A team of scientists from John Hopkins Bloomberg School of Epidemics, Maryland, USA, Transitional Health Science and Technology, New Delhi, with support from National Center for Disease Control, New Delhi, Indian Public Health Association, World Health Organization, and Bill and Melinda Gates Foundation set up a Cholera Expert Group, to provide the necessary roadmap for control of the disease. The group has studied the endemicity and epidemicity of cholera and identified factors and hotspots of the disease in India.
Cholera is an infectious disease caused by the bacterium Vibrio cholerae. The symptoms include mild to severe diarrhea, leading to dehydration and, if not treated, even death. In India, many parts of the country have fallen prey to a sporadic, endemic epidemic of cholera, with highest number of outbreaks occurring in Maharashtra, West Bengal, Odisha and Kerala. Yet, the disease remains an under-recognized health problem in the country.
For their study, the scientists used district level data on cholera cases between 2010 and 2015 from the Integrated Disease Surveillance program, while data on external factors, such as socioeconomic characteristics, sanitation, and access to water, was obtained from 2011 census. In all, 641 districts were sampled. A simple spatial analysis provided the cholera hotspots in the country, and another statistical tool called inflated Poisson regression gave them the factors leading to the disease.
The study identified 24 out of the 36 states had reported cholera cases, of which 13 states were classified as endemic, and a total of 27,615 cases of the disease was reported, in the 6-year period. The study also identified 78 districts in 15 states as hotspots of the disease with frequent outbreaks of cholera. Further, the study also found a reduction of the risk associated with cholera with increase in coverage of literate persons, access to treated water sources and owning mobile phones. While the risk increased with poor sanitation and drainage systems, and decreased urbanization.
The study confirms earlier beliefs that parts of India is still being ravaged by cholera. The researchers believe policymakers could use the data from this study to develop a roadmap for prevention and control of cholera in India.