Highly localized sensitivity to climate forcing drives endemic cholera in a megacity

Area of Science:

• Epidemiology
• Environmental Health
• Mathematical Biology

Background:

• Urban cholera dynamics, particularly seasonal outbreak variations, are poorly understood and unpredictable.
• Heterogeneity in urban demographics, socioeconomic factors, and environment complicates disease modeling.
• Previous cholera models focused on temporal dynamics, neglecting spatial structure and localized climate influences.

Purpose of the Study:

• To develop and apply a probabilistic spatial model for explaining cholera population dynamics in urban settings.
• To investigate the localized effects of climate variability on cholera transmission in a megacity.
• To establish a basis for accurate cholera forecasting at extended lead times.

Main Methods:

• Development of a probabilistic spatial model incorporating demographic, socioeconomic, and environmental heterogeneity.
• Application of the model to cholera dynamics in Dhaka, Bangladesh.
• Analysis of climate variability, including El Niño Southern Oscillation and flooding, and its spatial impact.

Main Results:

• The spatial model successfully explains cholera dynamics in Dhaka, Bangladesh.
• Climate variability's influence on cholera is localized, originating from a climate-sensitive urban core.
• Forecasts of cholera outbreaks are achievable with lead times up to 11 months.

Conclusions:

• A probabilistic spatial modeling framework can effectively capture and predict urban cholera dynamics.
• Localized climate variability, originating from specific urban areas, significantly drives cholera transmission.
• The developed modeling approach is adaptable for cholera prediction in other cities and for various infectious diseases in urban environments.