What is it about?
We used a machine learning approach to understand the risks and thresholds for cholera transmission and extreme events, taking into consideration pre-existing vulnerabilities. We estimated time varying reproductive number (R), a metric of transmission, from cholera incidence in Nigeria. We evaluated its association with extreme events (conflict, flood, drought) and pre-existing vulnerabilities (poverty, sanitation, healthcare). We then created a traffic-light system for cholera outbreak risk, using three hypothetical traffic-light scenarios (Red, Amber and Green) and used this to predict transmission. The system highlighted potential extreme events and socioeconomic thresholds for outbreaks to occur. We found that reducing poverty and increasing access to sanitation lessened vulnerability to increased cholera risk caused by extreme events (monthly conflicts and the Palmers Drought Severity Index).
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Why is it important?
Nigeria currently reports the second highest number of cholera cases in Africa, with numerous socioeconomic and environmental risk factors. Less investigated are the role of extreme events, despite recent work showing their potential importance. In order to control cholera transmission in Nigeria it is important to understand the risk factors and by identifying potential threshold, this helps to identify hotspots and priority areas for cholera interventions.
Perspectives
Increasing access to sanitation and decreasing poverty reduced the impact of extreme events in terms of cholera outbreak risk in Nigeria. These results add further evidence of the need for sustainable development for disaster prevention and mitigation and to improve health and quality of life. It is not the extreme event that causes the outbreak, but instead our ability to adapt and prepare for them. Improving quality of life, including expanding healthcare, education and access to sanitation, will have wide ranging health implications beyond cholera.
Gina Charnley
Imperial College London
Read the Original
This page is a summary of: The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria, PLOS Global Public Health, December 2022, PLOS,
DOI: 10.1371/journal.pgph.0000869.
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