Estimation of Vibrio cholerae O1 infection in India: a step towards identification of cholera hotspots

In 2018, the World Health Organization (WHO) Global Task Force on Cholera Control (GTFCC) declared an objective to reduce global cholera mortality by 90% and eliminate cholera in 20 priority countries by 2030. Despite years of cholera research, however, the burden and geographic variability of cholera across India is poorly understood due to underreporting, limited laboratory capacity, inconsistent case definitions, and apprehensions of negative impacts on travel, trade and commerce.

To address the issue, we propose to estimate incidence of V. cholerae O1 infections across 5 regions of India using seroepidemiological methods along with triangulation of data on cholera from available multiple sources (a) published literature and grey literature archives (b) program data like Integrated Disease Surveillance Program (IDSP), Field Epidemiology Training Program (FETP) reports, National Health Profile (NHP) maintained by Central Bureau of Health Intelligence (CBHI) and data on Swacch Bharat initiated sanitation drive (c) information from annual reports and (d) serological testing (vibriocidal) for cholera markers on stored samples collected during Dengue National serosurvey. Results from this study will generate robust estimates on risk-prone areas vulnerable to cholera outbreaks in India. Additionally, this will inform the selection of sentinel surveillance sites for the monitoring of culture-positive cholera cases. Given the genetic similarity of V. cholerae strains from other geographical regions, this study will have a profound impact on national and global levels.

This study will identify incidence of cholera in 5 regions of India through measuring the antibody levels in serum. A hotspot mapping of different regions and states in India will be done for Cholera by combining estimates of antibody proportion and magnitude of reported cholera in different types of published literature.

Results from this study will generate robust estimates on risk-prone areas vulnerable to cholera outbreaks in India. Additionally, this will inform the selection of sentinel surveillance sites for the monitoring of culture-positive cholera cases. Given the genetic similarity of V. cholerae strains from other geographical regions, this study will have a profound impact on national and global levels