ArticleThe Lancet. Global health2022
The seasonality of cholera in sub-Saharan Africa: a statistical modelling study.
Article in The Lancet. Global health, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed.
- A case for using spatial evidence in waterborne disease control.Bulletin of the World Health Organization · 2026Article
- Factors associated with in-hospital mortality during the 2023 cholera outbreak in Hammanskraal, South Africa: a cross-sectional study.BMC infectious diseases · 2026Article
- Cholera surveillance time series in Africa between 2010 and 2023.Gates open research · 2026Article
- Clinical presentation and outcome of cholera in a regional hospital in Khartoum State, Sudan.Sudanese journal of paediatrics · 2026Article
- Cholera in Nigeria: a five-decade review of outbreak dynamics and health system responses.Journal of health, population, and nutrition · 2025Review
- Integrating anticipatory action in disease outbreak preparedness and response in the humanitarian sector.BMJ global health · 2025Review
- Cholera in Africa: A Climate Change Crisis.Journal of epidemiology and global health · 2025Review
- Whole genome sequencing and transmission analysis ofmedRxiv : the preprint server for health sciences · 2025Article
- Cholera in Sub-Saharan Africa: Unveiling neglected drivers and pathways to elimination.PLoS neglected tropical diseases · 2025Article
- Stress adaptation underMicrobiology spectrum · 2025Article
- Article
- Vibrio cholerae: Understanding a persistent pathogen in Sub-Saharan Africa and the East Mediterranean Region.Pathogens and disease · 2025Review
- Integrating Surveillance and Climate Data for Cholera Early Warning in Ethiopia.Annals of global health · 2025Article
- Cholera Outbreak in Nigeria: History, Review of Socioeconomic and Meteorological Drivers, Diagnostic Challenges, and Artificial Intelligence Integration.Global health, epidemiology and genomics · 2025Review
- Article
- Cholera rages in Africa and the Middle East: A narrative review on challenges and solutions.Health science reports · 2024Review
- Enhanced cholera surveillance to improve vaccination campaign efficiency.Nature medicine · 2024Article
- Unmasking the Neglected Cholera Outbreaks in Sub-Saharan Africa.International journal of public health · 2024Article
- Pathways of exposure to Vibrio Cholerae in an urban informal settlement in Nairobi, Kenya.PLOS global public health · 2024Article
- Resource availability and capacity to implement multi-stranded cholera interventions in the north-east region of Nigeria.BMC global and public health · 2023Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundCholera remains a major threat in sub-Saharan Africa (SSA), where some of the highest case-fatality rates are reported. Knowing in what months and where cholera tends to occur across the continent could aid in improving efforts to eliminate cholera as a public health concern. However, largely due to the absence of unified large-scale datasets, no continent-wide estimates exist. In this study, we aimed to estimate cholera seasonality across SSA and explore the correlation between hydroclimatic variables and cholera seasonality.
methodsUsing the global cholera database of the Global Task Force on Cholera Control, we developed statistical models to synthesise data across spatial and temporal scales to infer the seasonality of excess (defined as incidence higher than the 2010-16 mean incidence rate) suspected cholera occurrence in SSA. We developed a Bayesian statistical model to infer the monthly risk of excess cholera at the first and second administrative levels. Seasonality patterns were then grouped into spatial clusters. Finally, we studied the association between seasonality estimates and hydroclimatic variables (mean monthly fraction of area flooded, mean monthly air temperature, and cumulative monthly precipitation).
findings24 (71%) of the 34 countries studied had seasonal patterns of excess cholera risk, corresponding to approximately 86% of the SSA population. 12 (50%) of these 24 countries also had subnational differences in seasonality patterns, with strong differences in seasonality strength between regions. Seasonality patterns clustered into two macroregions (west Africa and the Sahel vs eastern and southern Africa), which were composed of subregional clusters with varying degrees of seasonality. Exploratory association analysis found most consistent and positive correlations between cholera seasonality and precipitation and, to a lesser extent, between cholera seasonality and temperature and flooding.
interpretationWidespread cholera seasonality in SSA offers opportunities for intervention planning. Further studies are needed to study the association between cholera and climate.
fundingUS National Aeronautics and Space Administration Applied Sciences Program and the Bill & Melinda Gates Foundation.
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