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Peer-reviewedCC BY 4.0Science Advances

Defining epidemiologically relevant units of cholera transmission in sub-Saharan Africa

  • Bethany L. DiPrete1
  • Javier Perez-Saez2,3
  • Shirlee Wohl4
  • Nathaniel Matteson4
  • Seungwon Kim1
  • Andrew S. Azman2,3
  • Justin Lessler1,2,5
5 affiliations
  1. 1Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
  2. 2Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.
  3. 3Geneva Centre for Emerging Viruses and Division of Tropical and Humanitarian Medicine, Geneva University Hospitals, Geneva, Switzerland.
  4. 4Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA.
  5. 5Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Abstract

Much remains unknown about cholera transmission dynamics in Africa. Applying both traditional phylogeographic techniques and innovative methods for combining epidemiologic and genomic data, we identified three to four distinct “cholera transmission units” within which cross-border cholera transmission has been more frequent. These units can be grouped into two major transmission clusters, one in Western Africa and bordering countries and one spanning the Central, Eastern, and Southern regions. Simulation studies show that these clusters can be used to assess the risk of international spread of introduced cholera strains and identify heterogeneities in the speed of international spread based on outbreak location. Our methods further allow us to infer cholera incidence attributable to specific lineages in the absence of sequencing data. This work has clear implications for cholera control.

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Cite

BibTeXRIS
BibTeX
@article{diprete2026defining,
  title = {{Defining epidemiologically relevant units of cholera transmission in sub-Saharan Africa}},
  author = {Bethany L. DiPrete and Javier Perez-Saez and Shirlee Wohl and Nathaniel Matteson and Seungwon Kim and Andrew S. Azman and Justin Lessler},
  journal = {Science Advances},
  year = {2026},
  month = nov,
  doi = {10.1126/sciadv.aeb4683},
  url = {https://www.science.org/doi/abs/10.1126/sciadv.aeb4683},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - Defining epidemiologically relevant units of cholera transmission in sub-Saharan Africa
AU  - Bethany L. DiPrete
AU  - Javier Perez-Saez
AU  - Shirlee Wohl
AU  - Nathaniel Matteson
AU  - Seungwon Kim
AU  - Andrew S. Azman
AU  - Justin Lessler
PY  - 2026
DA  - 2026/11/04
JO  - Science Advances
DO  - 10.1126/sciadv.aeb4683
UR  - https://www.science.org/doi/abs/10.1126/sciadv.aeb4683
AB  - Much remains unknown about cholera transmission dynamics in Africa. Applying both traditional phylogeographic techniques and innovative methods for combining epidemiologic and genomic data, we identified three to four distinct “cholera transmission units” within which cross-border cholera transmission has been more frequent. These units can be grouped into two major transmission clusters, one in Western Africa and bordering countries and one spanning the Central, Eastern, and Southern regions. Simulation studies show that these clusters can be used to assess the risk of international spread of introduced cholera strains and identify heterogeneities in the speed of international spread based on outbreak location. Our methods further allow us to infer cholera incidence attributable to specific lineages in the absence of sequencing data. This work has clear implications for cholera control.
SN  - 2375-2548
ER  -