Interaction between climatic, environmental, and demographic factors on cholera outbreaks in Kenya

Infectious Diseases of Poverty

Omur Cinar Elci³  Daniel Langat²  Mark J Giganti³  Victoria Kimotho¹  Martin Matu¹  Muge Akpinar-Elci²  Jane Y Carter¹  James D Stoltzfus³ 

[1] African Medical and Research Foundation (AMREF), Nairobi, Kenya;Center for Global Health, College of Health Sciences, Old Dominion University, Norfolk, VA, USA;School of Medicine, Department of Public Health and Preventive Medicine, St. George’s University (SGU), West Indies, Grenada

关键词: Water supply;    Waste disposal;    Rainfall;    Poverty;    Population density;    Health infrastructure;    Education;    Cholera;   

Others  :  1136017
DOI  :  10.1186/2049-9957-3-37

 received in 2014-06-03, accepted in 2014-09-11,  发布年份 2014

【 摘 要 】

Background

Cholera remains an important public health concern in developing countries including Kenya where 11,769 cases and 274 deaths were reported in 2009 according to the World Health Organization (WHO). This ecological study investigates the impact of various climatic, environmental, and demographic variables on the spatial distribution of cholera cases in Kenya.

Methods

District-level data was gathered from Kenya’s Division of Disease Surveillance and Response, the Meteorological Department, and the National Bureau of Statistics. The data included the entire population of Kenya from 1999 to 2009.

Results

Multivariate analyses showed that districts had an increased risk of cholera outbreaks when a greater proportion of the population lived more than five kilometers from a health facility (RR: 1.025 per 1% increase; 95% CI: 1.010, 1.039), bordered a body of water (RR: 5.5; 95% CI: 2.472, 12.404), experienced increased rainfall from October to December (RR: 1.003 per 1 mm increase; 95% CI: 1.001, 1.005), and experienced decreased rainfall from April to June (RR: 0.996 per 1 mm increase; 95% CI: 0.992, 0.999). There was no detectable association between cholera and population density, poverty, availability of piped water, waste disposal methods, rainfall from January to March, or rainfall from July to September.

Conclusion

Bordering a large body of water, lack of health facilities nearby, and changes in rainfall were significantly associated with an increased risk of cholera in Kenya.

【 授权许可】

   
2014 Stoltzfus et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 3.

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