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Analysis of environmental factors influence on endemic cholera risks in sub-Saharan Africa

Girotto, Cristiane D; Behzadian, Kourosh; Musah, Anwar; Chen, Albert S; Djordjevic, Slobodan; Nichols, Gordon; Campos, Luiza C; (2024) Analysis of environmental factors influence on endemic cholera risks in sub-Saharan Africa. Science of The Total Environment , 926 , Article 171896. 10.1016/j.scitotenv.2024.171896. Green open access

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Abstract

The recurring cholera outbreaks in sub-Saharan Africa are of growing concern, especially considering the potential acceleration in the global trend of larger and more lethal cholera outbreaks due to the impacts of climate change. However, there is a scarcity of evidence-based research addressing the environmental and infrastructure factors that sustain cholera recurrence in Africa. This study adopts a statistical approach to investigate over two decades of endemic cholera outbreaks and their relationship with five environmental factors: water provision, sanitation provision, raising temperatures, increased rainfall and GDP. The analysis covers thirteen of the forty-two countries in the mainland sub-Saharan region, collectively representing one-third of the region's territory and half of its population. This breadth enables the findings to be generalised at a regional level. Results from all analyses consistently associate water provision with cholera reduction. The stratified model links increased water provision with a reduction in cholera risk that ranged from 4.2 % to 84.1 % among eight countries (out of 13 countries) as well as a reduction of such risk that ranged from 9.8 % to 68.9 % when there is increased sanitation provision, which was observed in nine countries (out of 13). These results indicate that the population's limited access to water and sanitation, as well as the rise in temperatures, are critical infrastructure and environmental factors contributing to endemic cholera and the heightened risk of outbreaks across the sub-Saharan region. Therefore, these are key areas for targeted interventions and cross-border collaboration to enhance resilience to outbreaks and lead to the end of endemic cholera in the region. However, it is important to interpret the results of this study with caution; therefore, further investigation is recommended to conduct a more detailed analysis of the impact of infrastructure and environmental factors on reducing cholera risk.

Type: Article
Title: Analysis of environmental factors influence on endemic cholera risks in sub-Saharan Africa
Location: Netherlands
Open access status: An open access version is available from UCL Discovery
DOI: 10.1016/j.scitotenv.2024.171896
Publisher version: https://doi.org/10.1016/j.scitotenv.2024.171896
Language: English
Additional information: Copyright © 2024 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
Keywords: Diseases, Outbreaks, Rainfall, Sanitation provision, Temperature, Water access
UCL classification: UCL
UCL > Provost and Vice Provost Offices > UCL BEAMS
UCL > Provost and Vice Provost Offices > UCL SLASH
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS
UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Civil, Environ and Geomatic Eng
UCL > Provost and Vice Provost Offices > UCL SLASH > Faculty of S&HS > Dept of Geography
URI: https://discovery.ucl.ac.uk/id/eprint/10190267
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