Use of Sat Scan for Identification of Cholera Hotpots in a High-Density Suburb of Harare, Zimbabwe.

Abstract

Background: The cholera pandemic remains a major public health risk in developing nations most of which are in the Sub Saharan regions. However, there is limited data on near real time analysis using the Sat Scan whichIn this study, of particular concern is the spatial-temporary distribution of cholera cases obtained from the mapping and detection of cholera hotspots or clusters in Budiriro on the outbreak, which occurred in September 2018. Methods: The research study used the spatial geographical distribution approach in order to study the clusters of high diseases incidence in Budiriro high-density suburb of Harare, Zimbabwe. The participants in this study included patients from all age groups and gender who were either suspects or confirmed cases of cholera according to the line lists provided by Harare City Health Department. Data was then analysed using the Python, Geographic Information Systems (GIS) and the Sat-Scan. Since this study, is an essential part of the health-needs assessment in the identification of high-risk areas for a disease, understanding the characteristics of high-risk areas was needed to indicate areas, which required improvements in the provision of WASH programmes in order to reduce the risk of cholera outbreaks. Results: The results from this study showed significant clusters or hotspots of cholera in Budiriro for the period of the outbreak (29 September-02 October 2019). People within 0.22km and 0.55km showed a significant risk of being susceptible to cholera (p=0.001). Clusters 1-3 were considered to be hotspots (p<0.05) for cholera outbreak and correspondingly there were more cases of cholera. These hotspots were linked to contaminated water sources (HA034, HA039 and HA075). Water was contaminated from low flow rate of sewage. Conclusions: Cholera and other general infectious disease surveillance can benefit from this perspective approach by monitoring outbreaks in real-time as new data becomes available. The results emphasised on the importance of focusing surveillance on emerging and active clusters during epidemics. Further we concluded that safe water provision could reduce the risk of such outbreaks if Sat-scans could be applied in locating possible areas of contamination.