Climate-driven endemic cholera is modulated by human mobility in a megacity

Area of Science:

• Epidemiology
• Climate Science
• Urban Dynamics

Background:

• Cholera transmission in megacities like Dhaka is influenced by climate variability.
• Previous studies noted differential sensitivity but lacked clarity on spatial spread patterns.

Purpose of the Study:

• To investigate the role of human mobility in modulating spatial cholera transmission in Dhaka.
• To understand how climate variability and mobility interact to drive cholera outbreaks.
• To improve cholera outbreak prediction models by incorporating human movement.

Main Methods:

• Utilized a probabilistic spatial model enhanced with human mobility data.
• Inferred mobility fluxes using population density mapping and a parameter-free human mobility model.
• Analyzed the sensitivity of cholera dynamics to the El Niño Southern Oscillation (ENSO).

Main Results:

• Cholera risk is significantly transmitted from the climate-sensitive urban core to the periphery.
• The urban center shows higher sensitivity to ENSO compared to the rural periphery.
• Including human mobility improved outbreak prediction performance by an 11-month lead time.

Conclusions:

• Human mobility is a critical factor in the spatial spread of cholera risk within megacities.
• Understanding the interplay of climate and mobility is essential for effective cholera control strategies in rapidly growing urban areas.
• The findings have implications for public health planning in developing megacities globally.