{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T04:18:45Z","timestamp":1791087525875,"version":"4.1.0"},"reference-count":30,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,6,1]]},"abstract":"<jats:p>Global cholera incidence is increasing, particularly in sub-Saharan Africa. We examined the impact of climate and ocean environmental variability on cholera outbreaks, and developed a forecasting model for outbreaks in Zanzibar. Routine cholera surveillance reports between 1997 and 2006 were correlated with remotely and locally sensed environmental data. A seasonal autoregressive integrated moving average (SARIMA) model determined the impact of climate and environmental variability on cholera. The SARIMA model shows temporal clustering of cholera. A 1\u00b0C increase in temperature at 4 months lag resulted in a 2-fold increase of cholera cases, and an increase of 200 mm of rainfall at 2 months lag resulted in a 1.6-fold increase of cholera cases. Temperature and rainfall interaction yielded a significantly positive association (<jats:italic>P<\/jats:italic> &lt; 0.04) with cholera at a 1-month lag. These results may be applied to forecast cholera outbreaks, and guide public health resources in controlling cholera in Zanzibar.<\/jats:p>","DOI":"10.4269\/ajtmh.2011.10-0277","type":"journal-article","created":{"date-parts":[[2011,6,1]],"date-time":"2011-06-01T18:44:22Z","timestamp":1306953862000},"page":"862-869","source":"Crossref","is-referenced-by-count":85,"title":["Climate Variability and the Outbreaks of Cholera in Zanzibar, East Africa: A Time Series Analysis"],"prefix":"10.4269","volume":"84","author":[{"given":"Rita","family":"Reyburn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deok Ryun","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Emch","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Khatib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz","family":"von Seidlein","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Ali","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"R1","series-title":"Weekly Epidemiological Record","author":"WHO","year":"2009"},{"key":"R2","series-title":"Am J Trop Med Hyg","first-page":"705","article-title":"Cholera: a new homeland in Africa?","volume":"77","author":"Gaffga","year":"2007"},{"key":"R3","author":"United Nations Office for the Coordination of Humanitarian Affairs","year":"2009"},{"key":"R4","series-title":"Science","first-page":"2025","article-title":"Global climate and infectious disease: the cholera paradigm","volume":"274","author":"Colwell","year":"1996"},{"key":"R5","series-title":"Lancet","first-page":"223","article-title":"Cholera","volume":"363","author":"Sack","year":"2004"},{"key":"R6","series-title":"Proc Natl Acad Sci USA","first-page":"1051","article-title":"Reduction of cholera in Bangladeshi villages by simple filtration","volume":"100","author":"Colwell","year":"2003"},{"key":"R7","series-title":"Curr Opin Biotechnol","first-page":"244","article-title":"Biofilms in water, its role and impact in human disease transmission","volume":"19","author":"Huq","year":"2008"},{"key":"R8","series-title":"J Infect Chemother","first-page":"121","article-title":"Viable but nonculturable bacteria: a survival strategy","volume":"6","author":"Colwell","year":"2000"},{"key":"R9","series-title":"Lancet","first-page":"1825","article-title":"Cholera","volume":"349","author":"Sack","year":"1997"},{"key":"R10","series-title":"Proc Natl Acad Sci USA","first-page":"1438","article-title":"Climate and infectious disease: use of remote sensing for detection of Vibrio cholerae by indirect measurement","volume":"97","author":"Lobitz","year":"2000"},{"key":"R11","series-title":"Soc Sci Med","first-page":"1015","article-title":"The spatial epidemiology of cholera in an endemic area of Bangladesh","volume":"55","author":"Ali","year":"2002"},{"key":"R12","series-title":"Proc Natl Acad Sci USA","first-page":"17676","article-title":"Environmental signatures associated with cholera epidemics","volume":"105","author":"Constantin de Magny","year":"2008"},{"key":"R13","series-title":"Am J Trop Med Hyg","first-page":"823","article-title":"Local environmental predictors of cholera in Bangladesh and Vietnam","volume":"78","author":"Emch","year":"2008"},{"key":"R14","series-title":"Environ Microbiol","first-page":"67","article-title":"A voyage of discovery: cholera, climate and complexity","volume":"4","author":"Colwell","year":"2002"},{"key":"R15","series-title":"Trans R Soc Trop Med Hyg","first-page":"137","article-title":"Influence of temperature and rainfall on the evolution of cholera epidemics in Lusaka, Zambia, 2003\u20132006: analysis of a time series","volume":"103","author":"Luque Fernandez","year":"2009"},{"key":"R16","series-title":"Country Health Profile","author":"MoHSW Z","year":"2008"},{"key":"R17","series-title":"Monthly weather data. 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