title: Understanding the cholera epidemic, Haiti.
abstract: After onset of a cholera epidemic in Haiti in mid-October 2010, a team of researchers from France and Haiti implemented field investigations and built a database of daily cases to facilitate identification of communes most affected. Several models were used to identify spatiotemporal clusters, assess relative risk associated with the epidemic's spread, and investigate causes of its rapid expansion in Artibonite Department. Spatiotemporal analyses highlighted 5 significant clusters (p<0.001): 1 near Mirebalais (October 16-19) next to a United Nations camp with deficient sanitation, 1 along the Artibonite River (October 20-28), and 3 caused by the centrifugal epidemic spread during November. The regression model indicated that cholera more severely affected communes in the coastal plain (risk ratio 4.91) along the Artibonite River downstream of Mirebalais (risk ratio 4.60). Our findings strongly suggest that contamination of the Artibonite and 1 of its tributaries downstream from a military camp triggered the epidemic.
authors.affiliation: Universite de la Mediterranee, Marseilles, France. renaud.piarroux@ap-hm.fr
authors.forename: Renaud
authors.initials: R
authors.lastname: Piarroux
authors.forename: Robert
authors.initials: R
authors.lastname: Barrais
authors.forename: Benoit
authors.initials: B
authors.lastname: Faucher
authors.forename: Rachel
authors.initials: R
authors.lastname: Haus
authors.forename: Martine
authors.initials: M
authors.lastname: Piarroux
authors.forename: Jean
authors.initials: J
authors.lastname: Gaudart
authors.forename: Roc
authors.initials: R
authors.lastname: Magloire
authors.forename: Didier
authors.initials: D
authors.lastname: Raoult
mesh_terms: D002771:Cholera / Q000175:diagnosis / Q000453:epidemiology / Q000401:mortality / Q000473:pathology / Q000635:transmission; D016000:Cluster Analysis; D058872:Epidemics / Q000706:statistics & numerical data*; D006205:Haiti / Q000453:epidemiology; D006801:Humans; D016017:Odds Ratio; D011159:Population Surveillance; D012307:Risk Factors; D045483:Rivers / Q000382:microbiology; D012499:Sanitation; D015996:Survival Rate; D014734:Vibrio cholerae / Q000254:growth & development