Dynamics of cholera epidemics from Benin to Mauritania

The countries of West Africa are largely portrayed as cholera endemic, although the dynamics of outbreaks in this region of Africa remain largely unclear. To understand the dynamics of cholera in a major portion of West Africa, we analyzed cholera epidemics from 2009 to 2015 from Benin to Mauritania...

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Bibliographic Details
Published in:	PLoS neglected tropical diseases Vol. 12; no. 4; p. e0006379
Main Authors:	Moore, Sandra, Dongdem, Anthony Zunuo, Opare, David, Cottavoz, Paul, Fookes, Maria, Sadji, Adodo Yao, Dzotsi, Emmanuel, Dogbe, Michael, Jeddi, Fakhri, Bidjada, Bawimodom, Piarroux, Martine, Valentin, Ouyi Tante, Glèlè, Clément Kakaï, Rebaudet, Stanislas, Sow, Amy Gassama, Constantin de Magny, Guillaume, Koivogui, Lamine, Dunoyer, Jessica, Bellet, Francois, Garnotel, Eric, Thomson, Nicholas, Piarroux, Renaud
Format:	Journal Article
Language:	English
Published:	United States Public Library of Science 09-04-2018 Public Library of Science (PLoS)
Subjects:	Analysis Bacteriology Benin - epidemiology Biology and Life Sciences Cholera Cholera - epidemiology Cholera - microbiology Coastal states Coasts Countries Disease Disease hot spots Disease Outbreaks Distribution Dynamics Epidemics Epidemiology Gene sequencing Genomes Genomics Genotype Ghana - epidemiology Guinea - epidemiology Health services Human health and pathology Humans Hygiene Infections Infectious diseases Investigations Life Sciences Mauritania - epidemiology Medical research Medicine and Health Sciences Minisatellite Repeats Molecular chains Outbreaks Pandemics Parasitology People and Places Phylogeny Public health Risk factors Sanitation Santé publique et épidémiologie Sierra Leone - epidemiology Task forces Tropical diseases Urban areas Vibrio cholerae Vibrio cholerae - classification Vibrio cholerae - genetics Vibrio cholerae - isolation & purification Waterborne diseases Benin Ghana Sierra Leone Mauritania Guinea Africa United Kingdom > UK Togo Senegal West Africa Ivory Coast France Central Africa
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Summary:	The countries of West Africa are largely portrayed as cholera endemic, although the dynamics of outbreaks in this region of Africa remain largely unclear. To understand the dynamics of cholera in a major portion of West Africa, we analyzed cholera epidemics from 2009 to 2015 from Benin to Mauritania. We conducted a series of field visits as well as multilocus variable tandem repeat analysis and whole-genome sequencing analysis of V. cholerae isolates throughout the study region. During this period, Ghana accounted for 52% of the reported cases in the entire study region (coastal countries from Benin to Mauritania). From 2009 to 2015, we found that one major wave of cholera outbreaks spread from Accra in 2011 northwestward to Sierra Leone and Guinea in 2012. Molecular epidemiology analysis confirmed that the 2011 Ghanaian isolates were related to those that seeded the 2012 epidemics in Guinea and Sierra Leone. Interestingly, we found that many countries deemed "cholera endemic" actually suffered very few outbreaks, with multi-year lulls. This study provides the first cohesive vision of the dynamics of cholera epidemics in a major portion of West Africa. This epidemiological overview shows that from 2009 to 2015, at least 54% of reported cases concerned populations living in the three urban areas of Accra, Freetown, and Conakry. These findings may serve as a guide to better target cholera prevention and control efforts in the identified cholera hotspots in West Africa.
Bibliography:	new_version PMCID: PMC5908202 The authors have declared that no competing interests exist.
ISSN:	1935-2735 1935-2727 1935-2735
DOI:	10.1371/journal.pntd.0006379