Spatiotemporal modelling of cholera and implications for its control, Uvira, Democratic Republic of the Congo

ABSTRACT The African Great Lakes region including Eastern Democratic Republic of the Congo is a hotspot for cholera transmission. We evaluated the local and global clustering of cholera using 5 years (2016—2020) of suspected cases positive by rapid diagnostic test in Uvira, South Kivu to detect spatiotemporal clusters and the extent of zones of increased risk around cases. We detected 26 clusters (mean radius 652m and mean duration 24.8 days) which recurred annually in three locations and typically preceded seasonal outbreaks. We found a 1100m zone of increased infection risk around cases during the 5 days following clinic attendance for the 2016—2020 period and a 600m radius risk zone for 2020 alone. These risk zone sizes correspond with the area typically used for targeted intervention in the Democratic Republic of the Congo. Our findings underscore the value of the site-specific evaluation of clustering to guide targeted control efforts.