Hydrology-climate-human health: a hydroclimatological approach to understand cholera transmission in South Asia and sub-Saharan Africa

摘要

Cholera broke out in the form of global pandemics from the Bengal Delta region of the Indian Subcontinent in the early 19th century. Two hundred years later, the disease still remains a major threat to public health in many developing countries around the world, especially in South Asia, sub-Saharan Africa, and Latin America. Despite major advances in the understanding of the micro-environmental conditions (ecological and micro-biological) of the cholera bacterium (Colwell, 2006), the role of the macro-environmental conditions, such as seasonality of this infectious disease and annual recurrence in endemic areas, remain a mystery (Jutla et al., 2010). Recent findings underscore the role of the regional hydroclimatic extremes such as droughts and floods on cholera outbreaks in South Asia (Akanda et al, 2009). However, the role of large-scale hydroclimatic processes and the impact of varying climate patterns affecting cholera dynamics in the 21st century is not well understood. The interaction between the complex micro-environment of this water-borne infectious disease, the coastal nature of the primary outbreaks around the world, and the role of seasonal hydroclimatic controls make this a "wicked" water problem.