{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,2]],"date-time":"2025-10-02T13:08:49Z","timestamp":1759410529686},"reference-count":20,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,11,5]]},"abstract":"<jats:p>We evaluated World Health Organization (WHO) national water and sanitation coverage levels and the infant mortality rate as predictors of endemic cholera in the 5-year period following water and sanitation coverage estimates using logistic regression, receiver operator characteristic curves, and different definitions of endemicity. Each was a significant predictors of endemic cholera at <jats:italic>P<\/jats:italic> &lt; 0.001. Using a value of 250 for annual cases reported in 3 of 5 years, a national water access level of 71% has 65% sensitivity and 65% specificity in predicting endemic cholera, a sanitation access level of 39% has 63% sensitivity and 62% specificity, and an infant mortality rate of 65\/1,000 has 67% sensitivity and 69% specificity. Our findings reveal the tradeoff between sensitivity and specificity for these predictors of endemic cholera and highlight the substantial uncertainty in the data. More accurate global surveillance data will enable more precise characterization of the benefits of improved water and sanitation.<\/jats:p>","DOI":"10.4269\/ajtmh.14-0331","type":"journal-article","created":{"date-parts":[[2014,9,9]],"date-time":"2014-09-09T02:59:19Z","timestamp":1410231559000},"page":"1023-1028","source":"Crossref","is-referenced-by-count":12,"title":["Cholera at the Crossroads: The Association Between Endemic Cholera and National Access to Improved Water Sources and Sanitation"],"prefix":"10.4269","volume":"91","author":[{"given":"Benjamin L.","family":"Nygren","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna J.","family":"Blackstock","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eric D.","family":"Mintz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"key":"R1","first-page":"1","article-title":"Millennium Development Goals and Beyond 2015: Fact Sheet","author":"United Nations Department of Public Information (UNDoP)","year":"2013"},{"key":"R2","first-page":"3","article-title":"Progress on Sanitation and Drinking-Water - 2013 update","author":"WHO","year":"2013"},{"key":"R3","series-title":"Int J Epidemiol","first-page":"330","article-title":"Are there national risk factors for epidemic cholera? The correlation between socioeconomic and demographic indices and cholera incidence in Latin America","volume":"27","author":"Ackers","year":"1998"},{"year":"2013","series-title":"Global Health Observatory (GHO) Data Repository","author":"WHO","key":"R4"},{"key":"R5","series-title":"Bull World Health Organ","first-page":"209","article-title":"The global burden of cholera","volume":"90","author":"Ali","year":"2012"},{"series-title":"Indicator Definition: Population Using Improved Drinking-Water Sources (%)","author":"WHO","key":"R6"},{"series-title":"Indicator Definition: Population Using Improved Sanitation Facilities (%)","author":"WHO","key":"R7"},{"series-title":"Indicator Definition: Infant Mortality Rate","author":"WHO","key":"R8"},{"series-title":"Indicator Definition: Number of Reported Cases of Cholera","author":"WHO","key":"R9"},{"series-title":"Indicator Definition: Number of Reported Deaths of Cholera","author":"WHO","key":"R10"},{"key":"R11","series-title":"Wkly Epidemiol Rec","first-page":"526","article-title":"Meeting of the Strategic Advisory Group of Experts on immunization, October 2009: conclusions and recommendations","volume":"84","author":"WHO","year":"2009"},{"key":"R12","series-title":"Wkly Epidemiol Rec","first-page":"127","article-title":"Cholera vaccines: WHO position paper","volume":"85","author":"WHO","year":"2010"},{"key":"R13","first-page":"4","article-title":"Progress on Sanitation and Drinking-Water - 2012 update","author":"WHO","year":"2013"},{"year":"2011","series-title":"United Nations Inter-Agency Group for Child Mortality Estimation: Levels and Trends in Child Mortlity","author":"UNICEF","key":"R14"},{"key":"R15","series-title":"PLoS Negl Trop Dis","first-page":"e2545","article-title":"The burden of cholera in Uganda","volume":"7","author":"Bwire","year":"2013"},{"key":"R16","series-title":"Indian J Med Res","first-page":"246","article-title":"How endemic is cholera in India?","volume":"135","author":"Sarkar","year":"2012"},{"key":"R17","series-title":"Am J Trop Med Hyg","first-page":"973","article-title":"Review of reported cholera outbreaks worldwide, 1995\u20132005","volume":"75","author":"Griffith","year":"2006"},{"article-title":"WHO Report on Global Surveillance of Epidemic-prone Infectious Diseases","year":"2000","author":"WHO","key":"R18"},{"key":"R19","series-title":"Wkly Epidemiol Rec","first-page":"309","article-title":"Cholera: global surveillance summary, 2008","volume":"84","author":"WHO","year":"2009"},{"year":"2014","series-title":"Cholera Surveillance and Number of Cases","author":"WHO","key":"R20"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/91\/5\/article-p1023.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/91\/5\/article-p1023.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/91\/5\/article-p1023.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T21:11:22Z","timestamp":1723065082000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/91\/5\/article-p1023.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,11,5]]},"references-count":20,"journal-issue":{"issue":"5"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.14-0331","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"type":"print","value":"0002-9637"},{"type":"electronic","value":"1476-1645"}],"subject":[],"published":{"date-parts":[[2014,11,5]]}}}