Spatial analysis of cholera cases and related socio economic factors in flood-prone areas of Budiriro and Glenview, Harare

Author

Nyawasha, Addmore

Title

Spatial analysis of cholera cases and related socio economic factors in flood-prone areas of Budiriro and Glenview, Harare

Abstract

Cholera remains a significant public health challenge in urban areas, particularly in regions prone to flooding. This study investigated the spatial distribution of cholera cases and the associated socio-economic and environmental factors in Budiriro and Glen View, Harare, Zimbabwe. A household survey was conducted using a questionnaire to obtain household level data on sanitation hygiene behaviours and practices and related socio-economic factors. Additional data was obtained through key informant interviews using an interview guide while historical data was obtained from City of Harare. Using spatial analysis techniques within a GIS framework, cholera hotspots were identified and correlated. Chi square was used to test for association. Results showed that proximity to sewer chokes significantly increases cholera risk (p-value ≤0.001). Distance from boreholes also significantly correlates with cholera cases (p ≤0.001), with intermediate distances (101–300m) showing higher cholera risk, likely due to cross-contamination. There is no statistically significant relationship found between water source types and cholera cases (p = 0.410). This implies that cholera risk may depend more on secondary factors rather than the type of source. Socio-economic factors also had varied influence on cholera cases. In terms of gender, males were significantly more affected than females (p = 0.002). This implies that gender-sensitive cholera prevention strategies are essential. Cholera risk also significantly varied across age groups (p ≤0.001), with individuals aged 15+ years most affected. Younger children had lower cases, possibly due to protective caregiving practices. Meanwhile, no significant relationship was found between education level and cholera risk (p = 0.433). Cholera cases were evenly distributed across education levels. This implies that knowledge alone may not reduce cholera risk. Knowledge levels showed no significant association with cholera risk (p = 0.350). This suggests a gap between knowledge and practice. Handwashing with soap is globally considered the most cost-effective way of preventing and controlling cholera. Handwashing practices were significantly associated with cholera risk (p ≤0.001). Regular handwashing reduced risk but did not eliminate it completely. This underscores the need for complementary interventions. While water treatment is expected to result in high protection, water treatment practices were not significantly associated with cholera risk (p = 0.343). This was counterintuitive and highlighted gaps in water treatment practice. Treated water could become re-contaminated due to improper storage, emphasising the need for consistent water quality monitoring. By addressing hotspots, environmental and socio-economic risk factors, these recommendations provide a holistic strategy to reduce cholera incidence in flood-prone urban areas.

Date

June 2024

Publisher

BUSE

Keywords

Spatial Analysis

Cholera Cases

Flood-Prone Area

Socio-economic Factor

Supervisor

Dr. T. Manyangadze