We study cholera transmission dynamics at multiple levels from individual-level data collected during cholera outbreaks to global incidence data, using a variety of methods including statistical and mechanistic models. Our work spans many disciplines and involves collaborators ranging from front-line public health workers to bench scientists. Our main bodies of current work are:
Global burden of cholera
Through working with multiple partners, including Médecins Sans Frontières (MSF), the World Health Organization (WHO), the United Nations High Commissioner for Refugees (UNHCR), and various Ministries of Health, we maintain a large database of cholera incidence and mortality that can accommodate surveillance data that comes in all shapes and sizes (for example, different case definitions, reporting intervals, and spatial scales). We have developed methods to integrate all of this data into a common statistical framework to better understand cholera burden and transmission dynamics worldwide and continue to work on making it more robust. On this site you can access parts of the database that are publicly available and browse meta-data for the entire repository in addition to accessing maps and other resources used by this project. We are very interested in seeing these data and our estimates used for making public health decisions and learning more about the epidemiology of cholera so please get in touch if you would like to collaborate.
Estimates of effectiveness and impact of interventions
We work on trying to better estimate the effectiveness and impact of cholera interventions, including cholera vaccine. This work ranges from developing new statistical methods to estimate intervention effectiveness from observational studies to retrospective case studies of outbreaks. Other global work, including consultations with GAVI, includes estimating the potential impact of large scale rollout of vaccination globally. This work is conducted in collaboration with multiple partners, including the Global Task Force for Cholera Control, Epicentre, Médecins Sans Frontières and GAVI.
Real-time and Strategic Modeling to Inform Outbreak Response
We work closely with those on the frontline of cholera epidemics including ministries of health, Global Task Force for Cholera Control members, Médecins Sans Frontières and others to analyse data in on-going cholera outbreaks to assess risk, often capitalizing on data from our cholera incidence repository, characterize key properties of transmission (e.g., modes of transmission, reproductive number) and to make short-term forcasts of the epidemic trajectory.
In collaboration with icddr,b, University of Utah, University of Florida and Harvard University, we are working to better characterize the kinetics of the human antibody response to infection by Vibrio cholerae and to exposure to (killed) oral cholera vaccine. Our ultimate aim is to develop new statistical methods and tools to allow us to use cross-sectional serologic samples to identify recent cholera infections, thus providing a new approach to understanding cholera transmission, independent of biases of clinic-based passive surveillance systems.
Mean annual cholera incidence rate (cases per population) in sub-Saharan Africa between 2010 and 2016.
Mean annual cholera incidence in sub-Saharan Africa between 2010 and 2016.