Geographical patterns of cholera outbreaks in Northern and Luapula provinces of Zambia during the period 1978-1982.

Abstract

The central theme in Medical Geography is the study of the spatial variation of disease and general effects of the environment on the occurrence of disease, A disease such as cholera is a disturbance of the normal harmony existing between bodily functions and their environment.Such a disequilibrium must be promptly controlled and contained in order to promote health,, Since a disease such as the cholera infection is a dynamic process which develops through time and space, an understanding of the physical and socio-cultural environmental conditions is vital in the control and eradication of the disease.Consequently this dissertation seeks to identify, analyse, and explain the spatial relationships, obtaining between cholera occurrences on the one hand and specific physical and socio-cultural factors in Northern and Luapula Provinces, on the other.The dissertation consists of six chapters. Chapter one discusses briefly the general introduction and lays emphasis on the rationale, objectives and methodology adopted in the present study,, Chapter two examines the physical socio-cultural and economic aspects of the study area and how these factors individually or in combinations have influenced the occurrence and spread of cholera in the two provinces. The third chapter discusses the epidemiology of cholera with special reference to the geography of cholera in Africa in general and in Zambia in particular.Chapters four and five are the foci of the study.These two chapters offer spatial and temporal analyses of cholera outbreaks and diffusion - focusing especially on the effects of unchecked human migrations across international borders such as those between Zambia and Zaire and/or Tanzania, poor sanitation, riverine and/or lake environment, and natural channels and barriers on the occurrence and diffusion of cholera.To this end statistical tests namely Spear man's rank correlation, Student's t, phi - coefficient and simple correlation tests have been utilised in order to obtain the associations between cholera occurrence and environmental factors.The study concludes by underlying the basic health problems of the interrelationships of poor sanitation, over-crowding/inadequate sewage and refuse disposal methods, unprotected and contaminated domestic water supply all of which are conditions obtaining in the study area.Consequently solutions and suggestions for the control of cholera in the study area have been advanced.