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The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria

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  • Gina E C Charnley
  • Sebastian Yennan
  • Chinwe Ochu
  • Ilan Kelman
  • Katy A M Gaythorpe
  • Kris A Murray

Abstract

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. To address this gap, we used a machine learning approach to understand the risks and thresholds for cholera outbreaks and extreme events, taking into consideration pre-existing vulnerabilities. We estimated time varying reproductive number (R) from cholera incidence in Nigeria and used a machine learning approach to evaluate 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 R. 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). The main limitation is the underreporting of cholera globally and the potential number of cholera cases missed in the data used here. Increasing access to sanitation and decreasing poverty reduced the impact of extreme events in terms of cholera outbreak risk. The results here therefore add further evidence of the need for sustainable development for disaster prevention and mitigation and to improve health and quality of life.

Suggested Citation

  • Gina E C Charnley & Sebastian Yennan & Chinwe Ochu & Ilan Kelman & Katy A M Gaythorpe & Kris A Murray, 2022. "The impact of social and environmental extremes on cholera time varying reproduction number in Nigeria," PLOS Global Public Health, Public Library of Science, vol. 2(12), pages 1-20, December.
  • Handle: RePEc:plo:pgph00:0000869
    DOI: 10.1371/journal.pgph.0000869
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    References listed on IDEAS

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    1. Nejat Anbarci & Monica Escaleras & Charles A. Register, 2012. "From Cholera Outbreaks to Pandemics: The Role of Poverty and Inequality," The American Economist, Sage Publications, vol. 57(1), pages 21-31, May.
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    3. Aaron A. King & Edward L. Ionides & Mercedes Pascual & Menno J. Bouma, 2008. "Inapparent infections and cholera dynamics," Nature, Nature, vol. 454(7206), pages 877-880, August.
    4. Arran Hamlet & Daniel Garkauskas Ramos & Katy A. M. Gaythorpe & Alessandro Pecego Martins Romano & Tini Garske & Neil M. Ferguson, 2021. "Seasonality of agricultural exposure as an important predictor of seasonal yellow fever spillover in Brazil," Nature Communications, Nature, vol. 12(1), pages 1-11, December.
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