CHOLERA CONTINUES TO BE A PUBLIC HEALTH THREAT PARTICULARLY IN REGIONS THAT LACK ACCESS TO SAFE DRINKING WATER AND SANITATION (WASH) INFRASTRUCTURE. MOST SYSTEMATIC RESEARCH ON THE ECOLOGY OF CHOLERA OVER THE PAST SEVERAL DECADES HAS FOCUSED ON AND DERIVED FROM DATA COLLECTED IN THE BENGAL DELTA REGION OF THE WORLD. AFRICA IS RAPIDLY BECOMING THE NEW HOMELAND OF CHOLERA (66% OF THE TOTAL CHOLERA OUTBREAKS REPORTED IN THE CONTINENT). OUR RESEARCH CATEGORIZED OCCURRENCE OF CHOLERA IN TWO MAJOR MODES: EPIDEMIC (A SUDDEN OUTBREAK IN A PREVIOUSLY DISEASE-FREE REGION AND PRIMARILY INLAND) AND ENDEMIC (RECURRING ESSENTIALLY ANNUALLY AND PREDOMINANTLY ALONG COASTS). EPIDEMIC AND ENDEMIC CHOLERA ARE SIGNIFICANTLY DIFFERENT IN MORTALITY RATES WITH EPIDEMIC CHOLERA HAVING HIGHER MORTALITIES. OUTBREAK OF CHOLERA (FOR BOTH MODES) CAN BE DIVIDED INTO TWO COMPONENTS: THE TRIGGER IN THE ENVIRONMENT AND THE TRANSMISSION OF THE DISEASE IN HUMAN POPULATION. GROWTH OF CHOLERA BACTERIA IN THE ENVIRONMENT IS LINKED TO HYDROCLIMATIC PROCESSES INFLUENCING THE ECOLOGICAL NICHE OF THE VIBRIO. CONSEQUENTLY CONSUMPTION OF WATER CONTAINING AN INFECTIVE DOSE OF THE BACTERIA FORMS THE TRIGGER COMPONENT. THE TRANSMISSION COMPONENT OF CHOLERA IS THE MECHANISM OF SPREAD OF INFECTION WITHIN THE HUMAN POPULATION. V. CHOLERAE EXISTS NATURALLY IN THE ENVIRONMENT THEREFORE IT IS NOT REALISTIC OR FEASIBLE TO CONSIDER ERADICATION OF THE PATHOGEN FROM THE AQUATIC ENVIRONMENT. A FUNDAMENTALLY TRANSFORMATIONAL APPROACH IS NEEDED TO DESIGN MITIGATION STRATEGIES (E.G. WASH DISTRIBUTION OF MEDICINES) TO MINIMIZE IMPACT OF THE DISEASE IN HUMAN POPULATION. THEREFORE THE GOAL OF THIS PROPOSAL IS TO EMPLOY EARTH OBSERVATIONS TO PREDICT THE RISK OF OUTBREAK (TRIGGER AND TRANSMISSION) OF CHOLERA IN THE ENVIRONMENT AND HUMAN POPULATIONS IN AFRICA AND THEREAFTER DEVELOP A COMPREHENSIVE CAPACITY BUILDING PLAN TO ENGAGE END-USERS TO INCORPORATE THIS INFORMATION INTO DECISION MAKING SO THAT APPROPRIATE INTERVENTION STRATEGIES CAN BE DEVISED AND DEPLOYED. FOCUSING EXCLUSIVELY ON AFRIGEOSS REGIONS TWO GOALS TO ADVANCE THE PREDICTIVE SCIENCE FOR CHOLERA ARE TO: (I) SYSTEMATICALLY VALIDATE THE EPIDEMIC AND ENDEMIC CHOLERA HYPOTHESIS FOR THE TRIGGER COMPONENT OF CHOLERA AND (II) DEVELOP CALIBRATE AND VALIDATE PREDICTIVE MODEL FOR THE TRANSMISSION COMPONENT OF CHOLERA. A NEW CLASS OF COMPARTMENTAL MODEL NAMELY THE CHOLERA TRANSMISSION MODEL (CTM) IS PROPOSED. THIS PROCESS BASED MECHANISTIC MODELING FRAMEWORK INTEGRATES EARTH OBSERVATIONS WITH ECOLOGICAL UNDERSTANDING OF CHOLERA TO DETERMINE POTENTIAL PATHWAYS OF INTERACTION OF VIBRIOS WITH THE HUMAN POPULATION. WE HAVE PARTNERED WITH GROUP OF EARTH OBSERVATIONS (GEO) SECRETARIAT VEOLIA FOUNDATION HEALTH INITIATIVES FOUNDATION AND TEAM OF ADVISORS FROM NASA AND NOAA TO DEVELOP PLANS ON BUILDING CAPACITY IN AFRIGEOSS REGION FOR TRANSITION INTEGRATION AND SUSTAINED USE OF OUR ALGORITHMS FOR PREDICTION OF CHOLERA. HENCE TWO CAPACITY BUILDING OBJECTIVE ARE TO: (I) DEVELOP A FEASIBILITY PLAN TO ENCOURAGE USE OF EARTH OBSERVATIONS FOR DECISION MAKING AND (II) DEVELOP A TRANSITION ADOPTION AND SUSTAINED APPLICATION PLAN TO MEET SUSTAINABLE DEVELOPMENT GOALS (SDG GOAL 3&6). THREE NEW DATASETS (GRIDDED CHOLERA RISK MAPS FOR EPIDEMIC AND ENDEMIC CHOLERA FOR AFRICA AND ENSEMBLE OUTBREAK TIME SERIES USING CTM SIMULATION MODEL FOR CHOLERA AFFECTED REGIONS) WILL BE PRODUCED. FOR CAPACITY BUILDING INITIATIVE WE EXPECT TO BUILD A CORE WORKING GROUP ON CHOLERA WITHIN AFRIGEOSS WHERE PERSONNEL WILL BE TRAINED TO USE AND PROMOTE THE VALUE OF EARTH OBSERVATIONS FOR DECISION MAKING PURPOSES. FOR A SUSTAINED OPERATION DISSEMINATION PLANS WITH VEOLIA AND HEALTH INITIATIVES FOUNDATION WILL BE DEVELOPED THAT WILL FURTHER ACT AS A VEHICLE OF LONG-TERM ADOPTION AND TRANSITION BEYOND THE DURATION OF PROJECT. THIS PROJECT IS WITHIN PURVIEW OF PUBLIC HEALTH SURVEILLANCE AND WATER RESOURCES MANAGEMENT OF GEO WORK PROGRAM.
$150,832FY2020National Aeronautics and Space AdministrationNASA
West Virginia University Research Corporation, Morgantown WV