The Importance of Maintenance
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World Bank, Washington, DC
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Understanding the specific factors
associated with cholera outbreaks is an integral part of
designing better approaches to mitigate their impact. This
paper uses georeferenced case data from the cholera epidemic
that occurred in Harare, Zimbabwe, from September 2018 to
January 2019. The paper applies spatio-temporal modeling to
understand how the outbreak unfolded and the factors
associated with higher risk of being a reported case. The
study highlighted a number of findings. First, using call
detail records to estimate weekly population movement
throughout the city, the results suggest that human movement
helps to explain the spatiotemporal patterns of the cases
observed. In addition, the results highlight a number of
sociodemographic risk factors and suggest that there is a
relationship between cholera risk and water infrastructure,
with populations living in close proximity to the sewer
network with high access to piped water being at higher
risk. A possible explanation for this surprising observation
is that sewer bursts led to the contamination of the piped
water network, turning access to piped water, usually
assumed to be protective, into a risk factor. Although
further studies are required to test this hypothesis, if it
is true, it highlights the importance of maintenance for
achieving the Sustainable Development Goals of improved
water and sanitation infrastructure.
Palabras clave
CHOLERA RISK, WATER INFRASTRUCTURE, SANITATION INFRASTRUCTURE, COMMUNICABLE DISEASE, INFRASTRUCTURE MAINTENANCE, CHOLERA OUTBREAKS, WATER-BORN ILLNESS