Spatio-temporal epidemiology of the cholera outbreak in Papua New Guinea, 2009–2011

Horwood, Paul F., Karl, Stephan, Mueller, Ivo, Jonduo, Marinjho H., Pavlin, Boris I., Dagina, Rosheila, Ropa, Berry, Bieb, Sibauk, Rosewell, Alexander, Umezaki, Masahiro, Siba, Peter M., and Greenhill, Andrew R. (2014) Spatio-temporal epidemiology of the cholera outbreak in Papua New Guinea, 2009–2011. BMC Infectious Diseases, 14 (449). pp. 1-10.

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Abstract

Background: Cholera continues to be a devastating disease in many developing countries where inadequate safe water supply and poor sanitation facilitate spread. From July 2009 until late 2011 Papua New Guinea experienced the first outbreak of cholera recorded in the country, resulting in >15,500 cases and >500 deaths.

Methods: Using the national cholera database, we analysed the spatio-temporal distribution and clustering of the Papua New Guinea cholera outbreak. The Kulldorff space-time permutation scan statistic, contained in the software package SatScan v9.2 was used to describe the first 8 weeks of the outbreak in Morobe Province before cholera cases spread throughout other regions of the country. Data were aggregated at the provincial level to describe the spread of the disease to other affected provinces.

Results: Spatio-temporal and cluster analyses revealed that the outbreak was characterized by three distinct phases punctuated by explosive propagation of cases when the outbreak spread to a new region. The lack of road networks across most of Papua New Guinea is likely to have had a major influence on the slow spread of the disease during this outbreak.

Conclusions: Identification of high risk areas and the likely mode of spread can guide government health authorities to formulate public health strategies to mitigate the spread of the disease through education campaigns, vaccination, increased surveillance in targeted areas and interventions to improve water, sanitation and hygiene.

Item ID: 46979
Item Type: Article (Research - C1)
ISSN: 1471-2334
Keywords: cholera; vibrio cholerae; spatio-temporal distribution; cluster analysis; Papua New Guinea
Additional Information:

© Horwood et al.; licensee BioMed Central Ltd. 2014

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

Date Deposited: 01 Feb 2017 02:14
FoR Codes: 11 MEDICAL AND HEALTH SCIENCES > 1103 Clinical Sciences > 110309 Infectious Diseases @ 100%
SEO Codes: 92 HEALTH > 9201 Clinical Health (Organs, Diseases and Abnormal Conditions) > 920109 Infectious Diseases @ 100%
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