Estimating the reproductive numbers for the 2008–2009 cholera outbreaks in Zimbabwe | PNAS

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Edited* by G. Balakrish Nair, National Institute of Cholera and Enteric Diseases, Kolkata, India, and approved March 25, 2011 (received for review January 4, 2011)

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Fig. 1.
Cholera cases and deaths in Zimbabwe from 1992 to 2009 (4). The y axis for the graph is logged.
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Fig. 2.
Map of Zimbabwe, provinces, and neighboring countries. The darker-colored regions show one of the cholera-affected districts (Manica) in Mozambique in 2006 (26) and some of the cholera-affected provinces (Southern and Lusaka) in Zambia in 2010 (27) that are on the border with Zimbabwe.
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Fig. 3.
Model flow diagram.
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Fig. 4.
Cholera model fitting for the cumulative cholera cases where the solid red line represents the model fit and the circles mark the reported data for the cumulative number of cholera cases in the provinces using parameter values in Table S1 and population sizes in Table 1.
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Fig. 5.
Cholera model fitting for the cholera cases. The solid line represents the model fit, and the dashed line and the circles mark the reported data for cholera cases in the provinces using parameter values in Table S1 and population sizes in Table 1.

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Table 1.

Population sizes (28), cholera cases, and deaths reported to the MoHCW from November 2008 to July 2009

	Population size	Total infected	Attack rate/10,000	Total deaths	CFR %
Harare	2,012,784	19,577	97	655	3.35
Bulawayo	718,278	445	6	18	4.04
Mashonaland Central	1,056,666	1,039	98	297	2.86
Mashonaland East	1,196,772	6,526	55	453	6.94
Mashonaland West	1,300,012	22,751	175	945	4.15
Midlands	1,554,058	7,156	46	331	4.63
Manicaland	1,665,451	13,673	82	667	4.88
Matebeleland South	693,230	5,257	76	159	3.02
Matebeleland North	748,317	1,166	16	71	6.09
Masvingo	1,401,672	11,644	83	691	5.93
Zimbabwe	12,347,240	98,585	80	4,287	4.35

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Table 2.

Estimates of R_e, R_h, and R₀

	R_e	95% CI	% R₀	R_h	95% CI	% R₀	R₀	95% CI
Harare	0.9	(0.57–1.24)	59.4	0.62	(0.57–0.72)	40.6	1.52	(1.14–1.96)
Bulawayo	0.14	(0.071–0.22)	10.6	1.22	(1.05–1.39)	89.4	1.36	(1.12–1.61)
Mashonaland Central	0.2	(0.11–0.29)	14.3	1.18	(1.11–1.25)	85.7	1.38	(1.21–1.54)
Mashonaland East	0.45	(0.31–0.58)	40.4	0.66	(0.58–0.74)	59.6	1.11	(0.90–1.32)
Mashonaland West	0.32	(0.01–0.62)	16.9	1.54	(1.33–1.76)	83.1	1.87	(1.34–2.38)
Midlands	0.077	(0.012–0.14)	5.5	1.31	(1.21–1.41)	94.5	1.39	(1.23–1.56)
Manicaland	0.2	(0.099–0.29)	9.5	1.87	(1.68–2.05)	90.5	2.06	(1.78–2.34)
Matebeleland South	1.44	(0.68–2.2)	52.9	1.28	(0.52–2.04)	47.1	2.72	(1.19–4.24)
Matebeleland North	0.14	(0.036–0.24)	8	1.58	(1.4–1.76)	92	1.72	(1.44–1.99)
Masvingo	0.25	(0.047–0.46)	15.8	1.36	(1.15–1.56)	84.2	1.61	(1.20–2.03)
Zimbabwe	0.2	(0.15–0.25)	17.3	0.95	(0.93–0.98)	82.7	1.15	(1.08–1.23)

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Table 3.
Estimates of minimum vaccination coverage
Vaccination coverage threshold, c %
Harare 44
Bulawayo 34
Mashonaland Central 35
Mashonaland East 13
Mashonaland West 59
Midlands 36
Manicaland 66
Matebeleland South 81
Matebeleland North 53
Masvingo 49
Zimbabwe 17

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Proceedings of the National Academy of Sciences: 108 (21)

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Biological Sciences
Medical Sciences

Physical Sciences
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