Seasonality of cholera in Kolkata and the influence of climate.


Journal

BMC infectious diseases
ISSN: 1471-2334
Titre abrégé: BMC Infect Dis
Pays: England
ID NLM: 100968551

Informations de publication

Date de publication:
02 Sep 2023
Historique:
received: 01 02 2023
accepted: 11 08 2023
medline: 4 9 2023
pubmed: 3 9 2023
entrez: 2 9 2023
Statut: epublish

Résumé

Cholera in Kolkata remains endemic and the Indian city is burdened with a high number of annual cases. Climate change is widely considered to exacerbate cholera, however the precise relationship between climate and cholera is highly heterogeneous in space and considerable variation can be observed even within the Indian subcontinent. To date, relatively few studies have been conducted regarding the influence of climate on cholera in Kolkata. We considered 21 years of confirmed cholera cases from the Infectious Disease Hospital in Kolkata during the period of 1999-2019. We used Generalised Additive Modelling (GAM) to extract the non-linear relationship between cholera and different climatic factors; temperature, rainfall and sea surface temperature (SST). Peak associated lag times were identified using cross-correlation lag analysis. Our findings revealed a bi-annual pattern of cholera cases with two peaks coinciding with the increase in temperature in summer and the onset of monsoon rains. Variables selected as explanatory variables in the GAM model were temperature and rainfall. Temperature was the only significant factor associated with summer cholera (mean temperature of 30.3 °C associated with RR of 3.8) while rainfall was found to be the main driver of monsoon cholera (550 mm total monthly rainfall associated with RR of 3.38). Lag time analysis revealed that the association between temperature and cholera cases in the summer had a longer peak lag time compared to that between rainfall and cholera during the monsoon. We propose several mechanisms by which these relationships are mediated. Kolkata exhibits a dual-peak phenomenon with independent mediating factors. We suggest that the summer peak is due to increased bacterial concentration in urban water bodies, while the monsoon peak is driven by contaminated flood waters. Our results underscore the potential utility of preventative strategies tailored to these seasonal and climatic patterns, including efforts to reduce direct contact with urban water bodies in summer and to protect residents from flood waters during monsoon.

Sections du résumé

BACKGROUND BACKGROUND
Cholera in Kolkata remains endemic and the Indian city is burdened with a high number of annual cases. Climate change is widely considered to exacerbate cholera, however the precise relationship between climate and cholera is highly heterogeneous in space and considerable variation can be observed even within the Indian subcontinent. To date, relatively few studies have been conducted regarding the influence of climate on cholera in Kolkata.
METHODS METHODS
We considered 21 years of confirmed cholera cases from the Infectious Disease Hospital in Kolkata during the period of 1999-2019. We used Generalised Additive Modelling (GAM) to extract the non-linear relationship between cholera and different climatic factors; temperature, rainfall and sea surface temperature (SST). Peak associated lag times were identified using cross-correlation lag analysis.
RESULTS RESULTS
Our findings revealed a bi-annual pattern of cholera cases with two peaks coinciding with the increase in temperature in summer and the onset of monsoon rains. Variables selected as explanatory variables in the GAM model were temperature and rainfall. Temperature was the only significant factor associated with summer cholera (mean temperature of 30.3 °C associated with RR of 3.8) while rainfall was found to be the main driver of monsoon cholera (550 mm total monthly rainfall associated with RR of 3.38). Lag time analysis revealed that the association between temperature and cholera cases in the summer had a longer peak lag time compared to that between rainfall and cholera during the monsoon. We propose several mechanisms by which these relationships are mediated.
CONCLUSIONS CONCLUSIONS
Kolkata exhibits a dual-peak phenomenon with independent mediating factors. We suggest that the summer peak is due to increased bacterial concentration in urban water bodies, while the monsoon peak is driven by contaminated flood waters. Our results underscore the potential utility of preventative strategies tailored to these seasonal and climatic patterns, including efforts to reduce direct contact with urban water bodies in summer and to protect residents from flood waters during monsoon.

Identifiants

pubmed: 37660078
doi: 10.1186/s12879-023-08532-1
pii: 10.1186/s12879-023-08532-1
pmc: PMC10474634
doi:

Substances chimiques

Water 059QF0KO0R

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

572

Subventions

Organisme : Engineering and Physical Sciences Research Council
ID : EP/L016214/1

Informations de copyright

© 2023. BioMed Central Ltd., part of Springer Nature.

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Auteurs

Debbie Shackleton (D)

College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, EX4 4QF, UK. dmshackleton@gmail.com.

Theo Economou (T)

Department of Mathematics, University of Exeter, Exeter, UK.
Climate and Atmosphere Research Centre, The Cyprus Institute, Nicosia, Cyprus.

Fayyaz Ali Memon (FA)

College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, EX4 4QF, UK.

Albert Chen (A)

College of Engineering, Mathematics, and Physical Sciences, University of Exeter, Exeter, EX4 4QF, UK.

Shanta Dutta (S)

National Institute of Cholera and Enteric Diseases, Kolkata, India.

Suman Kanungo (S)

National Institute of Cholera and Enteric Diseases, Kolkata, India.

Alok Deb (A)

National Institute of Cholera and Enteric Diseases, Kolkata, India.

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