ArticleProceedings of the National Academy of Sciences of the United States of America2017
El Niño and the shifting geography of cholera in Africa.
Article in Proceedings of the National Academy of Sciences of the United States of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
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Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it, 120 citations in OpenAlex.
- How climate change can affect cholera incidence and prevalence? A systematic review.Environmental science and pollution research international · 2020Pooled it
- Associations between El Niño-Southern Oscillation (ENSO) and tuberculosis incidence in China: a nationwide study.One health (Amsterdam, Netherlands) · 2026Article
- Extreme temperatures and the epithelial barrier theory.Seminars in immunopathology · 2026Review
- Program Evaluation of the WASHmobile PICHA7 Mobile Health and Chlorine E-Voucher Program in the Democratic Republic of the Congo.Tropical medicine & international health : TM & IH · 2026Article
- Epidemiologic Characteristics and Predictors of Mortality in Somalia's 2024 Cholera Outbreak.Journal of epidemiology and global health · 2026Article
- Article
- Understanding cholera dynamics in African countries with persistent outbreaks: a mathematical modeling approach.BMC public health · 2025Article
- Integrating anticipatory action in disease outbreak preparedness and response in the humanitarian sector.BMJ global health · 2025Review
- Spatio-temporal pattern and risk factors associated with cholera outbreaks in selected high-risk areas of Kenya.Transactions of the Royal Society of Tropical Medicine and Hygiene · 2025Article
- Article
- Impacts of Weather Anomalies and Climate on Plant Disease.Ecology letters · 2025Review
- Integrating Surveillance and Climate Data for Cholera Early Warning in Ethiopia.Annals of global health · 2025Article
- Climate change, its impact on emerging infectious diseases and new technologies to combat the challenge.Emerging microbes & infections · 2024Review
- Satellite-Derived, Smartphone-Delivered Geospatial Cholera Risk Information for Vulnerable Populations.GeoHealth · 2024Article
- Burden of childhood diarrhea and cholera outbreaks in the Lake Tana Basin (Ethiopia): Review.African health sciences · 2024Review
- Maternal preconceptional and prenatal exposure to El Niño Southern Oscillation levels and child mortality: a multi-country study.Nature communications · 2024Article
- Retrospective Analysis of Cholera/Acute Watery Diarrhea Outbreaks in Ethiopia From 2001 To 2023: Incidence, Case Fatality Rate, and Seasonal and Multiyear Epidemic Patterns.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Ethiopia National Cholera Elimination Plan 2022-2028: Experiences, Challenges, and the Way Forward.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Article
- Unveiling the role of climate in spatially synchronized locust outbreak risks.Science advances · 2024Article
Corrections and comments
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Authors and funding
11 authors at 4 institutions in 2 countries.
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Abstract
The El Niño Southern Oscillation (ENSO) and other climate patterns can have profound impacts on the occurrence of infectious diseases ranging from dengue to cholera. In Africa, El Niño conditions are associated with increased rainfall in East Africa and decreased rainfall in southern Africa, West Africa, and parts of the Sahel. Because of the key role of water supplies in cholera transmission, a relationship between El Niño events and cholera incidence is highly plausible, and previous research has shown a link between ENSO patterns and cholera in Bangladesh. However, there is little systematic evidence for this link in Africa. Using high-resolution mapping techniques, we find that the annual geographic distribution of cholera in Africa from 2000 to 2014 changes dramatically, with the burden shifting to continental East Africa-and away from Madagascar and portions of southern, Central, and West Africa-where almost 50,000 additional cases occur during El Niño years. Cholera incidence during El Niño years was higher in regions of East Africa with increased rainfall, but incidence was also higher in some areas with decreased rainfall, suggesting a complex relationship between rainfall and cholera incidence. Here, we show clear evidence for a shift in the distribution of cholera incidence throughout Africa in El Niño years, likely mediated by El Niño's impact on local climatic factors. Knowledge of this relationship between cholera and climate patterns coupled with ENSO forecasting could be used to notify countries in Africa when they are likely to see a major shift in their cholera risk.
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