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Contrasting Epidemiology of Cholera in Bangladesh and Africa

Sack, David A, Debes, Amanda K, Ateudjieu, Jerome, Bwire, Godfrey, Ali, Mohammad, Ngwa, Moise Chi, Mwaba, John, Chilengi, Roma, Orach, Christopher C, Boru, Waqo, Mohamed, Ahmed Abade, Ram, Malathi, George, Christine Marie, Stine, O Colin·2021·The Journal of Infectious Diseases
DOI 10.1093/infdis/jiab440PMC PMC8687066
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Abstract

In Bangladesh and West Bengal cholera is seasonal, transmission occurs consistently annually. By contrast, in most African countries, cholera has inconsistent seasonal patterns and long periods without obvious transmission. Transmission patterns in Africa occur during intermittent outbreaks followed by elimination of that genetic lineage. Later another outbreak may occur because of reintroduction of new or evolved lineages from adjacent areas, often by human travelers. These then subsequently undergo subsequent elimination. The frequent elimination and reintroduction has several implications when planning for cholera’s elimination including: a) reconsidering concepts of definition of elimination, b) stress on rapid detection and response to outbreaks, c) more effective use of oral cholera vaccine and WASH, d) need to readjust estimates of disease burden for Africa, e) re-examination of water as a reservoir for maintaining endemicity in Africa. This paper reviews major features of cholera’s epidemiology in African countries which appear different from the Ganges Delta.

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  • These water-borne diseases have a high mortality rate, especially for infants and children under 5 years of age (37%).

    “These water-borne diseases have a high mortality rate, especially for infants and children under 5 years of age (37%)75–78.”

    From Impact of untreated tannery wastewater in the evolution of multidrug-resistant bacteria in Bangladesh (2024) · cites this paper as [77]

    The Abstract says severe cholera can cause death if not treated promptly, and the Ganges Delta section says young children have the highest rates of cholera. Those rates refer to cases, not deaths. The paper does not support a 37% mortality rate for children under five or extend that figure to water-borne diseases generally. (LLM, conf=0.86)

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Metadata

Authors
Sack, D. A., Debes, A. K., Ateudjieu, J., Bwire, G., Ali, M., Ngwa, M. C., Mwaba, J., Chilengi, R., Orach, C. C., Boru, W., Mohamed, A. A., Ram, M., George, C. M., & Stine, O. C.
Venue
The Journal of Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2021-09-22
Volume
224
Issue
Supplement_7
Pages
S701-S709
ISSN
  • 0022-1899
  • 1537-6613
DOI
10.1093/infdis/jiab440
PMC
PMC8687066
Cited by
38
References
1
Language
en
Licence
creativecommons.org/licenses/by/4.0/ (vor)
Funders
  • Bill and Melinda Gates Foundation (OPP1148763)
  • National Institute of Allergy and Infectious Diseases (5R01AI123422)

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