Modelling cholera epidemics: the role of waterways, human mobility and sanitation

J R Soc Interface. 2012 Feb 7;9(67):376-88. doi: 10.1098/rsif.2011.0304. Epub 2011 Jul 13.

Abstract

We investigate the role of human mobility as a driver for long-range spreading of cholera infections, which primarily propagate through hydrologically controlled ecological corridors. Our aim is to build a spatially explicit model of a disease epidemic, which is relevant to both social and scientific issues. We present a two-layer network model that accounts for the interplay between epidemiological dynamics, hydrological transport and long-distance dissemination of the pathogen Vibrio cholerae owing to host movement, described here by means of a gravity-model approach. We test our model against epidemiological data recorded during the extensive cholera outbreak occurred in the KwaZulu-Natal province of South Africa during 2000-2001. We show that long-range human movement is fundamental in quantifying otherwise unexplained inter-catchment transport of V. cholerae, thus playing a key role in the formation of regional patterns of cholera epidemics. We also show quantitatively how heterogeneously distributed drinking water supplies and sanitation conditions may affect large-scale cholera transmission, and analyse the effects of different sanitation policies.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Cholera / epidemiology*
  • Cholera / transmission
  • Epidemics*
  • Humans
  • Models, Theoretical*
  • Population Dynamics
  • Sanitation*
  • South Africa / epidemiology
  • Vibrio cholerae
  • Water Microbiology