Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.

<h4>Background</h4>During the last eight years, North and South Kivu, located in a lake area in Eastern Democratic Republic of Congo, have been the site of a major volcano eruption and of numerous complex emergencies with population displacements. These conditions have been suspected to...

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Autores principales:	Didier Bompangue, Patrick Giraudoux, Martine Piarroux, Guy Mutombo, Rick Shamavu, Bertrand Sudre, Annie Mutombo, Vital Mondonge, Renaud Piarroux
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2009
Materias:	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
Acceso en línea:	https://doaj.org/article/40c4b94213d046dcaaa594a7a0b18643
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spelling	oai:doaj.org-article:40c4b94213d046dcaaa594a7a0b186432021-11-25T06:33:21ZCholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.1935-27271935-273510.1371/journal.pntd.0000436https://doaj.org/article/40c4b94213d046dcaaa594a7a0b186432009-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/19436726/pdf/?tool=EBIhttps://doaj.org/toc/1935-2727https://doaj.org/toc/1935-2735<h4>Background</h4>During the last eight years, North and South Kivu, located in a lake area in Eastern Democratic Republic of Congo, have been the site of a major volcano eruption and of numerous complex emergencies with population displacements. These conditions have been suspected to favour emergence and spread of cholera epidemics.<h4>Methodology/principal findings</h4>In order to assess the influence of these conditions on outbreaks, reports of cholera cases were collected weekly from each health district of North Kivu (4,667,699 inhabitants) and South Kivu (4,670,121 inhabitants) from 2000 through 2007. A geographic information system was established, and in each health district, the relationships between environmental variables and the number of cholera cases were assessed using regression techniques and time series analysis. We further checked for a link between complex emergencies and cholera outbreaks. Finally, we analysed data collected during an epidemiological survey that was implemented in Goma after Nyiragongo eruption. A total of 73,605 cases and 1,612 deaths of cholera were reported. Time series decomposition showed a greater number of cases during the rainy season in South Kivu but not in North Kivu. Spatial distribution of cholera cases exhibited a higher number of cases in health districts bordering lakes (Odds Ratio 7.0, Confidence Interval range 3.8-12.9). Four epidemic reactivations were observed in the 12-week periods following war events, but simulations indicate that the number of reactivations was not larger than that expected during any random selection of period with no war. Nyiragongo volcanic eruption was followed by a marked decrease of cholera incidence.<h4>Conclusion/significance</h4>Our study points out the crucial role of some towns located in lakeside areas in the persistence of cholera in Kivu. Even if complex emergencies were not systematically followed by cholera epidemics, some of them enabled cholera spreading.Didier BompanguePatrick GiraudouxMartine PiarrouxGuy MutomboRick ShamavuBertrand SudreAnnie MutomboVital MondongeRenaud PiarrouxPublic Library of Science (PLoS)articleArctic medicine. Tropical medicineRC955-962Public aspects of medicineRA1-1270ENPLoS Neglected Tropical Diseases, Vol 3, Iss 5, p e436 (2009)
institution	DOAJ
collection	DOAJ
language	EN
topic	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270
spellingShingle	Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Didier Bompangue Patrick Giraudoux Martine Piarroux Guy Mutombo Rick Shamavu Bertrand Sudre Annie Mutombo Vital Mondonge Renaud Piarroux Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.
description	<h4>Background</h4>During the last eight years, North and South Kivu, located in a lake area in Eastern Democratic Republic of Congo, have been the site of a major volcano eruption and of numerous complex emergencies with population displacements. These conditions have been suspected to favour emergence and spread of cholera epidemics.<h4>Methodology/principal findings</h4>In order to assess the influence of these conditions on outbreaks, reports of cholera cases were collected weekly from each health district of North Kivu (4,667,699 inhabitants) and South Kivu (4,670,121 inhabitants) from 2000 through 2007. A geographic information system was established, and in each health district, the relationships between environmental variables and the number of cholera cases were assessed using regression techniques and time series analysis. We further checked for a link between complex emergencies and cholera outbreaks. Finally, we analysed data collected during an epidemiological survey that was implemented in Goma after Nyiragongo eruption. A total of 73,605 cases and 1,612 deaths of cholera were reported. Time series decomposition showed a greater number of cases during the rainy season in South Kivu but not in North Kivu. Spatial distribution of cholera cases exhibited a higher number of cases in health districts bordering lakes (Odds Ratio 7.0, Confidence Interval range 3.8-12.9). Four epidemic reactivations were observed in the 12-week periods following war events, but simulations indicate that the number of reactivations was not larger than that expected during any random selection of period with no war. Nyiragongo volcanic eruption was followed by a marked decrease of cholera incidence.<h4>Conclusion/significance</h4>Our study points out the crucial role of some towns located in lakeside areas in the persistence of cholera in Kivu. Even if complex emergencies were not systematically followed by cholera epidemics, some of them enabled cholera spreading.
format	article
author	Didier Bompangue Patrick Giraudoux Martine Piarroux Guy Mutombo Rick Shamavu Bertrand Sudre Annie Mutombo Vital Mondonge Renaud Piarroux
author_facet	Didier Bompangue Patrick Giraudoux Martine Piarroux Guy Mutombo Rick Shamavu Bertrand Sudre Annie Mutombo Vital Mondonge Renaud Piarroux
author_sort	Didier Bompangue
title	Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.
title_short	Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.
title_full	Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.
title_fullStr	Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.
title_full_unstemmed	Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.
title_sort	cholera epidemics, war and disasters around goma and lake kivu: an eight-year survey.
publisher	Public Library of Science (PLoS)
publishDate	2009
url	https://doaj.org/article/40c4b94213d046dcaaa594a7a0b18643
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Cholera epidemics, war and disasters around Goma and Lake Kivu: an eight-year survey.

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