title: Impact of drainage networks on cholera outbreaks in Lusaka, Zambia.
abstract: OBJECTIVE
  We investigated the association between precipitation patterns and cholera outbreaks and the preventative roles of drainage networks against outbreaks in Lusaka, Zambia.
  
  
  METHODS
  We collected data on 6542 registered cholera patients in the 2003-2004 outbreak season and on 6045 cholera patients in the 2005-2006 season. Correlations between monthly cholera incidences and amount of precipitation were examined. The distribution pattern of the disease was analyzed by a kriging spatial analysis method. We analyzed cholera case distribution and spatiotemporal cluster by using 2590 cholera cases traced with a global positioning system in the 2005-2006 season. The association between drainage networks and cholera cases was analyzed with regression analysis.
  
  
  RESULTS
  Increased precipitation was associated with the occurrence of cholera outbreaks, and insufficient drainage networks were statistically associated with cholera incidences.
  
  
  CONCLUSIONS
  Insufficient coverage of drainage networks elevated the risk of cholera outbreaks. Integrated development is required to upgrade high-risk areas with sufficient infrastructure for a long-term cholera prevention strategy.
authors.affiliation: Division of Public Health, Department of Infectious Disease Control and International Medicine, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachi-dori Chuo ward, Niigata, 951-8510, Japan. ssasaki@med.niigata-u.ac.jp
authors.forename: Satoshi
authors.initials: S
authors.lastname: Sasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Suzuki
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Fujino
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Kimura
authors.forename: Meetwell
authors.initials: M
authors.lastname: Cheelo
mesh_terms: D002771:Cholera / Q000453:epidemiology*; D004196:Disease Outbreaks; D004323:Drainage, Sanitary; D040362:Geographic Information Systems; D006801:Humans; D015994:Incidence; D011891:Rain; D012621:Seasons; D013029:Space-Time Clustering; D014505:Urban Population; D014881:Water Supply; D015024:Zambia / Q000453:epidemiology