Global Patterns of Trends in Cholera Mortality

Abstract

Background: Cholera is a large public health issue, especially in countries with limited resources. The aim of the study was to determine trends in global cholera mortality from 1990-2019.

Methods: This research is an observational, descriptive epidemiological study. The age-standardized rates (ASRs, per 100,000 population) of cholera mortality from 1990 to 2019 were evaluated through joinpoint regression analysis (by calculating Odds Ratio-OR, with corresponding 95% Confidence Interval-95% CI).

Results: From 1990-2019 in the world, the number of deaths due to cholera in both sexes together increased, ranging from 83,045 in 1990 to 117,167 in 2019. During the observed period, there were about 3.0 million deaths due to cholera in the world. In both sexes together in 2019, the cholera mortality rate was the highest in Nigeria (ARS = 39.19) and Central African Republic (ARS = 38.80), followed by populations in Eritrea (ARS = 17.62) and Botswana (ARS = 13.77). Globally, cholera-related mortality significantly decreased in males (AAPC = -0.4%, 95% CI = -0.7 to -0.1), while a stable trend was noted in females (AAPC = -0.1%, 95% CI = -0.4 to 0.2) in the observed period. In the African Region, significantly increasing cholera-related mortality trends were observed both in males and females (AAPC = 1.3% and AAPC = 1.1%, respectively).

Conclusions: Cholera mortality showed a constantly increasing trend in the African Region over the last three decades. More efforts in cholera management are necessary for effective response to the growing mortality in developing countries.

Keywords: cholera; epidemiology; mortality.

Figure 1

The number of cholera deaths in the world, 1990–2019 (Source of data Ref. [10]).

Figure 2

The number of cholera deaths, by regions of World Health Organization and sexes, 2019 (Source of data Ref. [10]).

Figure 3

Mortality of cholera (global and by regions of World Health Organization), by sex, 2019 (Source of data Ref. [10]).

Figure 4

Estimated age-standardized rates (ASRs, per 100,000 population) of cholera mortality by countries and by sex ((A) Males; (B) Females), 2019 (Source of data Ref. [10]).

Figure 5

Joinpoint regression analysis of cholera mortality (global and by regions of World Health Organization), 1990–2019. * Statistically significant trend (p < 0.05). (Source of data Ref. [10]).

Figure 6

Joinpoint regression analysis of global cholera mortality, by sexes, 1990–2019. * Statistically significant trend (p < 0.05). (Source of data Ref. [10]).

Figure 7

Trends in cholera mortality (age-standardized rates, per 100,000 population), by regions of World Health Organization and by sex, 1990–2019: a joinpoint regression analysis. * Statistically significant trend (p < 0.05); ** Joinpoint results are not shown for mortality in the region because no case of cholera death occurred in at least one year in the observed period. (Source of data Ref. [10]).