Climate and socioeconomic influences on interannual variability of cholera in Nigeria.

Cholera is one of the most important climate sensitive diseases in Nigeria that pose a threat to public health because of its fatality and endemic nature. This study aims to investigate the influences of meteorological and socioeconomic factors on the spatiotemporal variability of cholera morbidity and mortality in Nigeria. Stepwise multiple regression and generalised additive models were fitted for individual states as well as for three groups of the states based on annual precipitation. Different meteorological variables were analysed, taking into account socioeconomic factors that are potentially enhancing vulnerability (e.g. absolute poverty, adult literacy, access to pipe borne water). Results quantify the influence of both climate and socioeconomic variables in explaining the spatial and temporal variability of the disease incidence and mortality. Regional importance of different factors is revealed, which will allow further insight into the disease dynamics. Additionally, cross validated models suggest a strong possibility of disease prediction, which will help authorities to put effective control measures in place which depend on prevention, and or efficient response.