Operational Forecasting of Cholera in Artibonite, Haiti

The Praecipio International infectious disease forecasting team, sponsored by Direct Relief International and thanks to HEAS partner efforts in sharing data, has just completed the first phase of an extensive statistical review of epidemiological data for cholera in Artibonite.  We have had the honor and benefit of working with some of the world's experts in meteorological forecasting, including three National Academy of Science members.  All of these individuals were excited to have the opportunity to support the People of Haiti. 

We went through this exercise to get our hands around the question of "what seasonality is cholera settling into"?  While we have often seen media reports of association with rainfall, which makes sense based on prior experience in countries like Bangladesh, we needed to make sure of this in Haiti. 
 
The bottom line is we have identified a target signature pattern for Artibonite that is now testable in the humanitarian theater.  Obviously, we would be more sure of our conclusions if we had 10-20 years of reliable data, but with 2 years of baseline it is the best we have at the moment.  It appears that in Artibonite, the peak weeks for transmission are Epidemiological Weeks 27 (first week of July) and 46 (second week of November), respectively.  This means we would issue forecasts for Artibonite at 60 and 30 day intervals prior to all of the Haitians and NGOs operating in this area.  We are in the process of determining whether variation in these signatures exist from village to village.
 
We will now be executing live forecasts from this point forward.  The crucial next step is validation, of course, of these forecasts.  Validation contributes to refinement of the forecast libraries.
 
One of the other observations made was a statistically significant decrease in overall rates of cholera transmission, which of course makes sense as the disease is settling into an endemic state.  We are planning to publish this as an academic paper for the world's benefit.
 
This is just the beginning….