Time-space clustering of Vibrio cholerae 01 in Matlab, Bangladesh, 1970-1982. 1988

M Craig
Department of Community Medicine, United Medical School, Guy's Hospital, London, England.

Growing evidence for the existence of an aquatic reservoir of Vibrio cholerae has led some observers to postulate the existence of two distinct modes of disease transmission: primary and secondary. In primary transmission vibrios pass from the aquatic reservoir to humans via edible aquatic flora or fauna, or drinking water. Secondary transmission consists of faecal-oral transmission from person-to-person and may spawn epidemics. Cholera outbreaks are particularly well documented for the Matlab area of Bangladesh, where a field station has been run since 1963, at which patients from a study population of nearly 200,000 are treated for diarrhoeal diseases and monitored in a longitudinal demographic surveillance system. This paper seeks to illuminate the process of secondary transmission by presenting preliminary results of an analysis of the time-space distribution of cholera cases in Matlab for the period 1970-1982. It is argued that the detection of time-space clusters of cases resulting from secondary transmission requires locational data below the level of the village, that is at the level of the bari, or patrilineally-related household group because this is where inter-personal contact is greatest. The mapping of the study area at the bari level is described briefly and it is argued that the proportion of all asymptomatic infections and cases which can be mapped is great enough to enable inferences about transmission processes to be drawn. Results of the analysis of time-space interaction using the Knox method are presented and provide some support for within-bari clustering of cases resulting from secondary transmission.(ABSTRACT TRUNCATED AT 250 WORDS)

UI MeSH Term Description Entries
D002771 Cholera An acute diarrheal disease endemic in India and Southeast Asia whose causative agent is VIBRIO CHOLERAE. This condition can lead to severe dehydration in a matter of hours unless quickly treated. Vibrio cholerae Infection,Choleras,Infection, Vibrio cholerae,Infections, Vibrio cholerae,Vibrio cholerae Infections
D006760 Hospitalization The confinement of a patient in a hospital. Hospitalizations
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D001459 Bangladesh A country in Southern Asia, bordering the Bay of Bengal, between Burma and India. The capital is Dhaka.
D013029 Space-Time Clustering A statistically significant excess of cases of a disease, occurring within a limited space-time continuum. Clustering, Space-Time,Clusterings, Space-Time,Space Time Clustering,Space-Time Clusterings

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