The spread of cholera in western Democratic Republic of the Congo is not unidirectional from East–West: a spatiotemporal analysis, 1973–2018

BMC Infectious Diseases

Jérémie Muwonga¹  Catherine Linard²  Hippolyte Situakibanza³  Pierre Ozer⁴  Michel Moutschen⁵  Didier Bompangue⁶  Harry César Ntumba Kayembe⁷ 

[1] Département de Biologie Clinique, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo;Département de Géographie, Université de Namur, Namur, Belgium;Département de Médecine Interne, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo;Département de Parasitologie Et Médecine Tropicale, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo;Département de Sciences Et Gestion de L’environnement, Faculté Des Sciences, Université de Liège, Arlon, Belgium;Département des Sciences Cliniques, Immunopathologie–Maladies infectieuses et Médecine interne générale, Université de Liège, Liege, Belgium;Service d’Ecologie et Contrôle des Maladies Infectieuses, Département des Sciences de Base, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo;Chrono-Environnement, UMR CNRS 6249, Université de Franche-Comté, Besançon, France;Service d’Ecologie et Contrôle des Maladies Infectieuses, Département des Sciences de Base, Faculté de Médecine, Université de Kinshasa, Kinshasa, Democratic Republic of the Congo;Département de Sciences Et Gestion de L’environnement, Faculté Des Sciences, Université de Liège, Arlon, Belgium;Service d’Ecologie et Contrôle des Maladies Infectieuses, Département des Sciences de Base, Faculté de Médecine, Université de Kinshasa, Kin XI, B.P. : 834, Kinshasa, Democratic Republic of the Congo;

关键词: Cholera;    Vibrio cholerae;    Epidemic spread;    Spatiotemporal analysis;    Clusters;    Democratic Republic of the Congo;   

DOI  :  10.1186/s12879-021-06986-9

来源: Springer

【 摘 要 】

BackgroundCholera outbreaks in western Democratic Republic of the Congo (DRC) are thought to be primarily the result of westward spread of cases from the Great Lakes Region. However, other patterns of spatial spread in this part of the country should not be excluded. The aim of this study was to explore alternative routes of spatial spread in western DRC.MethodsA literature review was conducted to reconstruct major outbreak expansions of cholera in western DRC since its introduction in 1973. We also collected data on cholera cases reported at the health zone (HZ) scale by the national surveillance system during 2000–2018. Based on data from routine disease surveillance, we identified two subperiods (week 45, 2012–week 42, 2013 and week 40, 2017–week 52, 2018) for which the retrospective space–time permutation scan statistic was implemented to detect spatiotemporal clusters of cholera cases and then to infer the spread patterns in western DRC other than that described in the literature.ResultsBeyond westward and cross-border spread in the West Congo Basin from the Great Lakes Region, other dynamics of cholera epidemic propagation were observed from neighboring countries, such as Angola, to non-endemic provinces of southwestern DRC. Space–time clustering analyses sequentially detected clusters of cholera cases from southwestern DRC to the northern provinces, demonstrating a downstream-to-upstream spread along the Congo River.ConclusionsThe spread of cholera in western DRC is not one-sided. There are other patterns of spatial spread, including a propagation from downstream to upstream areas along the Congo River, to be considered as preferential trajectories of cholera in western DRC.

【 授权许可】

CC BY