a 1-month lag. These results may be applied to forecast cholera outbreaks, and guide public health resources in controlling cholera in Zanzibar.
Reyburn, R., Kim, D. R., Emch, M., Khatib, A., Von Seidlein, L., & Ali, M. (2011). Climate Variability and the Outbreaks of Cholera in Zanzibar, East Africa: A Time Series Analysis. American Journal of Tropical Medicine and Hygiene, 84(6), 862-869. https://doi.org/10.4269/ajtmh.2011.10-0277