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Local Environmental Predictors of Cholera in Bangladesh and Vietnam

Environmental factors have been shown to be related to cholera and thus might prove useful for prediction. In Bangladesh and Vietnam, temporal cholera distributions are related to satellite-derived and in-situ environmental time series data in order to examine the relationships between cholera and the local environment. Ordered probit models examine associations in Bangladesh; probit models examine associations at 2 sites in Vietnam. Increases in ocean chlorophyll concentration are related to an increased magnitude of cholera in Bangladesh. Increases in sea surface temperature are most influential in Hue, Vietnam, whereas increases in river height have a significant role in Nha Trang, Vietnam. Cholera appearance and epidemic magnitude are related to the local environment. Local environmental parameters have consistent effects when cholera is regular and more prevalent in endemic settings, but in situations where cholera epidemics are rare there are differential environmental effects.

Received September 23, 2007. Accepted for publication January 16, 2008.

Acknowledgments: This work was supported by a grant from NOAA: Oceans and Human Health Program.

^* Address correspondence to Michael Emch, Department of Geography, 205 Saunders Hall, CB 3220, University of North Carolina—Chapel Hill, Chapel Hill, NC 27599. E-mail: emch{at}unc.edu

Authors’ addresses: Caryl Feldacker, Mohammad Yunus, Peter Kim Streatfield, Vu DinhThiem, Do Gia Canh, and Mohammad Ali. Michael Emch, Department of Geography, 205 Saunders Hall, CB 3220, University of North Carolina—Chapel Hill, Chapel Hill, NC 27599, E-mail: emch{at}unc.edu and Carolina Population Center, University of North Carolina—Chapel Hill, North Carolina. Caryl Feldacker, Department of Health Behavior and Health Education, University of North Carolina—Chapel Hill, and Carolina Population Center, University of North Carolina at Chapel Hill, CB# 8120, University Square, 123 West Franklin Street, Chapel Hill, NC 27516-2524, E-mail: caryl{at}unc.edu. Mohammed Yunis, ICDDR,B, Centre for Health and Population Research, Bangladesh, E-mail: myunus{at}icddrb.org. Peter Kim Streatfield, ICDDR,B, Centre for Health and Population Research, Bangladesh, E-mail: Streatfield-kims{at}icddrb.org. Vu Dinh Thiem and Do Gia Canh, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam, E-mails: vudinthiem{at}hn.vnn.vn and Canh-uncddp2{at}hn.vnn.vn. Mohammad Ali, International Vaccine Institute, Seoul, Korea, E-mail: mali{at}ivi.int.

Reprint requests: Michael Emch, Department of Geography, 205 Saunders Hall, Campus Box 3220, University of North Carolina—Chapel Hill, Chapel Hill, NC 27599, Telephone: +1 (919) 843-1010, Fax: +1 (919) 962-1537, E-mail: emch{at}unc.edu.