ArticleEnvironmental science & technology2023
Water, Sanitation, and Cholera in Sub-Saharan Africa.
Article in Environmental science & technology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 18 citations in OpenAlex.
- Seasonal variation, temporal trends, and factors associated with PCR-confirmed cholera in Goma city and surrounding health zones in Eastern Democratic Republic of the Congo, 2020-2024: a multilevel analysis.Tropical medicine and health · 2026Article
- Clinical presentation and outcome of cholera in a regional hospital in Khartoum State, Sudan.Sudanese journal of paediatrics · 2026Article
- Geographical shifting of cholera burden in Africa and its implications for disease control.Nature medicine · 2025Article
- Plant-based edible vaccines: Can cholera be the case study in Africa?Journal, genetic engineering & biotechnology · 2025Review
- Cholera in Africa: A Climate Change Crisis.Journal of epidemiology and global health · 2025Review
- Exploring the Impact of Traditional Practices onInternational journal of environmental research and public health · 2025Article
- Vibrio cholerae: Understanding a persistent pathogen in Sub-Saharan Africa and the East Mediterranean Region.Pathogens and disease · 2025Review
- Navigating water crisis, cholera, and refugee context: Lessons from Nakivale refugee settlement, Isingiro District, Uganda.PLOS global public health · 2025Article
- The specter of cholera in Libya and North Africa: Natural disasters and anthropization threaten human health during recent years.Journal of preventive medicine and hygiene · 2023Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Improvements in water and sanitation should reduce cholera risk though the associations between cholera and specific water and sanitation access measures remain unclear. We estimated the association between eight water and sanitation measures and annual cholera incidence access across sub-Saharan Africa (2010-2016) for data aggregated at the country and district levels. We fit random forest regression and classification models to understand how well these measures combined might be able to predict cholera incidence rates and identify high cholera incidence areas. Across spatial scales, piped or "other improved" water access was inversely associated with cholera incidence. Access to piped water, septic or sewer sanitation, and septic, sewer, or "other improved" sanitation were associated with decreased district-level cholera incidence. The classification model had moderate performance in identifying high cholera incidence areas (cross-validated-AUC 0.81, 95% CI 0.78-0.83) with high negative predictive values (93-100%) indicating the utility of water and sanitation measures for screening out areas that are unlikely to be at high cholera risk. While comprehensive cholera risk assessments must incorporate other data sources (e.g., historical incidence), our results suggest that water and sanitation measures could alone be useful in narrowing the geographic focus for detailed risk assessments.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.