title: Satellite Based Assessment of Hydroclimatic Conditions Related to Cholera in Zimbabwe.
abstract: BACKGROUND
  Cholera, an infectious diarrheal disease, has been shown to be associated with large scale hydroclimatic processes. The sudden and sporadic occurrence of epidemic cholera is linked with high mortality rates, in part, due to uncertainty in timing and location of outbreaks. Improved understanding of the relationship between pathogenic abundance and climatic processes allows prediction of disease outbreak to be an achievable goal. In this study, we show association of large scale hydroclimatic processes with the cholera epidemic in Zimbabwe reported to have begun in Chitungwiza, a city in Mashonaland East province, in August, 2008.
  
  
  RESULTS
  Climatic factors in the region were found to be associated with triggering cholera outbreak and are shown to be related to anomalies of temperature and precipitation, validating the hypothesis that poor conditions of sanitation, coupled with elevated temperatures, and followed by heavy rainfall can initiate outbreaks of cholera. Spatial estimation by satellite of precipitation and global gridded air temperature captured sensitivities in hydroclimatic conditions that permitted identification of the location in the region where the disease outbreak began.
  
  
  CONCLUSIONS
  Satellite derived hydroclimatic processes can be used to capture environmental conditions related to epidemic cholera, as occurred in Zimbabwe, thereby providing an early warning system. Since cholera cannot be eradicated because the causative agent, Vibrio cholerae, is autochthonous to the aquatic environment, prediction of conditions favorable for its growth and estimation of risks of triggering the disease in a given population can be used to alert responders, potentially decreasing infection and saving lives.
authors.affiliation: Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, United States of America.
authors.forename: Antarpreet
authors.initials: A
authors.lastname: Jutla
authors.affiliation: Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, United States of America.
authors.forename: Haidar
authors.initials: H
authors.lastname: Aldaach
authors.affiliation: Department of Civil and Environmental Engineering, West Virginia University, Morgantown, WV, United States of America.
authors.forename: Hannah
authors.initials: H
authors.lastname: Billian
authors.affiliation: Department of Civil and Environmental Engineering, University of Rhode Island, Kingston, RI, United States of America.
authors.forename: Ali
authors.initials: A
authors.lastname: Akanda
authors.affiliation: Maryland Pathogen Research Institute, University of Maryland, College Park, MD, United States of America.
authors.forename: Anwar
authors.initials: A
authors.lastname: Huq
authors.affiliation: Maryland Pathogen Research Institute, University of Maryland, College Park, MD, United States of America; Centre for Bioinformatics and Computational Biology, University of Maryland, College Park, Maryland, United States of America; Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America.
authors.forename: Rita
authors.initials: R
authors.lastname: Colwell
mesh_terms: D002771:Cholera / Q000453:epidemiology* / Q000382:microbiology / Q000401:mortality; D004196:Disease Outbreaks; D058872:Epidemics; D006801:Humans; D008954:Models, Biological; D011891:Rain; D063809:Satellite Imagery; D012621:Seasons; D062206:Spatial Analysis; D014329:Tropical Climate; D014734:Vibrio cholerae; D015030:Zimbabwe / Q000453:epidemiology