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. 2023 Jan 6;3(1):e0001261.
doi: 10.1371/journal.pgph.0001261. eCollection 2023.

Spatial distribution of suspected and confirmed cholera cases in Mwanza City, Northern Tanzania

Monica T Madullu  1 , Deborah S K Thomas  2 , Elias C Nyanza  1 , Jeremiah Seni  3 , Sospatro E Ngallaba  1 , Sophia Kiluvia  4 , Moses Asori  2 , Joseph Kangmennaang  5
Affiliations

Spatial distribution of suspected and confirmed cholera cases in Mwanza City, Northern Tanzania

Monica T Madullu et al. PLOS Glob Public Health. .

Abstract

Cholera, which is caused by Vibrio cholerae, persists as a devastating acute diarrheal disease. Despite availability of information on socio-cultural, agent and hosts risk factors, the disease continues to claim lives of people in Tanzania. The present study explores spatial patterns of cholera cases during a 2015-16 outbreak in Mwanza, Tanzania using a geographical information system (GIS) to identify concentrations of cholera cases. This cross-sectional study was conducted in Ilemela and Nyamagana Districts, Mwanza City. The two-phase data collection included: 1) retrospectively reviewing and capturing 852 suspected cholera cases from clinical files during the outbreak between August, 2015, and April, 2016, and 2) mapping of residence of suspected and confirmed cholera cases using global positioning systems (GPS). A majority of cholera patients were from Ilemela District (546, 64.1%), were males (506, 59.4%) and their median age was 27 (19-36) years. Of the 452 (55.1%) laboratory tests, 352 (77.9%) were confirmed to have Vibrio cholerae infection. Seven patients (0.80%) died. Cholera cases clustered in certain areas of Mwanza City. Sangabuye, Bugogwa and Igoma Wards had the largest number of confirmed cholera cases, while Luchelele Ward had no reported cholera cases. Concentrations may reflect health-seeking behavior as much as disease distribution. Topographical terrain, untreated water, physical and built environment, and health-seeking behaviors play a role in cholera epidemic in Mwanza City. The spatial analysis suggests patterns of health-seeking behavior more than patterns of disease. Maps similar to those generated in this study would be an important future resource for identifying an impending cholera outbreak in real-time to coordinate community members, community leaders and health personnel for guiding targeted education, outreach, and interventions.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Study area, Mwanza City, Tanzania.
Base map data source: OCHA, https://data.humdata.org/dataset/cod-ab-tza. Map created by: Deborah Thomas.
Fig 2
Fig 2. Kernel density estimation of home locations for suspected cholera cases in Mwanza City, Tanzania, during the August 2015- April 2016 outbreak.
The darker the color, the higher the concentration of where patients at camps lived. Base map data source: OCHA, https://data.humdata.org/dataset/cod-ab-tza. Map created by: Deborah Thomas.
Fig 3
Fig 3. Case ratio of ward as compared to the case ratio of Mwanza City for patients attending cholera camps for treatment during the August 2015- April 2016 outbreak.
Base map data source: OCHA, https://data.humdata.org/dataset/cod-ab-tza. Map created by: Deborah Thomas.
See this image and copyright information in PMC

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